HSV1, HSV2, or neither?

[Megan50]

Hi everyone! New to HC. Glad you all are here. :)

My story:

I acquired GHSV 1 at the age of eighteen. Classic symptoms within 3 days, 3 blisters on left side of vulva. Fever, swollen lymph nodes, body aches. 

 

Had 2 more out breaks after that I know of: both very, very mild. 1 blister in same location as original OB. Went away in 3-4 days. 1st recurrence was 3 mo after original OB; 2nd recurrence was ~10-12 years later. 

Both had classic prodrome itching prior. 

 

Divorced two years ago and recently dated someone who disclosed they were GHSV2+. 

We used condoms throughout. I never had symptoms of any OB. 

 

We broke up January 20. 

 

I began a new relationship a couple of months later and he asked if we could have sex without condoms. I said we would both need to go for STD screening. He obliged. 

 

The day after I went to my doctor for screening (may 8), I developed a sensitive patch on my butt (on right side above my sit bone). It did not itch at all (all of my OB’s have begun with prodromal itching) and never itched. I checked the next day —4 little red bumps (in an area where my skin is already “bumpy”) on my right sit bone area. Bumps went away in 4-5 days, but the skin there remained sensitive. I also had pains in the groin and down the right leg for the next week or so. 

The area never felt quite right. Seemed like a yeast infection was going on, too...so treated that.  Another single red spot popped back up right at the hair follicle 2 weeks later. (In fact —the original bumps seemed to all be at the base of hair follicles. 

 

The original bumps appeared 2 days following a 5 mile run which was directly followed by an 18 mile bike ride (trying to prep a duatholon) I could tell the bike seat was chafing the exact area where the bumps ultimately appeared. I frequently bruise there early in bike season. I also had bruising there this time. 

 

I am currently dealing with perimenopausal as well (age 47)

 

My worries:

1)Is this a GHSV1 recurrence (worst one yet) in a NEW location with NEW prodrome?

2. Could this be GHSV2 acquired from former partner (last sexual encounter 4 mo ago)?
3. Could I have acquired this from new guy who was wearing a condom — last encounter prior to symptoms 24 days prior?

My recent test results:

GHSV2 igg negative (>4 mo past exposure to GHSV2+ partner; 1 mo past exposure to new partner—status unknown, but few partners in his life)

 

HSV1&2 igm combo equivocal

 

Please help! 

 

 

[Megan50]

Added picture

[WilsoInAus]

Hey @Megan50 welcome and thank you for the questions. Hopefully you'll find a lot of help and support from the website.

I can't help a lot with the picture, but it doesn't overly scream an HSV 1/2 outbreak.

I'll answer the questions as best I can though.

1. In short, yes the lesion patch on your butt might be related to your genital HSV-1, however there are plenty of other things it could be too from staph to irritation to a range of dermatitis issues. A swab may help you determine what's giving rise to the issues.

2. No, your testing is conclusive that you did not acquire HSV-2 from the previous partner of some months back. There is little reason to doubt the test result and you had no genital lesions during your time with him.

3. This is not feasible, a very theoretical possibility only. Upon an initial infection, to the extent that an outbreak occurs, it will commence with the actual infected nerve endings and may expand outwards from there. An initial HSV infection will typically show up in a discrete location away from the initial infection site within a 24 day period.

You can disregard the IgM test. As you have HSV-1, all IgM testing is meaningless and may be positive (as a result of your HSV-1 infection) or negative.

[Megan50]

@WilsoInAus 

Thank you so much for your thoughtful and thorough response! 

Just to clarify on 3... I was past the window for an initial outbreak at 24 days, yes? And, based on that, if these little bumps are, in fact HSV, they are probably related to my GHSV1? 

 

[WilsoInAus]

Yes perfect clarification. It is unlikely you were infected recently with HSV-2 owing to no outbreak at a feasible site of entry. Further, it would be highly, highly unlikely that the HSV-2 virus would travel through your nerves to result in an outbreak on your butt where you describe in 24 days.

Exactly as you put it, if this is a HSV 1/2 lesion patch (an open question of itself) then it is almost certainly HSV-1.

Edited May 28, 2018 by WilsoInAus

[Megan50]

@WilsoInAus

Thank you!!!