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Have had HSV. Took anti fungal medication for yeast infection. Chances of herpes?

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I have had HSV 1 since I was a little girl. I am always very careful when I have a cold sore. My boyfriend and I have been in a monagomous relationship for 2 years. We have had unprotected intercourse, including oral and anal. Recently I had a yeast infection. During that time we did not have sex. I completed 2 courses of antifungal medication and thought that my yeast infection was gone. Since then we have had unprotected sex. Recently he has had a burning sensation when he urinates, he felt sick and achey and he said he had sores on his penis (I did not see them). He went to the walk-in clinic (he does not have medical ins). The Doctor looked at him and told him that he has HSV 2 and a yeast infection. She did not do a blood test or take a culture. I went to the Doctor today and she ordered a blood test. After talking to my Doctor, I feel as though he may have been misdiagnosed. Could a yeast infection be misdiagnosed as herpes? Why didn't she order any tests for him? Please help me.
Posted Wed, 6 Mar 2013 in Sexually Transmitted Diseases
Answered by Dr. Timothy Raichle 21 minutes later
Hello, I would be happy to help you with your question.

Here are some facts:
1. HSV1 is typically oral and HSV2 is typically genital
2. HSV1 and HSV2 can both be found in oral and genital locations
3. Oral HSV1 can be transmitted to the genitals and vice versa
4. The typical symptoms related to a 'primary' genital herpes infection is a flu-like illness followed by an outbreak of genital sores
5. You can have shedding of the HSV1 virus even when you do NOT have a sore

So from what you are telling me, it sounds like your boyfriend has genital herpes. You can NOT tell which strain of the virus is present just by lookin at the sores. This would require cultures or blood tests.

With regard to the yeast infection issue, this is NOT an STD. It is not considered to be transmissable through sexual contact. In other words, if a patient had a yeast infection and had sex, we do not recommend treatment of the partner. That does not mean that he does not have a yeast infection too, but it is almost like a separate issue. I hope this is not confusing so far!

So what to do...
1. If it is too late for a culture of his penis, then I guess you could simply assume what I have explained as truth. If he has recurrences, then they should be much more mild, and he can take valtrex when he feels the onset of symptoms
2. If there is any concern that he got this from someone else, then you (and he) need full STD testing.

I hope that this helps and good luck!

I hope that this helps. Please ask if you have additional questions.
Above answer was peer-reviewed by
Follow-up: Have had HSV. Took anti fungal medication for yeast infection. Chances of herpes? 20 hours later
I would like to know if it is possible to misdiagnose herpes? Could his yeast infection been misdiagnosed as herpes? If he had a sore, why would a Doctor not do a blood test or take a culture? I have read that without any test, a physical exam may lead to a misdiagnosis. How common is this?
Answered by Dr. Timothy Raichle 55 minutes later
I have personally seen what I thought was herpes where the cultures were negative. In that case, I still believe that they had herpes, but we did have to question the diagnosis. Maybe it was actually something else.

So in answer to your question, yes it is possible to misdiagnose herpes. In women, there is a small list of infections that can cause breakdown and ulceration of the skin, including yeast infections.

I am not sure why the doctor did not take a culture. It would have made sense to get a culture and start him on an anti-viral while he waited for the culture results.

But, if it acts like herpes and looks like herpes, then it is probably herpes. It would not be wrong to make this assumption and then spend time sorting out the truth. One way to do this would be for him to have bloodwork to look for antibodies to the herpes virus. It is possible that less was done because of his lack of insurance and the cost of these tests.

I hope that this helps. Please ask if you have followup questions.
Above answer was peer-reviewed by
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