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false positive culture?

My husband and I have been married for two years. In those two years, I have never had bumps or ulcers or lesions and neither has he. Last week he and I had sex and he sucked both my nipples really hard. So hard it hurt when he did it. The very next day my breasts were in pain. Two days after that I noticed my left brest was larger and red. I also noticed small blisters on my areola and 1 on my breast. It was burning. I went to uurgent care and the doc did a quick swab of my nipple (literally took 10 seconds) and sent me away with Bactrium. The next day the pain got so bad I went to the emergency room. By this time my right breast was also swollen and also had some blisters, although a lot fewer than the left. They gave me clindamycin through IV and both the redness and swelling went down dramatically within 45 minutes. But my culture came back positive for herpes--no typing. I developed a low fever and also a sore throat with a white ulcer in the back of my throat. I went to my primary care and he said it looked like cellulitis and I needed antibiotics through IV immediately as it was now on my right breast as well. When I went to the emergency room the doctor said he thought it was herpes and gave me valtrex and clyndamicin. The PCR blood test he did came back negative for both type 1 and type 2 HSV. It has now been a week and I no longer have a fever and all the blisters have turned into yellow crusts that are falling off. I never had anything ooze out of my nipples. I also had an ultrasound and everything looks good. Could the culture be a false positive?? How many people get herpes on their nipples??
Best Answer
101028 tn?1419603004
odds are this is a hsv1 infection on your breasts.  if it's a new infection for you, it might not show up on the igg blood test for a few weeks or months ( if at all ).  odds are this is a newly acquired infection - from your lack of prior history of similar symptoms on your breast. it would've come from your husband's mouth whether he had an obvious cold sore or not ( or if he can even recall ever having had one ).

could you also have had a secondary bacterial infection that caused a cellulitis which the iv clindamycin was helpful for? yes indeed!  mouth germs aren't so  normal in the breast area if the skin was broken and it could've easily caused a cellulitis as well as the herpes skin infection. sometimes if it weren't for bad luck, you'd have no luck at all as the saying goes.

should you doubt your lesion culture? not at all.

should herpes pcr blood testing been done on you? no as was already mentioned. herpes is not a blood borne infection so detecting herpes dna in the blood is very time sensitive and typically only with a newly acquired infection  with a very limited window of opportunity in adults so your test coming back negative is not surprising at all.   your provider should better educate themselves on herpes blood testing so they can offer the best testing for their patients.  If they are routinely doing herpes pcr blood testing, a patient could sue them for malpractice!

so what do you do now? well continue the antibiotics and antivirals. is it worth more herpes testing for you or hubby? well not really.  pretty clear cut from the sounds of things - hsv1 skin infection on the breast that came from hubby's mouth. in the future the only real precaution you should take is if hubby has an active cold sore, he shouldn't perform oral sex on you. we don't really know how much protection a hsv1 breast infection would give you from contracting hsv1 genitally from oral sex but overall the risk is very low.  no real other precautions to take.   should you get a recurrence of symptoms on your breast, start acyclovir within 24-48 hours to help speed healing.  

grace
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Avatar universal
My IGM and IGG came back negative for Herpes.
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1998092 tn?1391242845
Certainly possible. I think rule out everything.
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Avatar universal
I guess I just wonder why the clyndamycin helped so much in the hospital through IV....that's an antibacterial instead of an antiviral. I'm wondering if what I actually had was impetigo nonbullous....
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Avatar universal
I know the swab wasn't PCR. They said something about gram positive. I did in fact take an IGG and IGM blood test the day after. I won't know any results until Monday at the earliest.  
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1998092 tn?1391242845
I don't know why doctors are doing PCR blood tests rather than PCR swabs. The blood test will come back with a false negative quite often. The swab, if done early enough, is extremely sensitive and accurate. In fact, he may have done a PCR swab on you. But I wish it had been typed.

Yes, we can contract HSV anywhere. All it requires is a portal (cut, wound, tear, abrasion) or a mucous membrane (mouth, genitals) for the virus to enter.

I strongly recommend both you and your husband get tested right away with an IgG type-specific blood test, as the quickest and most available of the reliable tests, but see if you can get something other than the ELISA, which has had problems in recent years. If one of you returns a negative, you'll want to re-test in about 16 weeks, to be sure any antibodies have fully formed.
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