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Strong Suspicion--please help!!

Hi,

I am a 27 y/o male, and have had numerous partners, a few without protection. Recently, a week after a sexual encounter, I had a rash around my pubic area which I thought was due to friction during intercourse. My partner contacted me to tell me she thought she might have herpes and claimed that I might have given them to her. Around the same time my "rash" began itching and formed a scab. I also just noticed a few tiny bumps.

My questions are the following:

1) I am going to the doctor ASAP, what test(s) should I ask for? I understand blood tests only detect antibodies months later and so wouldn't be reliable if I was just exposed. On the other hand, can they do tissue tests on a scab/itchy skin only??

2) I understand that HSV-2 outbreaks are rare in the pubic region (versus genitals) is that true or just misinformation, and if so, would it likely be HSV-1 or something else??

3) is there any way of knowing whether it was my partner who infected me or vice versa and could it be possible that it lay dormant in either one of us until our sexual encounter?

4) and finally, I remember having what I thought was jock itch periodically during my late teens and early twenties (with no scabs or bumps); could these have been herpes outbreaks and if so, could it have been passed from my scrotum to my pubic region--in other words does it always occur in he same place or can it jump to other areas??

5) finally, if I do have HSV-1 or 2, and am experiencing my first outbreak, is it true that the sooner I treat it the less severe subsequent outbreaks will be?? And if so, should I ask my doctor for a script even before a diagnosis to be on the safe side??

I know that I am asking a lot of questions for not even having a diagnosis, but I want to go to my Dr's appointment as prepared as possible. Thanks so much in advance; this is an amazing forum!!!!

16 Responses
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101028 tn?1419603004
there is a high false negative rate with the herpes lesions cultures.  A negative culture requires follow up blood testing at the appropriate time to confirm.  

the lab should still have the culture frozen to try to type it for you. most labs keep them frozen for  a few weeks in case there are issues.

hard to tell why you suddenly had a noticeable ob at this point. could just be coincidence even.
Helpful - 0
Avatar universal
Thanks for the prompt reply.
The only thing I'm still a little puzzled about is why my ob came up right after I had sex with her if I was infected before (ive heard friction can cause obs--is that true??) And then, why would her culture have come up negative (are you saying it might be a false negative??)

Also, do you think they can still find out the type for me from the culture they collected a week ago?? Thanks for your help!
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101028 tn?1419603004
if your partner's igg testing for herpes was negative then odds are you had herpes first and potentially transmitted it to her. she'll need to repeat her herpes igg blood testing 3 months after you had last had sex prior to her symptoms starting. You can get yours done when you are back in the country to see if hsv1 or hsv 2 is the issue here.  

the vast majority of people who have hsv2 have no idea until they either get tested, transmit it to a partner and get tested or have an ob that is more noticeable than previously to go and be seen and get a proper diagnosis.  your situation is far more common than most folks suspect.
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Avatar universal
Hi grace,
So, I did ask about typing, and the nurse I spoke with said that as far as she could tell, they had not typed the culture. I asked if they could still type it, and she said she wasn't sure but that she would pass the request on to the doc (I'm gonna call back today to follow up).

As far as Igg blood testing, I had requested it when they swabed me but my doc said because she doubted it was herpes, that she wanted to wait till the results came back for the culture, and go from there. Unfortunately, I'm out of the country right now, so I'm gonna have to wait till Jan 10 to see her.

As far as my partner, she says she had 'everything' tested for, and came out negative. When I asked her specifically, she said she had culture done and a blood test done (she didn't know which blood test). She said the doctor told her that a lesion she had was just torn tissue from rough sex.

Is it possible that I've had herpes a while now without knowing it? And that I just had a noticeable outbreak now?? And that my partner wasn't infected?? It sounds a little strange to me.

Any thoughts, comments, suggestions for next steps??
Helpful - 0
101028 tn?1419603004
forgot you said you did have a partner - what was her test results?
Helpful - 0
101028 tn?1419603004
the only way to get a false positive from a culture is clerical error. The lesion cultures rely on actually growing out herpes virus in the lab which is hard to do.   You have no reason to doubt a + lesion culture.

did they say if it's hsv1 or hsv2? If they didn't, call back tomorrow and ask if it was typed. if they didn't type the lesion culture, ask them to please follow the CDC recommendations of typing all lesion cultures for herpes and call and ask the lab to do so for you.  

do you have a regular partner?  did you also have herpes igg blood testing done too?

grace
Helpful - 0
Avatar universal
So...I finally got my results back from the culture, and it is positive. I don't know what the values are, or anything, but what are the chances of it being a false positive from a culture?? Do any of you know??
Helpful - 0
897535 tn?1295206435
If it's fungal or bacterial, a steroid cream won't do anything - if anything it may aggravate it more. Up to you, but if you're going Monday you may want to just wait.
Helpful - 0
Avatar universal
Im no doc, but it probably isnt herpes, if cortisone cream is going to make you feel better than why not apply it!  If you were to get cultured anyway, the best time to do it is the first 48 hours of symptoms...it seems like u passed that, especially if your appt is Monday.  Keep us posted with everything!! good luck! :)
Helpful - 0
Avatar universal
Hey, so I just spoke with a nurse over the phone and described my symptoms, and she said since I didn't have pain but just itching associated with my rash/lesion that it prob wasn't HSV, but to put some cortisone on it and come back Monday when the Dr is in. What do u guys think about what she said?? Thanks!!
Helpful - 0
897535 tn?1295206435
We recommend have a STD/birth control discussion with any potential partner anyway. It goes both ways (as you should know from your current situation), that you need to know your partners STD/herpes status too.

