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Query about herpes genitalis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Vaginal and Uterus Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 2685 Questions
User :   Hi, my doctor says that I may have herpes. I shaved my genital area about 4 weeks ago and just two weeks ago it began to itch and I scratched the area. I woke up the next day with a headache and a little dizziness, my lyphm nodes where swollen and I had a few bumps on my genital. The bumps were not on or around my vagina but directly on the top not too far from the navel. The doctor took a swab and blood two days later. Just yesterday she said that I may have herpes. She said she sent the labs to two labatories. One said HSV1 0.69 and HSV2 2.69. I am freaking out because I do not have intercourse please give me the best answer.
Doctor :   hi
User :   hi
User :   Hi sir
User :   And you are a real doctor right?
Doctor :   yes
Doctor :   i am a certifed MD
User :   Ok did you read my question
User :   this is what the paper said..hold on
User :   Interpretations: User :   Negative 0.90
User :   interminate 0.90-1.09
User :   postive 1.10
User :   HSV1 IGG/EIA...........0.69
User :   SAME FOR HSV 11 IGG
Doctor :   OK
User :   2.96
Doctor :   THE TEST RESULTS are completely normal for hsv 1
User :   OK what does this mean
User :   what about HSV11?
User :   2.96?
Doctor :   they are also perfectly normal
User :   OK Doctor what does this mean
User :   Do I have both
Doctor :   HSV ii , is HSV 2
Doctor :   NO it means the tests are normal
Doctor :   and u are not having any of the above
User :   what she said im positive
Doctor :   No that is incorrect,
Doctor :   the serology reports indicate the antibody levels to be in the nonreactive range
User :   So why would the results say positive
User :   OMg
User :   see doctor I dont know what to do
User :   I mean what do you think it could be?
Doctor :   as per yor history u need not worry at all
User :   I did have an infection
Doctor :   as you have had no sexual intercourse before
User :   my lyphm nodes did swell
Doctor :   the infection is due to skin bacteria following shaving of pubic hair
User :   no sexual intercourse but I have to tell you Im not a straight female
Doctor :   Do u use IV drugs for recreation ?
User :   no sir
Doctor :   then thats fine , no need to worry as well
User :   I have a girlfirend and she is freaking out too
Doctor :   the lymph nodes can enlarge due to skin bumps related infections as well
Doctor :   did u have skin to skin contact with your girl friend ?
User :   Ok but please tell why do you think results said positive?
User :   Yes we have skin to skin contact
Doctor :   did u ever have chickenpox befor ein your childhood ?
User :   yes sir I have had chickenpox
Doctor :   ok, Chicken pox is a infection caused due to Varicella virus, which is a form of HSV virus
Doctor :   So occasionally, presence of antibodies to VZV (varicella virus) could be interpreted by tests to be HSV as they do cross react
Doctor :   for exact diagnosis, a Tzanck smear of the skin lesions can be done to reveal the virus involved
User :   yes but they are healed already
User :   so what shoukd I do?
Doctor :   you need not do anything
Doctor :   just relax and u will be fine
Doctor :   can u mention the exact test that was done ?
User :   IGG
Doctor :   and what did the doctor mention after looking at the results ?
User :   all she said was I have herpes
User :   I said this cant be right
User :   she said if I have an outbreak come see her
User :   thats it
Doctor :   can u give me the interpretations for HSV 2 LEVELS ?
User :   negative =
User :   interminate 0.91-1.09
User :   postive>=1.10
Doctor :   is it mentioned that for both HSV 1 AND HSV 2, the interpretaion is the same ?
User :   yes
User :   but HSV1 said.....HSV1 IGG/EIA....0.69 Index SERUM
Doctor :   HSV 1 - is nonreactive for you, meaning you are not exposed to HSV 1
User :   AND HSV 11 IGG........2.96 (
Doctor :   Cross reactivity between HSV and other members of the Herpes group (CMV,EBV and VZV) is very common, especially the close
relationship between HSV 1 and HSV 2 may cause false positive results with the VIR-ELISA test ANTI-HSV 1-IgG and ANTI-HSV 2-IgG.
Doctor :   IN the absence of major symptoms of HSV 2 (in the form of rashes, genital ulcers, etc) this is a false postive test and need not be worried about
User :   Ok so you think this is a false test
User :   Would you recommend I go to another doctor to get tested?
