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jfoster12

False negatives: how long until HSV shows up on IgM?

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jfoster12

(cold sore scenario)

Hey guys,

I searched and didn't quite see an answer to my exact position. I developed something that resembled a cold sore 2 days after having sex with someone I don't know vey well. I was snow skiing all day in bright sun and my lips always tend to burn on the border between the lip and face. This time it felt very different on one spot, and a red bump about the size of a pencil eraser appeared and got worse over the next 48 hours. Some white marks also present, but not those classic vesicles. It hasn't changed much since (I am now 7 days out from when it appeared). I know my body and this was/is a very unique event. Researching online, all symptoms pointed to HSV infection. When I told my doc (especially about what appeared to me a very obvious sun trigger) he confirmed the same suspicion: HSV. He wanted to leave it there but I insisted on blood work.

So 4 days after commencement of cold sore (6 days after possible exposer) we did a swab, IgG, and IgM test. Unfortunately this worthless lab report doesn't give you the exact result number, but IgG and IgM was in the (0.00<0.91 ) negative range, and the swab doesn't isolate the virus either. He told me he was surprised by the result's, but I had nothing to worry about, as the IgM would have shown a recent affection. That said, I'm not sure I properly communicated how recent the incident was (only 6 days prior to testing).

So here's my question: Exactly how quickly should IgM show up on a blood test? It's supposed to be quick, is it (6 days post exposure/ 4 days post symptoms) quick? I understand the swab would have probably been the most accurate this early in the game, but 4 days out, it may have been healing and a false negative as well. Another way to look at my question: my symptoms occurred less than 48 hours after this possible exposure, with no flue like symptoms. Is it possible for primary outbreak to happen that quickly?

I know this was all done extremely early in the process and the best advice is probably to give it some more time and order a new blood test, but I have a trip abroad in a couple days with a long distance (non exclusive) gf and I really want to know how much I need to address this with her, how confident (at all?) should I be in the now negative diagnosis. I just worry about protecting her.

Thanks!

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VVK

IgM antibodies typically show up within a couple of weeks and disappear after 2-3 months. 6 days post exposure may be a bit too soon to see them.

You could have been having an outbreak, but it sounds very unlikely based on the description. Sounds like lip trauma to me.

Have you asked your 'long distance' girlfriend whether or not she ever had cold sores?

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JBnATL

Don't trust IgM blood tests. Most experts say these tests are highly inaccurate.

It is possible to get symptoms withing hours of having contact with this virus.

Tell your travel companion about your concerns and let her decide how to proceed. If you just contracted this virus you are most contagious, but there is a great chance she already has this virus. 90% of all adults have hsv1 oral.

Good luck!

JB

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jfoster12

Thanks guys.

I have not asked her about cold sore history, but I will.

Quick update: I gently squeezed it (I know I'm not supposed to do that) and some very obvious, white puss came out. White as in the color that comes out of a zit, not yellowish. But this sure doesn't seem like a zit.

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WilsoInAus

But it is almost certainly bacterial and not herpes.

If you had just been infected with HSV-1 then more than likely you'd have a lot more than a single ambiguous sore.

If this is herpes though and you're from a subset of 1 in 10 people that do not test positive for HSV-1 despite having it, then you'd have had this virus since childhood.

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jfoster12

All,

An update. I know the only thing to know for sure is to have some blood tests done after more tests have passed, but this is what this forum is for, right?

So I have had further symptoms. 3 weeks after the bump on my lip formed (which has reduced greatly in size but still discolored), I have several red areas around the mouth. They show no signs of vesticles, just a red tender area about the size of a dime. Maybe they are a little more tender the first few days I notice them. All in all, I have 3 of them in various areas, each about a centimeter away from the lips- not touching lips at all. Anyone have anything like this for first outbreak? They don't seem to get better, they don't seem to get worse. They just stay there. Would this point more to HSV or bacterial infection?

Thanks all.

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jfoster12
It doesn't really point to either. Do you use any products on your face?

I mean, I use a pretty generic face soap but have used that for years. I haven't really changed anything much in what I do.