No reason to say "hey I think I have herpes", instead more so along the line of what asianslore suggested.

Nothing online replaces being seen by a medical provider, so be sure to do that.
Helpful - 0
Avatar universal
Yeah, as far as waiting till I find out, I think you're totally right, and I think the way you phrased that will definitely help if things progress with a girl I just started seeing (which was my concern). And, no I'm not bringing strangers home, but I could be more careful about being sure of people's STD status...I'm definitely taking this as a wake up call though and think it IS time to settle down. I'm just trying to find a balance between being careless and being overly paranoid (Though I guess its better to err on the side of paranoia!) Thanks again, and good luck to you too!!
Helpful - 0
Avatar universal
I think you should not have sex or oral sex until you know for sure, and that you should not have sex with anyone unless you know their STD status. Beware that many STD testing panels do NOT include herpes, so people might they they are clean, but infact were not tested for herpes.

Right now you cant be going out and bringing partners home, hopefully you dont do that now, and after this scare hopefully you wont ever!...

If you develop a new relationship I would just say something like "i am in the process of getting STD tested to make sure everything is cool, so I dont want to do anything until I know" ..  They should appreciate the honesty. And not for anything, if your negative (which u probably are) this should scare the crap out of you. STDs are nothing to mess around with.. Im a 26 y/o female..had multiple partners in college..always protected, and some unprotected sex with long relationships...and I am positive (according to tests..thats another story) ... I almost feel lucky that this is only herpes and not HIV, hepitatis, or any other chronic infection that would have a detriment on my life.  Consider this a huge reality check!!   Best of LUCK! .. I think it might be time to settle down for you... and be more cautious w ur sex partners.
Helpful - 0
Avatar universal
Thank you both for your input...it def helps clarify a few things. I'm gonna try and post on the expert forum to try to get at that last one.

One last thing, more on an ethical note...so, if I come back negative, in the interim till I get tested again, say three months down the road, am I supposed to disclose my concerns to any new potential partners?? I mean, I want to do the right thing and prevent infecting others (if I do have hsv), but at the same time, if I don't even know, is there a point in scaring people away!!?? I'd appreciate your input
Helpful - 0
Avatar universal
Asianlore is correct.  If they are scabbed over, they may not swab it.  Next time you get symptoms, try to have them swabbed within 24-48 hours.   Yes, they can swab itchy skin, but the results may not be very reliable.  An IgG test for both you and your partner is imperative.  What kind of testing has she had so far?

If you both test negative, another blood test 3 months down the road for the two of you would be a good idea.  Make sure she has any symptoms swabbed, if they reoccur.  

Outbreaks can definitely appear in the pubic region; it's the initial ones that typically do not.  

I'm not certain as to if treating your first outbreak has any correlation to the severity of subsequent ones.  That's a great question for Grace.  I would venture to guess that it does not affect future outbreaks (unless you start antiviral therapy on a daily basis).
Helpful - 0
Avatar universal
answers to your questions:

1) you need to ask for a type specific IGG HSV 1 and  HSV 2 test.  They may want to perform IGM test, but it is not reliable.  If your "outbreak" already scabed, I doubt the doctor would swab the area because it is already healed. As far as swabbing "itchy" skin, Im not too sure.

2) People on this forum will tell you that if you have genital hsv 2 you can potentially get outbreaks in the "boxer short area" so i guess thats mid thigh up to waist.

3)There is no way to tell by testing who gave hsv to who... if you had prior testing and you were negative, you may be able to figure out who most likely gave it to you, but thats not an important factor. I know u wanna know where the hell this came from, but you dont even know if it is HSV.

4) I think i remember reading that outbreaks occur in the same area for some people, but different areas in others.

5) Keep in mind, almost 90% of people have hsv 1. If your doctor suspects herpes, he/she would give u a prescription for valtrex or another antiviral and possibily an antibiotic until your test results come back.

Just make sure you get an IGG TYPE SPECIFIC TEST for both HSV 1 AND hsv 2... WHEN YOU GET YOUR RESULTS, MAKE SURE YOU TAKE NOTE OF THE VALUE, IF ITS A LOW FIGURE, IT CAN POTENTIALLY BE A FALSE POSITIVE AND FURTHER TESTING IS NECESSARY.  GOOD LUck!  and dont worry until you have to.

Keep in mind though, you should wait at least 3 or 4 months post exposure for accurate results.
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