Doctor :   yes this is a false test
User :   Ever since I got that news I have been itching and freaking out, I cant sleep.
Doctor :   first can u tell me , if u have any ulcers or rashes in the genital areas or any other part of the body, either now or anytime before ?
User :   Im overseas right now but I think I need a real doctor. These doctors here are not actual doctors
Doctor :   may i know where u reside ?
User :   No I have not had any rashes
Doctor :   and how do u know that those are not doctors ?
User :   That was the first time I ever had a bump
User :   These people are RN's I think they do not have PHD's they are in the military.
Doctor :   in that case you need not worry at all
Doctor :   since u have a history of chicken pox, it seems to be a cross reactive antibodies
Doctor :   can u scan the copies of the results and send it
Doctor :   so that i can get a clear view of the report myself
User :   ok
Doctor :   please mention in the subject line - referred
Doctor :   are u there ?
User :   yes
Doctor :   have u sent it ?
User :   I was just thinking
User :   No sir I do not have a scanner
User :   I really really wish I could send it now
Doctor :   can u tell me the test name as mentioned in the report , so that i can cross check the results from the database
User :   Sir exactly where is that found
User :   it says herpes c: final report
Doctor :   just in the name of the test, under or above your name in the letter
Doctor :   anyway as the time is running out i would like to tell u that u just need to relax as u dont have herpes at all
User :   sir I am going to recharge now will i still talk to you
Doctor :   and most likely it is going to be a false positive
Doctor :   yes sure
User :   when i recharge will u sill be here
Doctor :   yes
Doctor :   hello
User :   hello
Doctor :   Dr Anvekar here
Doctor :   welcome back
User :   yes I am trying to figure out where the test name is
User :   all it says is Herpes simplex virus type 2 isolated
User :   test performed at SCL
User :   7-14, Dongbinggo-dong, Yonsang-gu-Seoul
User :   then it has the interpretations
User :   for both 1 and 2 HSV
User :   but the labs went to two labratories
Doctor :   have u told the interpretations as the same as before ?
User :   HSV1 went to Yonsang and so did 2 with the same intrepretations that I told you before
Doctor :   ok
Doctor :   so the only tests they did was HSV TYPE 1 AND 2 IGG antibodies - is this right ?
User :   yes
Doctor :   have they done HSV TYPE 1 AND 2 IgM tests ?
User :   no the results doesnt mention that test
Doctor :   so as per you, u have all the tests done so far, at the clinic , so far ?
Doctor :   i mean u have all the test reports that have been done so far ?
User :   yes I have them sitting right here with me
Doctor :   ok
Doctor :   When someone is first infected, with HSV 2 he or she may have obvious and painful blisters at the site of infection, which usually appear within two weeks after the virus is transmitted and usually heal within two to four weeks.
Doctor :   This primary episode can include a second outbreak of blisters and even flu-like symptoms of fever and swollen glands.
Doctor :   Once someone is infected and the initial infection resolves, he or she will harbor the HSV in a latent form.
Doctor :   During periods of stress or illness, the virus may reactivate
Doctor :   In most cases, HSV outbreaks are a painful annoyance rather than a health threat
Doctor :   now i have explained u the disease process of hsv
Doctor :   Do u think u have had any of such symptoms , other than the lymph node enlargement?
User :   No, immediately after I scratched my pubic hairs the next day bam I had enlarged lymph nodes and I felt sick.
Doctor :   this is not due to viral infection, but is due to bacterial origin
Doctor :   did u have blisters , that were painful ?
User :   I had bumps appear after I scratched the sit but I thought they were hair bumps
User :   it just itched
User :   my lymph nodes hurt when I touched them
Doctor :   u mean pustules where you had shaved ?
User :   the area itched like crazy
User :   ok Doc I dont know what pustles are teaching me alot really
Doctor :   as i had said earlier, since u had the symptoms after shaving . rather than exposure to some one having the infection, it cant be attributed to HSV at all
Doctor :   also about the antibodies, let me give u some info on that ...
Doctor :   HSV IgG antibody production begins after HSV IgM production
Doctor :   Once someone has been infected with HSV, they will continue to produce small quantities of HSV IgG
Doctor :   but the IgM levels subside within the first few weeks
Doctor :   now to confirm whether you had HSV, then the most sensitive test would be HSV DNA testing
Doctor :   This method can detect the virus as well as identify the type and is good in circumstances where the virus is present in low numbers
User :   so the IGG testing is really not good enough is that what you are saying Doc?
