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Positive swab but being told I’m negative


CbenZ

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Quite an interesting title I’m sure, hopefully this will stir other’s a bit as it has myself. I’m very early into all this so I know time should soon answer the things I’m looking to know. On May 5th, I engaged in rough unprotected sex , and didn’t shower for approximately 12 hours afterward(Gross i know, it was a first), I experienced typical soreness from such an act and didn’t think anything further (or bother to examine my penis). On May 8th, I went to use the restroom during work and noticed a very small, slightly raised, whitish clear bump on the upper part of my shaft. High up enough to where I usually wouldn’t think of it as a follicle issue, but still prodded it hoping it was an ingrown hair. To my demise, all that came out seemed to be just a slight bit of clear fluid. Obviously left to fear the worst, I went to the nearest walk in clinic the next morning to have myself tested. To this point today and when asked by the doctor, I have presented no other symptoms of HSV. No headache, fever, itch, burn, stomach ache, nothing. The doctor and assistant felt inclined to tell me that including the fact I didn’t have symptoms, this one small wound didn’t resemble herpes and especially for first time OB. The wound had slightly scabbed over, and wasn’t realeasing fluid, so the doctor prodded me pretty hard with a needle to retrieve anything. Took the scab, hardly any fluid and some blood from the wound. May 13th, I received the call that the culture tested positive for HSV-1. Typing confirmed by monoclonal antibody microscopic immunofluorescence. I called the doctor who worked with me that day and she said that given the small localized wound and no symptoms, she really wasn’t expecting that result. Nonetheless, I hung up the phone in dismay. I decided to call a physician I know through a source I won’t name, that’s been involved in the medical field for over 24 years and has a long line of expertise dealing with STD’s . Upon arriving to his office, he settled me a lot about the stigma involved and expressed how lucky I am it’s only GHSV-1 and not HIV or another ailment. At the end of the conversation he asked me if the wound was still present and I said yes, it’s still healing considering the walk in probed me with a needle to culture it a few days prior, so I showed him, and his facial expression immediately changed to confused. “That’s not herpes.” He immediately shuffled to a book and was mumbling medical terms describing why the wound I had wasn’t the same as a herpes sore. “Look at these diagrams, do those look alike to you?” They didn’t. “In 24 years of dealing with STD’s, I have never once in my career diagnosed a case of herpes with one single wound that looks like that, with no symptoms. We will take blood tests for the next few months that I bet will come back negative and you will never have another OB”. He didn’t care about the culture swab result. He said anything could happen to produce an incorrect result, contamination, etc. Whatever the case may be I’m currently left in a “herpetic limbo” and don’t really know what to think until time passes and things become more clear. Today I examined the wound and was able to remove a tiny hair that I didn’t realize was there prior to all of this, just to add more confusion. In the mean time I’m left with these questions. 

1. Could the culture since being induced with blood actually be indicating an oral infection of HSV-1? Is something like this even possible? I can’t even remember if I had cold sores as a kid but I’m sure the blood result will answer that question for me shortly being if it’s positive it’ll mean I’ve had it for awhile.

2. If this wound disappears, I never have any recurring OB or symptom of HSV, and any blood test I take from this point forward come back negative, would you consider it morally ethical to not disclose with partners? I’m going to make my own decision here but I want an opinion. If I’m told by an expert I don’t have herpes and all further testing backs this theory, it’s a hard conclusion to come to. 

(I will be adding a photo when I learn how to condense to the very small size requirement for this forum)

 

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Did you receive a lot of oral sex during the episode?

Swabs are definitive. Only a lab mix up could result in this not being a herpes infection for you. What you describe is actually the more typical presentation of a herpes infection. Symptoms beyond lesion patches are actually on the rarer side.

For now, you need to assume that you have genital HSV-1.

Are you getting an IgG HSV test performed right now? 

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23 minutes ago, WilsoInAus said:

Did you receive a lot of oral sex during the episode?

Swabs are definitive. Only a lab mix up could result in this not being a herpes infection for you. What you describe is actually the more typical presentation of a herpes infection. Symptoms beyond lesion patches are actually on the rarer side.

For now, you need to assume that you have genital HSV-1.

Are you getting an IgG HSV test performed right now? 

Brief oral sex was preformed . Swabs are definitive given there isn’t contamination or clumsy mis-handling of tubes/etc. also I believe to consider something defintive would be synonymous with 100% , which what I’ve read so far is that no test is 100%. Although I get what your saying, the swab is considered the “gold standard” for this instance. I intend on treating myself as HSV-1+ and handling it accordingly until I feel throughly proven wrong about the results. I am waiting on IGG results now and should have them by end of week. Would also be interested if you have any insight on my first question as well. 

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A culture swab looks for the virus itself, so the presence of blood (which carries only antibodies and not the virus) is not relevant. With a PCR test, cross contamination in the sense of someone scratching their lip and rubbing the area swabbed can produce a positive PCR result as it is so, so sensitive. However cultures need a decent amount of viable virus that tends to only from from active nerve endings at the site of swab.

Just jumping ahead to the possible IgG results:

  • If negative for HSV-1, this likely means the infection is very recent and then you'll test again in 12 weeks and it will likely be positive. If it is still negative in 12 weeks then yes it is time to examine possibilities. Not sure it will come to that.
  • If strongly positive for HSV-1, this will throw a spanner! I'd suggest that the better interpretation would be that the genital HSV-1 infection could be old and the rough sex triggered an outbreak (hence the reason why it's such as small indistinguishable lesion).

Let's work off the actual result though.

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52 minutes ago, WilsoInAus said:

A culture swab looks for the virus itself, so the presence of blood (which carries only antibodies and not the virus) is not relevant. With a PCR test, cross contamination in the sense of someone scratching their lip and rubbing the area swabbed can produce a positive PCR result as it is so, so sensitive. However cultures need a decent amount of viable virus that tends to only from from active nerve endings at the site of swab.

Just jumping ahead to the possible IgG results:

  • If negative for HSV-1, this likely means the infection is very recent and then you'll test again in 12 weeks and it will likely be positive. If it is still negative in 12 weeks then yes it is time to examine possibilities. Not sure it will come to that.
  • If strongly positive for HSV-1, this will throw a spanner! I'd suggest that the better interpretation would be that the genital HSV-1 infection could be old and the rough sex triggered an outbreak (hence the reason why it's such as small indistinguishable lesion).

Let's work off the actual result though.

Fair enough, I will be certain to update once I receive the results of the first IgG and so forth. My opinion regardless of being + or - is that the first IgG will probably come back negative, I can assume your predications are the same. If anything you and I probably agree the thoughts are , I have it, it was received recently/upon the one noticeable symptom, and the later IgG will determine that to be the case. The only thing that shook me off course of this prediction was the original doctors opinion, and the medical professionals persistent opinion that it just can’t be herpes. Otherwise I’d be moot and done with the whole thing. I guess on the note of those opinions I can ask 2 open ended questions to yourself and anyone reading,

1. Have you to this day ever heard of a HSV culture sample being contaminated? 

2. Have you to this day ever heard of a HSV culture being switched or mis properly labeled? 

Ive done heaps of research on false positives on an HSV culture before posting this article, and have only come across two cases. One had a sort of herpes zoster, and the other had a skin condition, I believe it was lichen planus? They both claimed there were false positive cultures. 

Anyway, I do appreciate your input so far! 

 

 

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