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Desperate: Neg HSV IgGs, pos HSV IgM, please help.
OK, here is my third attempt to get a little more information from this website...I am not sure if I am posting incorrectly (I have two paid posts, one forum post)...we will see, I guess!
I truly am beside myself. Went to the doctor with a terrible one-sided genital rash (the pain literally floored me) -- my husband and I thought it was herpes zoster. Doctor took one look, thought it was HSV 1 or 2 but then took a closer look and sort of hem-hawed that it could be shingles. Ordered blood tests (which took over a week!).
Test results: typical antibody levels for zoster (I had chickenpox as a kid) but negative IgM for zoster. Negative IgG results for both HSV1 and HSV2. But a positive IgM result (non-specific: could be either 1 or 2 or both I guess)!! The cultures came back negative but apparently there was very little fluid to culture. I had lesions, swelling and the most intense pain I have yet to experience. Shooting pains, burning sensation, chill, you name it -- if it was unpleasant, I experienced it. Day 1 I felt a weird sensation and by Day 4 I could barely walk. Day 5 I saw the doctor and got my blood tested.
When doctor called with results, he explained that I must have been exposed to the HSV virus recently, otherwise I would have had a positive IgG test. He wants me to have my blood tested again at 4 weeks (4 1/2 weeks from initial symptoms).
Now, I know people may think I am crazy or naive, but I know 100% that my husband did NOT cheat on me. I am reading a lot about false positive IgM results for HSV and that in general, the test is not very trustworthy. But what else could have given me these terrible symptoms? Husband has never had a cold sore or anything like it in his life. Neither had I until this weird episode. We only have had sex once within 6 weeks of my episode (it was either 4 or 5 weeks before my episode started). So none of this makes sense.
How can this be happening? Please help!
I truly am beside myself. Went to the doctor with a terrible one-sided genital rash (the pain literally floored me) -- my husband and I thought it was herpes zoster. Doctor took one look, thought it was HSV 1 or 2 but then took a closer look and sort of hem-hawed that it could be shingles. Ordered blood tests (which took over a week!).
Test results: typical antibody levels for zoster (I had chickenpox as a kid) but negative IgM for zoster. Negative IgG results for both HSV1 and HSV2. But a positive IgM result (non-specific: could be either 1 or 2 or both I guess)!! The cultures came back negative but apparently there was very little fluid to culture. I had lesions, swelling and the most intense pain I have yet to experience. Shooting pains, burning sensation, chill, you name it -- if it was unpleasant, I experienced it. Day 1 I felt a weird sensation and by Day 4 I could barely walk. Day 5 I saw the doctor and got my blood tested.
When doctor called with results, he explained that I must have been exposed to the HSV virus recently, otherwise I would have had a positive IgG test. He wants me to have my blood tested again at 4 weeks (4 1/2 weeks from initial symptoms).
Now, I know people may think I am crazy or naive, but I know 100% that my husband did NOT cheat on me. I am reading a lot about false positive IgM results for HSV and that in general, the test is not very trustworthy. But what else could have given me these terrible symptoms? Husband has never had a cold sore or anything like it in his life. Neither had I until this weird episode. We only have had sex once within 6 weeks of my episode (it was either 4 or 5 weeks before my episode started). So none of this makes sense.
How can this be happening? Please help!
Thanks. Am planning on retesting but did a little research and apparently, the IgM results for zoster are also known to be inaccurate in many cases. See below from a paper called "Serology and DNA detection in shingles" -- they found lots of problems. It certainly would explain my situation!
"Surprisingly low prevalence of VZV IgM antibodies (9%) was detected by the EIA in the acute zoster sera and the majority of zoster patients (38%) also remained IgM negative in the convalescent sera. The frequency of IgM antibodies in the zoster patients described by other authors varied widely from 10 to over 70% depending on the method used, the patients’ clinical status and the time of specimen collection. However, even with the most sensitive test system IgM responses were not detected in a satisfactory proportion of patients and the IgM assay is not a particularly helpful approach to zoster serodiagnosis."
With the IgG neg HSV results and the physical unlikelihood of me having contracted HSV from a single sexual encounter with my husband over 4 weeks before my "outbreak", it seems unlikely that I have HSV.
Thanks again for your time, I will update you with results.
"Surprisingly low prevalence of VZV IgM antibodies (9%) was detected by the EIA in the acute zoster sera and the majority of zoster patients (38%) also remained IgM negative in the convalescent sera. The frequency of IgM antibodies in the zoster patients described by other authors varied widely from 10 to over 70% depending on the method used, the patients’ clinical status and the time of specimen collection. However, even with the most sensitive test system IgM responses were not detected in a satisfactory proportion of patients and the IgM assay is not a particularly helpful approach to zoster serodiagnosis."
