Genital herpes or not?

[confusedgal85]

Can someone help me out? Okay, it's a long story. I'm in a long term relationship (almost 10 years) and in 2008 we briefly separated and I ended up having a one night stand with an acquaintance (early september), who's quite a player. There was some major genital grinding, unprotected oral sex (both way) and a few seconds of unprotected vaginal penetration. Then he put a condom on, but never ejaculated. He said he was STD free and used to get tested every 6 months or so.
As for my regular partner, he had sex with other woman previously (around 2, 3 women). I never spotted any genital or oral abnormal symptoms in him during this 10 year period.
So I had the one night stand and I freaked out about STDs, specially HIV (I didn't even consider herpes at the time). I remember feeling kinda raw for a couple of days later, but nothing extraordinary. Two days later I also felt some lower back pain, but the doctor said it was a muscle strain and gave me some advil or something like that. I went to my GYN a couple of weeks later (late september) and everything was apparently ok. She even told me that if I had a STD I would be showing symptoms by 2 weeks. Still, I had some blood work for the usual STDs, all ok.
By then, me and my partner were back together and we decided to resume sex with condom, just to be on the safe side. But when my GYN told me everything was ok, we stopped using condom.
So...around 10 weeks after the one night stand (mid november), and around two weeks after having sex with my regular partner, I get a bad flu and a sore throat. I think that a week before that I experienced some groin pain, but I never thought it could be swollen nodes - maybe it was. I was also getting some discharge (thought about yeast, which is recurrent to me). A couple of weeks before I had had my pap smear and my doctor mentioned yeast, but nothing about sores/bumps. So during my 2nd or 3rd flu day I decided to take a look at my vagina and I spotted several flat sores, reddish ones. They didn't hurt at the time. I freak out and saw my (useless) GYN the other day. She said I had some yeast going on and it was probably from scratching my vulva or maybe from masturbation the day before. I asked about herpes, but she didn't think so. Gave me a bunch of yeast medicine to take/apply.
The sores eventually turned into canker sore things and urinating was excruciating. So around 5-6 days into the "outbreak" my GYN decides to swab a sore and my cervix, already convinced it was herpes. Prescribed me valtrex after the swab.
The results: my PCR swab was negative for HSV1 and HSV2. A week after the onset, I mistakenly had one of those older non type specific tests - HSV1 was like 1.2 and HSV2 was 0.6. A month later I had a HerpeSelect - HSV1 3.5, HSV2 equivocal. Another month later, HSV1 1.5, HSV2 0.4. All IgG, no IgM was performed.
My regular partner tested HSV1 3.0, HSV2 0.6. The acquaintance got tested 4 months after our encounter, negative for HSV1 and HSV2, IgG and IgM. I never had other sexual partners. They both sent me copies of their results.
So we were officially confused. During that year, I had several other blood tests, and so did my boyfriend. Always HSV1+, HSV2-. I also convinced my one night stand to have a HerpeSelect almost two years before our encounter and his HSV2 was like 0.5 or 0.6.
Over a year after the incident, I spot another red sore in my vulva (during sex with my boyfriend, to make things worse). The same thing happens - red sore that turns into a painful canker sore, during an episode of flu/sore throat. GYN wouldn't see me so I missed the chance of swabbing it again. Haven't had another episode since then.
So I'm pretty convinced I have genital herpes and I'm patiently waiting for another outbreak to be swabbed. The question is - who did I catch it from, considering the whole timeline I described above? Shouldn't the blood test be showing positive for HSV2 for me or my partners? Can anyone shed a light on what might be going on? I feel like I did everything I could but I still have no answers. =(

[gracefromHHP]

if you do have genital herpes, it would be more likely to be hsv1 genitally than hsv2. The only way to prove this is with a lesion culture and typing of active symptoms. since your partner also has hsv1 himself, not really an issue if you do other than of course the pain during recurrences.

grace

[confusedgal85]

Doesn't it take a cold sore to pass on HSV1? My boyfriend never had a cold sore that I recall of. I remember him having some sort of pimple on his upper lips in early november 2008 but it didn't look like a typical cold sore.

I also felt a little confused about the negative PCR. If you have a herpetic open canker sore in your vulva, shouldn't the test be positive?

Besides, isn't a bit odd that symptoms start to show up weeks after that one night stand? I spent 8 years with my guy without ever having an issue...I'm just afraid I might be putting him at risk. I mean, last time I had an active sore while having sex with him! I felt horrible. =(

[gracefromHHP]

no, you don't have to have obvious cold sores present in order to transmit hsv1 from the oral area to the genital area through oral sex.

depending on how long into things the test was done, not unusual for the swab to come back negative.

