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Negative HSV test due to a "local" infection?
I've had Herpes-like symptoms recurring in my genital area for over 1,5 years after an sexual encounter. So i have had 3 blood tests done during this time: first after 8 weeks from possible exposure, second after 11 months from possible exposure, and last of them was done last month, 1,5 years ater possible exposure. The type on the test performed to my understading was ELISA that didn't differentiate between HSV1 and HSV2. And that didn't really matter because the result was negative everytime, meaning - due to the general guidance, that i am HSV-negative altogether. Right?
But: the infectious disease specialist i saw, said that if the infection is local, the body doesn't produce antibodies to be detected in a blood test. That is somewhat confusing, because i thought that most of the herpes infections are "local" and not systemic? If my doctor is right, that would mean that all the general info about herpes blood tests and their accuracy in diagnosing herpes, oral or genital, was wrong or at least very misleading.
So, is it really so? Of course i asked my doctor this : Isn't herpes almost always local and not systemic, meaning it presents itself as a sore or a blister on lips or genitals? And why are antibody tests then used and recommended fo diagnosing that type of HSV-infections if the body isn't really likely to produce antibodies to be detected?
Answer was that the body produces antibodies to be detected in blood mostly if there is, for example, mouth full of blisters - but not if there is, for example, one blister on a lip?
This goes against pretty much everything i've read about diagnosing herpes via blood tests and the reliability of them in doing so.
I understand that false positives and false negatives do happen but do they really happen that way? And if they do, wouldn't that mean that most of the negative blood tests for HSV (when there is a reason to believe in a possibility of being infected) were actually false negatives, if it really is that Unusual for the antibodies to be produced in a way that could be detected in a blood test if the infection (like most of the HSV-infections?) is local?
But: the infectious disease specialist i saw, said that if the infection is local, the body doesn't produce antibodies to be detected in a blood test. That is somewhat confusing, because i thought that most of the herpes infections are "local" and not systemic? If my doctor is right, that would mean that all the general info about herpes blood tests and their accuracy in diagnosing herpes, oral or genital, was wrong or at least very misleading.
So, is it really so? Of course i asked my doctor this : Isn't herpes almost always local and not systemic, meaning it presents itself as a sore or a blister on lips or genitals? And why are antibody tests then used and recommended fo diagnosing that type of HSV-infections if the body isn't really likely to produce antibodies to be detected?
Answer was that the body produces antibodies to be detected in blood mostly if there is, for example, mouth full of blisters - but not if there is, for example, one blister on a lip?
This goes against pretty much everything i've read about diagnosing herpes via blood tests and the reliability of them in doing so.
I understand that false positives and false negatives do happen but do they really happen that way? And if they do, wouldn't that mean that most of the negative blood tests for HSV (when there is a reason to believe in a possibility of being infected) were actually false negatives, if it really is that Unusual for the antibodies to be produced in a way that could be detected in a blood test if the infection (like most of the HSV-infections?) is local?
DO u mean the nerve test can be something else not herpes ?
We didn't really discuss about the nerve pain itself, but i think something like this was implied:
Since the herpes virus resides in a nerve cell, that would cause some nerve sensations - but it would still be a "local" infection due to it appearing only on one area in the skin.
I haven't really discussed about other local infections and their possible relations to nerve pains with any doctor.
It's hard to think about any purely dermatological penis issues that would be also accompanied by nerve sensations down the legs. But there are different autoimmune conditions for example that can cause something like that - reactive arthritis for example could be broadly defined as a condition of which symptoms can be "rash on penis, leg pains and urinary issues" (though eye involment usually occurs also) and i think it wouldn't be impossible to misdiagnose that as genital herpes. For me it has been pretty much ruled out with HLA-B27 gene test, CPR, SED and WBC though.
And, in the end, maybe some dermatological conditions could also cause such nerve sensations, because the nerve-endings in the genital area could be sensitive enough to somehow remotely reflect primarily dermatological sensations to other places too. Nerves are interconnected after all, aren't they?
Since the herpes virus resides in a nerve cell, that would cause some nerve sensations - but it would still be a "local" infection due to it appearing only on one area in the skin.
I haven't really discussed about other local infections and their possible relations to nerve pains with any doctor.
It's hard to think about any purely dermatological penis issues that would be also accompanied by nerve sensations down the legs. But there are different autoimmune conditions for example that can cause something like that - reactive arthritis for example could be broadly defined as a condition of which symptoms can be "rash on penis, leg pains and urinary issues" (though eye involment usually occurs also) and i think it wouldn't be impossible to misdiagnose that as genital herpes. For me it has been pretty much ruled out with HLA-B27 gene test, CPR, SED and WBC though.
And, in the end, maybe some dermatological conditions could also cause such nerve sensations, because the nerve-endings in the genital area could be sensitive enough to somehow remotely reflect primarily dermatological sensations to other places too. Nerves are interconnected after all, aren't they?
Did the doctor tell ur if the nerve pain is a local infection or not ?
Thank you.
Thank you.
Yes, let's hope so.
Talking of it reoccuring, i think it would be good to mention that there's not That clear line between the rash being on or off. Because i can see almost all the time very little to moderate traces of it on the area it usually appears - so that area looks at least little scaly all the time, and when the rash "recurs", the area becomes more noticeably scaly and the "scales" become red. I think that is somewhat non-herpes-like trait unless the area has been little scarred (due to herpes) so that i can see the change in it although it's not on?
Something like psoriasis has came to my mind too (that can cause joint sensations too) but i don't know how likely it would present itself only as a sexual reaction on genitals and not anywhere else.
Talking of it reoccuring, i think it would be good to mention that there's not That clear line between the rash being on or off. Because i can see almost all the time very little to moderate traces of it on the area it usually appears - so that area looks at least little scaly all the time, and when the rash "recurs", the area becomes more noticeably scaly and the "scales" become red. I think that is somewhat non-herpes-like trait unless the area has been little scarred (due to herpes) so that i can see the change in it although it's not on?
Something like psoriasis has came to my mind too (that can cause joint sensations too) but i don't know how likely it would present itself only as a sexual reaction on genitals and not anywhere else.
all sorts of skin issues that can occur that will also cause tingling and such. you saying it looks scaly sounds more like a fungal infection or even eczema or something going on. hopefully your rash reoccurs on a weekday and you can be seen promptly for a better work up!
No i haven't seen a dermatologist with the rash on because it's difficult to have the right timing for an appointment. But now i got a "time-flexible" appointment to a dermatologist so i can negotiate about being seen with the rash.
The dermatologist i saw without the rash though said also that it's not herpes and that i can pretty much rely on my blood test results (there were two taken at the time). But he didn't say what else it could be. Of course i understand it's hard to say without seeing the rash.
Still, the nerve pains and the rash being recurrent - coming and going - doesn't bring anything else to mind than herpes.
The dermatologist i saw without the rash though said also that it's not herpes and that i can pretty much rely on my blood test results (there were two taken at the time). But he didn't say what else it could be. Of course i understand it's hard to say without seeing the rash.
Still, the nerve pains and the rash being recurrent - coming and going - doesn't bring anything else to mind than herpes.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