Doctor :   yes the Antibody testing is not senstive enough and has lot of crossreactive and falsenegative issues
Doctor :   Ab testing is used to screen people and not to confirm that u had an infection
Doctor :   HSV-1 or HSV-2 IgG antibodies indicate a previous infection
Doctor :   The presence of HSV-1 or HSV-2 IgM antibodies indicates an active or recent infection.
User :   So does it mean once you are screened does it mean that you may have it if labs are positive?
User :   So I have IgM antibodies?
Doctor :   There are over 25 viruses in the herpes family and at least 8 types that infect humans
Doctor :   No u have IgG antibodies and not IgM antibodies
Doctor :   and most antibodies of these groups can crossreact
User :   Ok so what does IgG antibodies present mean?
Doctor :   HSV-1 or HSV-2 IgG antibodies indicate a previous infection
User :   So this would mean I was infected before?
Doctor :   so as per your results , the tests could be refering to the chicken pox infection you had earlier
User :   Im 25 years old I had chicken pox in my early years, so can the antibodies still be present
Doctor :   yes definitely
Doctor :   once infected , you are immune to Chicken pox, and this prevents re infection again and hence people get chicken pox only once in their lifetime
Doctor :   this immunity is provided by the IgG antibodies that u have now
Doctor :   i hope u have followed my advice here
User :   Yes I am going to get a HSV DNA test when I go to the states
User :   Also, what I am about to say may contribute to some of this
Doctor :   so when r u leaving for the US ?
User :   on the 30th
Doctor :   OK
User :   I stubed my big toe on my right foot about 4 months ago, just about two months ago it started falling out the toe nail is dead.
User :   Would this contribute to any infection?
User :   I think my toe may have been infected.
Doctor :   YES
Doctor :   INJURY leads to infection
User :   Do you think it could ahve played a part in the infection I had?
Doctor :   no , both r completely independent
User :   Im not trying to be in denial but I honestly do not think I have that virus, especially with no symtoms until I scratched my pubic hairs.
Doctor :   that is my impression too
Doctor :   u mean u scratched or shaved ?
User :   I had shaved about 3 weeks and my hair was growing back and itching and I scratched it.
Doctor :   ok
Doctor :   hats ok
Doctor :   thats ok i meant
User :   And wouldnt my partner have some kind of infection too then? If this is the case?
Doctor :   not necessarily, since this could be due to a bacterial infection in you
User :   No Im saying if I had HSV?
Doctor :   yes
Doctor :   that could occur
User :   especially since we do oral and genital to genital right?
Doctor :   yes thats right
User :   she has NO symtoms at all of any sort
User :   she just had a pap done and she was fine
Doctor :   thats means that its not HSV in either of u
User :   she had swabs for hsv done and she was fine
Doctor :   have u done the swabs for hsv ?
User :   yeah they took it right off the site
User :   when i scracted it
Doctor :   what were the results of the swab test?
Doctor :   hello
User :   there were no results
User :   hello
Doctor :   and welcome back again
User :   lol
User :   thanks
Doctor :   so u did not get the results of the swab test ?
User :   it said (vesicle base) and one for serum
Doctor :   vesicle base - results ?
User :   yes this is what the paper says
Doctor :   are u there ?
User :   YES
User :   the printout of the results says what I mentioned above
User :   I guess thats what they called swab results I dont know.
Doctor :   no the virology results will come in the form of histology / microscopic appearance
Doctor :   and should mention - as no viruses or bodies seen, if it is normal
Doctor :   the results u mentioned before in the chats are that of serology
User :   Oh ok cause it says Herpes simplex virus type 2 isolated
Doctor :   u mean to say, HSV-2 isolated in the swab culture ?
User :   yes
Doctor :   i would advice u to repeat the test once again in a reputed lab
User :   you want me to tell you exactly what the test said verbatum?
Doctor :   and do the HSV- DNA analysis , later on
Doctor :   you have already mentioned it to me
User :   whats a reputed lab? Just taking the test again in a lab form with serum?
Doctor :   i meant in a good laboratory
User :   lol ok
User :   so what do you interpret this means....HSV 11 IGG......2.96
Doctor :   no that does not seem significant to me
Doctor :   the isolation of hsv-2 in swab culture does seem important
User :   because they are basically saying that I do not have oral but I do have genital herpes right?