With the IgG neg HSV results and the physical unlikelihood of me having contracted HSV from a single sexual encounter with my husband over 4 weeks before my "outbreak", it seems unlikely that I have HSV.
Thanks again for your time, I will update you with results.
MEDICAL PROFESSIONAL
You should be sure he tested with the swab for both HSV and VZV- some commercial tests test only for HSV and miss VSV. VZV also typically takes longer to grow than HSV.
When you re-test please let me know. EWH
When you re-test please let me know. EWH
Hello and thank you so much for the thoughtful response. Yes, I am on the zoster-recommended dosage of Valtrex. Within a day of taking it, the symptoms (pain etc) abated significantly.
The doctor said that there was very little liquid in the lesions to culture, and that perhaps that was why the test came back negative (for everything: I assume he swabbed for HSV and VSV).
I am just so confused: this was such a painful episode. What else cause lesions and pain like this? If zoster, why would I have a negative iGm result? and an iGg of 2.86? If HSV, why am I testing iGg negative? It is very distressing. Thanks again: I keep trying to remind myself that there are far more serious medical problems that I and my husband may face in the future, yet I still am so confused and upset by this.
The doctor said that there was very little liquid in the lesions to culture, and that perhaps that was why the test came back negative (for everything: I assume he swabbed for HSV and VSV).
I am just so confused: this was such a painful episode. What else cause lesions and pain like this? If zoster, why would I have a negative iGm result? and an iGg of 2.86? If HSV, why am I testing iGg negative? It is very distressing. Thanks again: I keep trying to remind myself that there are far more serious medical problems that I and my husband may face in the future, yet I still am so confused and upset by this.
MEDICAL PROFESSIONAL
Welcome to the Forum. I'm sorry you have to struggle with this dilemma. There are several things I need to say that I think will help to sort this out.
First, I'm afraid your doctor is incorrect. The fact is that positive IgM tests are not reliable and are often falsely positive because they detect not only IgM antibodies but also IgG antibodies. Thus it is possible and perhaps probably that your "positive" IgM test is actually detecting IgG antibodies.
Second, you need more information. I'm troubled that your culture tests were negative. If your lesions were due to HSV, five days into your outbreak the tests should have been positive. I do agree that repeat antibody tests a month after your outbreak may be helpful and would test for HSV-1, -2 and Herpes zoster. I would not test for IgM of any sort.
Third, the timing of your outbreak also is not consistent with herpes but it is compatible with Herpes zoster which can occur at almost any time. Typically initial episodes of HSV occur between 4 and 14 days after an exposure. As I understand your post, it was 4-5 weeks between your last episode of sex and the beginning of your outbreak- this is not suggestive of HSV.
I see no reason to assume that your husband has cheated on you and will not suggest it. Asking your husband to get type specific HSV antibody tests might also be helpful in sorting out what has happened.
I'm sorry I don't have better answers for you at this time. As I said, more information might help us. In addition, as a side comment, I need to ask if you are taking therapy for your illness. Whether or not this is herpes zoster or HSV, you should be on therapy for the outbreak. Drugs such as valacyclovir will help whether this is zoster or HSV. EWH
First, I'm afraid your doctor is incorrect. The fact is that positive IgM tests are not reliable and are often falsely positive because they detect not only IgM antibodies but also IgG antibodies. Thus it is possible and perhaps probably that your "positive" IgM test is actually detecting IgG antibodies.
Second, you need more information. I'm troubled that your culture tests were negative. If your lesions were due to HSV, five days into your outbreak the tests should have been positive. I do agree that repeat antibody tests a month after your outbreak may be helpful and would test for HSV-1, -2 and Herpes zoster. I would not test for IgM of any sort.
Third, the timing of your outbreak also is not consistent with herpes but it is compatible with Herpes zoster which can occur at almost any time. Typically initial episodes of HSV occur between 4 and 14 days after an exposure. As I understand your post, it was 4-5 weeks between your last episode of sex and the beginning of your outbreak- this is not suggestive of HSV.
I see no reason to assume that your husband has cheated on you and will not suggest it. Asking your husband to get type specific HSV antibody tests might also be helpful in sorting out what has happened.
I'm sorry I don't have better answers for you at this time. As I said, more information might help us. In addition, as a side comment, I need to ask if you are taking therapy for your illness. Whether or not this is herpes zoster or HSV, you should be on therapy for the outbreak. Drugs such as valacyclovir will help whether this is zoster or HSV. EWH
You are reading content posted in the STDs Forum
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.