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jfoster12

Maybe it's just easier to share a pic. Attached is a pic of the thing on my lip when it was at it's worst, as well as one of the read areas below. Lip thing has mostly gone away, red areas seem to be increasing, but not showing vesticules. As for the classic lip bump right on that border, can that really be anything other than HSV 1 or 2? It didn't swab positive but we all know those are prone for false negatives.

http://tinypic.com/r/2cse3ci/8

8

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VVK
As for the classic lip bump right on that border, can that really be anything other than HSV 1 or 2? It didn't swab positive but we all know those are prone for false negatives.

It could be something else, even though it does look a lot like a cold sore. I'm thinking though that this is partially due to your squeezing and traumatizing the area. No idea about the smaller red spot..

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Guest

To share my personal experience, I actually had a similar sore recently. Basically in the same exact spot too. The difference for me was it wasn't fully on the actual lip as yours is and wasn't as big, but nonetheless very similar, even the head of the sore looks similar to what I had.

Mine didn't feel like a pimple either because it was extremely tender and liquid came out when squeezed which hurt when squeezed as well. More pain than when I would squeeze a pimple. However, mine even when manipulated which cause it to swell, faded almost completely within 3 days. It looked and acted like a cold sore (dried and flaked off) but it went away rather quickly. I personally have experienced lesions like this the past year since my genital/oral exposure to someone HSV1 positive. I've swabbed similar lesions and there always negative. Every one. Although I didn't swab this last one because I assumed the result wouldn't change. Maybe a mistake on my end but it gets tiring seeing doctors every time something like this sprouts up.

If it gives you any solace, I get very similar lesions in similar spots on lip line yet my IGG tests for herpes are negative and always have been negative over a year post exposure. So I don't know what these things are, but maybe not herpes?

However, WilsoInAus states some people will fall in the 1 of 10 category that truly has herpes but may never test positive, so maybe I fall in this category and yourself.

Bottom line, negative tests is a good thing. Does it "look" like a cold sore? Yes. Did mine? A friend said yes, but negative tests are negative tests. It's the best we got man.

Stay positive!

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jfoster12
To share my personal experience, I actually had a similar sore recently. Basically in the same exact spot too. The difference for me was it wasn't fully on the actual lip as yours is and wasn't as big, but nonetheless very similar, even the head of the sore looks similar to what I had.

Mine didn't feel like a pimple either because it was extremely tender and liquid came out when squeezed which hurt when squeezed as well. More pain than when I would squeeze a pimple. However, mine even when manipulated which cause it to swell, faded almost completely within 3 days. It looked and acted like a cold sore (dried and flaked off) but it went away rather quickly. I personally have experienced lesions like this the past year since my genital/oral exposure to someone HSV1 positive. I've swabbed similar lesions and there always negative. Every one. Although I didn't swab this last one because I assumed the result wouldn't change. Maybe a mistake on my end but it gets tiring seeing doctors every time something like this sprouts up.

If it gives you any solace, I get very similar lesions in similar spots on lip line yet my IGG tests for herpes are negative and always have been negative over a year post exposure. So I don't know what these things are, but maybe not herpes?

However, WilsoInAus states some people will fall in the 1 of 10 category that truly has herpes but may never test positive, so maybe I fall in this category and yourself.

Bottom line, negative tests is a good thing. Does it "look" like a cold sore? Yes. Did mine? A friend said yes, but negative tests are negative tests. It's the best we got man.

Stay positive!

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jfoster12

Thanks for the responses guys! I'm still preparing for what I feel is a HSV diagnosis at some point, but you are right a negative test for now is good.

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    • viralfrog
      I'm 99% confident that these are caused by Herpes. This is what they looked like when I first caught the virus, and in the same spots as well, although now much milder and smaller in size.  I have tested positive via swab when I first got the virus, and two times via blood test. However, since several people here are doubting my symptoms are caused by HSV, I might do another swab just to be sure. It's still good to rule anything else out beforehand. 
    • Nicki0605
      And btw  @ayekayelle I’m sorry you’re considering divorce. I hope you are able to work it out with him. But if you’re not happy I think it’s worth taking the risk of leaving! You deserve to be happy!
    • Nicki0605
      Ikr! I’ll have guys be like “oh yeah you’re right, you’re not gross or less valuable but it is a deal breaker” I don’t really blame them (because I am still coming to terms with it being “not a big deal”) 
    • G77
    • Quest
      It's very possible he or you were mostly a carrier. Neither one of you have to have sores all you have to do is shed.
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