Doctor :   yes
User :   Thats weird shouldnt I have both in that case?
Doctor :   not nessarily
User :   Oh so if my partner goes down on me would she get oral HSV?
Doctor :   yes
Doctor :   oral lesions due to hsv-2
User :   and if I go down on her I can contract HSV 1 also right?
Doctor :   no
Doctor :   as she is not infected, she cant give u the infection
User :   so only if I kissed her would I get HSV1 is that what you are saying?
Doctor :   no
Doctor :   none of u have hsv1
Doctor :   u can give hsv 2 to her, which can cause oral or genital lesions depending on the exposure
User :   ok Doc what do you mean by exposure?
Doctor :   exposure meaning by oral or genital sex
User :   we have alot of sex Doc...dont mean to be so blunt sorry
Doctor :   thats fine
Doctor :   oral to genital contact , and genito-genital contact can spread the infection in case one of u r infectious
Doctor :   but the serology reports do not clarify your infectivty status as the igM levels have not been checked
Doctor :   so u just needto do the tests that i mentioned earlier
User :   ok so if I do have HSV11 thats means I got it from a person that went down on me or that had genital to genital sex with??
User :   or can it be both either way?
Doctor :   genital to genital sex could be the way
User :   And my girlfriend would have some type of reactions right now right?
User :   sorry so many questions I just want to get a good understanding
Doctor :   as her tests are negative so far, there is no need to be worried
Doctor :   but the symptoms would begin within the range of 2-4 weeks
Doctor :   after exposure
Doctor :   i hope u have followed my comments here
User :   Yes I have
Doctor :   do u have any other doubts ?
Doctor :   Hello, are u there ?
User :   this is her girlfriend I have a question for you
Doctor :   ok, please proceed
User :   since I have gone down on her serveral times since she has had these bumps and if it is hsv how long would it take for me to show symptoms of it
Doctor :   2-4 weeks, will be the duration within which you will have symptoms of bumps , vesicles, oral ulcers, that are painful
Doctor :   other symptoms like lymph node enlargement, mild fever, etc may also be seen
User :   Well its been about 3weeks and I havent had any symptoms those far
Doctor :   as i have counselled nicholette, that her symptoms do not seem to be due to HSV
Doctor :   and she needs to repeat the tests that i have mentioned to her for confirming the diagnosis
User :   thats understandable I told her that it seems to not be hsv and might be some type of infection possible from shaving
Doctor :   that was my primary diagnosis as well that has been conveyed to her already
Doctor :   most of the results of her tests do not indicate a current infection
Doctor :   and there is no need to panic at all
User :   sometimes I have a odor after my period what could that be from
Doctor :   thats a common symptom that is specific to each person due to release of body odours in the sweat and other secretions
Doctor :   if u find a foul smell, or fishy smell, that could signify a bacterial or protozoal infection
User :   ok whats protozoal infection
Doctor :   trichomoniasis
Doctor :   is a protozoal infection, with fishy smell and watery secretions
User :   well Nicholette wants to know that if she uses the same wash cloth for her whole body but not her face would the infection spread to other parts of the body
Doctor :   it could cause separate lesions due to autoinoculation in case she is truely infected
Doctor :   i mean to say with using same the washcloths on different places of the body
User :   where are you located
Doctor :   INDIA
User :   do you know any good doctors in the new york area
Doctor :   Well there are a lot of good doctors in Manhattan as well as New york medical colleges
Doctor :   you can consult any gynacologists who are board certified
User :   what is the name of the test so we can write it down
Doctor :   or any internists who can help u out
Doctor :   HSV -DNA analysis , the most sensitive
Doctor :   the other is SEROLOGY for HSV 1 & 2 - IgG and IgM
Doctor :   if IgM is positive , it means a recent exposure and infection
Doctor :   Do u have any other doubts ?
User :   lgG is not strong enough to show it but the lgM is
User :   is there another test that starts with a z
Doctor :   No YOU CAN READ THE CHAT TRANSCRIPT, where i have explained the whole disease process and importance of antibodies as well
Doctor :   IgG is a antibody that indicates immune status
Doctor :   it does not mean its not strong or weak
Doctor :   the 2 tests mentioned are good enough to confirm the diagnosis
User :   thanks so much doc for all your help
Doctor :   you are welcome
Doctor :   thanks for consulting me here
Doctor :   take care and merry christmas and a happpy new year
Doctor :   bye for now
User :   same too you
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