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Dr. Andrew Rynne

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Suggest ways to rule out herpes

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Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2770 Questions

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Posted on Sun, 12 Mar 2017 in Sexually Transmitted Diseases
Question: After really rough sex with my long term boyfriend of almost a year, a few days later I began having yellow discharge and then i felt pain inside my vagina. I went to go see a nurse who examined me and told me i was torn inside my vagina. she said it was filled with pus that was leaking out of the tear and infected with bacteria. she took a swab of the tear to rule out herpes and did some other tests (I tested position chlamydia which I probably had for years and didn't know), also i had blood work done. for precaution, she gave me antivirals and antibiotics because we didnt know what caused the problem, so she just told me to take both medicines for precaution. the blood work that was done was for hsv-1 and hsv-2 igG. the hsv-2 was negative and hsv-1 was positive. the swab also showed hsv-1. I used to get frequent cold sores a long time ago, almost one cold sore every few weeks, but after time it stopped and has never happened again in years. I'm wondering if that's why these tests were positive. it's been a month now and everything eventually healed. just want to understand the cause of the tear because it happened after really rough sex. is it possible that my previous cold sore infections are the reason these tests are positive? im very frustrated because I don't understand what's going on. thanks for your help, I appreciate it so much.since the culture report isolated hsv-1, does that mean the virus is at the site the sample was taken? or it was just detecting that the virus / antibody was in my body? I appreciate your time.
doctor
Answered by Dr. S. Murugan 21 hours later
Brief Answer:
Get examined by an expert and get well soon.

Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.

First of all, Get examined by a experienced Physician, not by nurse.
Vaginal tear could have happened with rough sex rarely.
HSV is a virus and not a pus forming organism. HSV 1 is the cause for cold sore. So your HSV 1 IgG came positive. Presence of IgG indicates an old infection and not a recent infection. HSV 1 is essentially a non-sexually transmitted infection whereas HSV 2 is a sexually transmitted infection. In any population 40-50% of people will show positive for HIV 1 infection.
Chlamydia is also not responsible for either pus formation or secondary infection.
You should have undergone culture and sensitivity for common and non specific organisms and should have recieved treatment with appropriate antibiotics..
Once again I recommend you to consult an experienced Gynecologist or a infectious disease specialist or a sexually transmitted infection specialist and get examined. He/she will examine you and find out the cause for your problem and ascertain whether the tear healed completely or not. Then you can resume your sexual activity.
Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. S. Murugan 19 hours later
i have set up an appointment to see a gynecologist tomorrow to understand more. since the culture report isolated hsv-1, does that mean the virus is at the site the sample was taken? or it was just detecting that the virus / antibody was in my body? and not necessarily at that exact place? I appreciate your help
doctor
Answered by Dr. S. Murugan 3 hours later
Brief Answer:
Isolation of HSV 1 virus from vagina is unusual

Detailed Answer:
Hi,
Welcome back.
Isolation of organism from culture means the virus not the antibodies. But the culture of virus is not done routinely in all the hospitals on laboratories. The culture specimen was taken from where? Isolation of HSV 1from vagina is not common
Dr S. Murugan
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. S. Murugan 7 hours later
hello, thanks for the reply. I have attached my lab reports to this thread. The swab was taken from the tear. but I was told it a possible that precious oral outbreaks can be detected through secretions from many locations tthroughout the body, making it positive. thanks for your help.*previous oral outbreaks. just wondering if it's possible that the swab was positive because the virus was already in my body from previous hsv-1 oral outbreaks. thanks for the help, I really appreciate it
doctor
Answered by Dr. S. Murugan 7 hours later
Brief Answer:
Possibility of HSV isolation when there was a prior genital infection

Detailed Answer:
Hi,
Welcome back.
As per your report, it is true that HSV 1 was isolated from culture specimen from (site not mentioned) the specimen.
HSV 1 can rarely be present in genitals and even can have manifestations over genitals especially following some sort of oral sex. Viral shedding also can occur in these instance without any manifestation.

But isolation of virus from genital discharge of a woman who had history of only oral manifestations (no previous genital infection) is unheard. It is not true that HIV virus present in all secretions unless the individual is an immunocompromised and having a wide spread viremia inside the body. Virus are present usually in the posterior nerve ganglion of a sensory nerve and discharged periodically along the nerve endings during recurrences.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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