[confusedgal85]

thanks grace. the swab was very painful to perform 'cause I had those canker sore things all over my vulva...we were all expecting it to be positive and to know the type. such a bummer that was. =/

just a couple of questions (sorry to bother you guys):
1) that first test, the non type specific one (that claims to be specific...), was positive for HSV1 a week after. Isn't that a bit odd if this is actually HSV1? My doctor said it would take around 2 months for it to be positive.
2)  I read about HSV1 delaying seroconversion in case of HSV2 infection. Is there any evidence that prior HSV1 might delay HSV2 SYMPTOMS? I mean, let's say I caught HSV2 from that one night stand. It took me 10 weeks to show symptoms (well, at least it took me 10 weeks to notice them). Would prior HSV1 play a role in such scenario?
3) My doctor says I don't have HSV2 because "no one (me or the guys) has ever had a positive result for HSV2". Is she right? Simple as that?

[gracefromHHP]

actually  you can test + on the igg test in as little as 2 weeks after being infected. Hard to tell sometimes if it's an old or new infection.

odds are you don't have hsv2 based on your description of things. as I said, unless you get a return of symptoms genitally to have cultured, no quick and easy answers :(

[confusedgal85]

Thanks Grace. Yes, I know...another swab is necessary to sort things out.

Last question: before the flu symptoms kicked in, I believe I felt some groin pain while climbing stairs like a week before...does that mean I had blisters in my vulva by that time? 'Cause when I spotted the sores, they were not bumpy/blistery. Is there a recognized "timeline" of symptoms?

As I said above, I'm afraid it took me a long time to notice that something was going on, which would probably make it the more likely that I caught from that one night encounter.

[confusedgal85]

Up?

[confusedgal85]

Can anyone help me with the symptoms timeline question?

[gracefromHHP]

groin pain can be due to any number of things. no real way to determine at this point if that was herpes related or not. also herpes pain will not only be while climbing stairs, it would be constant for a few days.

[confusedgal85]

So...an update. I've spotted a bump up in my right labia majora. It`s like a swollen bump with a white center. Not sure if it's an ulcer or just a white head. It might be defined as a clogged pore, but I guess it could also be herpes.
I've also spotted two red small spots inside my left side of vagina. I'm not sure if they are related at all. Urinating hasn't been painful yet - which would probably be if they really were herpetic.

I'll try to see my dermatologist tomorrow morning, to get another swab. I'll tell you how the appointment goes.

[confusedgal85]

So my dermatologist saw the sore and classified it as an ulcer. Still, she is not thinking it's herpes (don't know why), but she also doesn't know what's going on. She referred me to a dermatologist who is an expert in genitals.

She swabbed the sore, even though she claimed there was not a lot of material available (it was a clean and dry ulcer, she said).

So I had a swab less than 24h after spotting the bump. When I first spotted it (sunday afternoon), it was a bump with a tiny white center. Now the tiny white center is bigger, and it's more like a flat white ulcer, like a canker sore. Will the swab be accurate this time?

[gracefromHHP]

hopefully you get some better answers soon :)  A lesion culture done within 24 hours of the appearance of symptoms has a good chance of being accurate.

[confusedgal85]

Thanks, Grace. The results will take 10 days to come back, I'll let you know the results.

Although my dermatologist believes the ulcer was not herpetic, I really cannot imagine other causes for recurrent vulvar ulceration. For me, it's just a matter of finding out if this is HSV1 or HSV2. If his turns out to be HSV2, I'll be very upset - not because of the diagnosis itself, but because I spent a lot of money on blood tests (for me and for my partners!) and I kept getting negative results. =/

[gracefromHHP]

many things can cause recurrent genital ulcers, just herpes is the most common cause.

were you also tested for yeast and bacterial infections vaginally too?

[confusedgal85]

I see.

Nope. The dermatologist is trying to exclude herpes for the time being, I guess she hasn't even considered yeast and bacterial infections.

[gracefromHHP]

ask to be tested for them every time you have symptoms.

[Sunny2406]

Could this be a bartholin gland?

[gracefromHHP]

they won't look ulcerated.

[Sunny2406]

Ah, ok. Thanks.

[confusedgal85]

No, not only because they are ulcerated lesions, but mostly because the current ulcer is not located anywhere near the bartholin gland.

[confusedgal85]

Ok, this is getting awkward...my PCR swab came back negative for HSV1 and HSV2.
I'll set an appointment with my dermatologist again, but in the meantime, I should trust this result, right? Sunday afternoon I noticed a bump with a tiny white center; by the next Monday afternoon the ulcer was swabbed.

Also, the guy at the lab understood me wrong and put the specimen as taken from my "shoulder" (?). I guess that does not matter in terms of result, right?

I don't know what the hell is going on. =( It's not normal for someone to get vulvar ulcers during flu episodes. Feeling very upset right now.

[gracefromHHP]

no it doesn't matter if they misunderstood you as to the location - it's the same test whether it's your genital area or your shoulder.

actually yes there are conditions that will cause genital ulcers after viral illness. Ulcus vulvae acutum  is one such condition that your providers will need to rule out.

continue to follow up with the dermatologist as you have symptoms for better answers.

[confusedgal85]

Thank you very much, Grace. I guess after two negative PCR swabs and many negative blood tests for HSV2, it's time to move on and find another cause for my ulcers.

[gracefromHHP]

please be sure to stop back when you do get answers to post about it in this post so that others reading get "the rest of the story" :)

best of luck!