Hello,
Thanks for posting your query at DoctorSpring.com
The symptoms sound more like abrasion / irritation due to rough sex, however only looking at the lesions would make me more confident.
Could you please upload some photographs of the area so that I can offer a better opinion ?
Looking forward to hearing from you.
Regards.
Patient replied :
Please find the image attached. I would like to note that pain from urination has nearly disappeared.
This is the first day no alcohol or witch hazel has been applied to the area. There is no abnormal smell or discharge.
I'd like to note that I used tampons on Saturday with no pain. I also had little to no pain when the area was rubbed to collect cultures for the lab. The doctor was sure it would be very painful but it was actually rather mild. Overall my discomfort level peaked on Sunday and today I feel even better than I did on Friday, the first day.
would a first herpes outbreak actually heal this quickly? Would those ingrown hair type bumps stay the same for a few days? Is it even possible that I would have symptoms this quickly when my partner (the alleged carrier) has had nothing as of yet?
thanks for your time and opinion.
Hello,
I have gone through the image.
It DOES look very much like herpes to me too , I can see the sores, of course I would have had a much better idea if I had seen the area at the peak of the discomfort.
All you can do is await the lesions.
Yes, ingrown hairs can remain stable for years and not cause any issues.
Yes, a first outbreak can heal this early.
Yes, you could show symptoms even if your partner was asymptomatic but a carrier.
Yes to all those.
The gold standard would be the test.
Do let me know the results, would fortify or improve my clinical acumen too.
How were you tested by the way, swabbing the active lesions is the most definitive way to get a diagnosis.
Was that done ?
Regards.
Patient replied :
Hello,
The results came back as HSV-1 from a culture swab, but negative for antibodies in the blood. My doctor said that this is because it is newly transmitted. Do you agree that this is the only way a culture can be positive and the blood negative?
My boyfriend only had blood tests since he had no physical symptoms and his results came back negative. However in the past few days he had a couple sores on his tongue that the doctor swabbed. He also swabbed his throat since it was sore and swollen. His lymph nodes were also rather swollen. The doctor is not confident that what he has now in his mouth is herpes. Is it possible for his blood test to come back negative even though he was contagious ?
So we're now trying to figure out how this was transmitted vaginally. Could it have been transmitted weeks ago from his mouth or genitals even though he had no observed symptoms? Why is it that i do not have any cold sores in my mouth (a little tingling but nothing visible)? How is it that he does not have any sores on his genitals since we had unprotected sex the night before my symptoms became apparent?
Above all I want to make sure that there is no possible way I could have gotten this from anyone but him. I haven't had sex with anyone else in over a year and this is definitely the first time I've ever had a condition like this.
thanks for your help!
Here goes -
1. New infection is the commonest reason why a culture would be positive, and bloodwork negative. Other reasons - lab errors, inherently low sensitivity and specificity of blood tests for detecting herpes, low immune system etc.
2. If he was contagious, the blood work would be mostly positive, but yes, again, there could be false negatives, in the sense, that sometimes, blood tests can come up negative even if he is a carrier.
3. Even though he had no symptoms, he could transmit the infection to you , orally or genitally.You need not have cold sores in the mouth, cold sores can be on the genitals or the mouth, and you have genital ones. As mentioned earlier, he need not have sores on the genitals in order to transmit herpes to you.
4. There is no real way to confirm that he gave it to you, unless his blood work / throat swabs come out positive.
Take care.
Regards.