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Can CLIA Method Help In The Diagnosis Of Herpes Infection?

Posted on Mon, 6 Jul 2015

Question: HELLO DOCTOR, i got infection in my genital area first in last month.so i did self trating with applecide vinegar and lemon juice.but it cant control infection.then i troed fucidin cream it wont helpe me.and then half of that month i shown this problem to UROLOGIST.he gave me BETAMETHASONE CREAM. i used it and infection healed in 5 days.(but skin is not ready like before).after ishow this infection picture to DERMATOLOGIST ,so he doubt me it is human herpes. and suggest me to do HSV1&2 TEST(elisa,igg and igm.) but i did CLIA TEST method. is this fine doctor?

Answered by Dr. Charu Bansal (43 minutes later)

Brief Answer:
kindly attach images

Detailed Answer:
Hello. Welcome to Healthcaremagic.com.
I have read your query.
I have seen the attached reports also.
I understand your concern.
You have attached igG reports but not IgM report. IgM signifies present infection while IgG can be positive in past Infection also. Although in your case even IgG is negative.
There is no problem with CLIA method also.
Its just that the sensitivity of ELISA is higher.
So herpes infection is unlikely to be there.
I would like to know following details-
1) is there any rash or discharge genital area?
2) is it itchy?

Kindly upload the images of the area so that I can visualize the lesion and help to my best.
Kindly describe the rash also that was peesent in the starting.
Get back to me with the answers to my question and uploaded images.
Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Charu Bansal (12 hours later)

I have uncomfortable with testicles, no ithing i feel

Answered by Dr. Charu Bansal (5 hours later)

Brief Answer:
kindly upload images

Detailed Answer:
I have already seen your IgG reports as I said but I want to know about igM levels.
It is IgM.levels that have some relevance . At present IgG levels are of no use. As I mentioned , even IgG is negative.
As per details, it can be fungal infection or viral infection of genitalia.
Usually when someone applies betamethasone, fungal infection settles down in few days but only to reappear again in worse condition.
In such cases, I advice my patients to apply topical cream containing clotrimazole and tablet fluconazole.
It would have been better if you could attach photographs of affected area and upload your IgM report.
You can share my opinion with your treating doctor.
I hope it helps.
Stay healthy.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Charu Bansal (51 minutes later)

So doctor i have to do test again in which method? And here ill upload pic

Answered by Dr. Charu Bansal (1 hour later)

Brief Answer:
fungal infection is most likely possibility

Detailed Answer:
Hello. Welcome back.
I have seen the attached photograph.
It seems that you are having fungal infection of skin involving the genitalia.
In this condition, betamethasone is contraindicated. As I told it only relieves temporary and worsen it .
In my such patients, I prefer to advise oral fluconazole weekly doses. Also topical antifungals like clotrimazole cream/miconazole cream helps.
Keep the area clean and dry.
It doesn't look like herpes. Still if you want to be sure, you may go for igM for HSV 1 and 2 by XXXXXXX or CLIA method.
Your doctor may order KOH test to look for fungal elements.
You can discuss this with your doctor.
You need to get prescription to buy these medication. So visit your doctor in person and share my opinion with him.
I hope it helps.
Take care.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Charu Bansal (1 hour later)

doctor this is my current situation and also ill upload one more pic when this start,when it start i not give treatment for 20days

Answered by Dr. Charu Bansal (2 hours later)

Brief Answer:
fungal infection

Detailed Answer:
Hello.
Your current photograph indicates that it is fungal infection of skin involving the genitala.
AS I discussed you need to start oral and topical antifungals.
You may put the pic when it started. It would infact help us to better understand the disease.
THANKS

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Charu Bansal (2 days later)

Hello doctor I shown this to dermetologist here,he also said me this is fungal infection. So do i need to go for any test??

Answered by Dr. Charu Bansal (8 minutes later)

Brief Answer:
no more tests are required

Detailed Answer:
Hello. Welcome back.
If its diagnosed as fungal infection finally
by your Dermatologist also then you need not to go for any test.
You should start antifungals like clotrimazole cream and tablet fluconazole as we discussed last time.
You must have got prescription from your doctor.
If you have any further query, you may ask me.
Stay healthy.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad