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What Causes A Pimple In The Groin Area After Unprotected Intercourse?
Question: I had a vaginal pool std panel done on 6/23/15 after my last boyfriend and every thing came back negative. I started dating a guy in September and we had unprotected sex ( a lot). Around October 20th or so he noticed a pimple on his groin area and a few days later he had a full blown herpes out break. Around the same time I came down with flu like symptoms and he feared that he gave me herpes. He got tested and his results came back negative or inclusive with an IGG of 8.4. and a few months later he retested positive.I will still feeling ill and had lower abdominal pain but no outbreak and visited a med express on 11/1/15 and my IGG came back positive at 35.9 and my swab came back negative. Since then I have had several outbreaks and thought that having HSV1 was suppose to be less severe then HSV2. My question is that I know I was negative from my vaginal pool std panel and haven't been with anyone since that testing and actually wasn't with anyone a few months before the testing until him.I was married and then had one partner before him and they are both negative for anything. How could he be the one that gave it to me but tested negative ? It is all so confusing to me but I want to prove that he was the carrier since he had the outbreak and even tried treating me with an anti viral to try to stop me from getting it. He admitted that he had the outbreak first and had to have been the carrier but I don't seem to understand the medical terminology behind it. Any knowledge on this matter would be greatly appreciated.
Brief Answer:
HSV infection and detection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
HSV transmission can result from contact with persons who have active ulcerative lesions or with persons who have no clinical manifestations of infection but who are
shedding HSV from mucocutaneous surfaces.Asymptomatic seropositive persons shed virus on mucosal surfaces almost as frequently as do those with symptomatic disease.
HSV infection is best confirmed in the laboratory by detection of virus, viral antigen, or viral DNA in scrapings from lesions.The sensitivity of all detection methods depends on the stage of the lesions (with higher sensitivity for vesicular than for ulcerative lesions), on whether the patient has a first or a recurrent episode of the disease (with higher sensitivity in first than in recurrent episodes), and on whether the sample is from an immunosuppressed or an immunocompetent patient (with more antigen or DNA in immunosuppressed patients). But your partner must have undergone serological assay for HSV infection.
Serologic assays [measure antibodies to glycoprotein G of HSV-1 (gG1) and HSV-2 (gG2)] are useful for differentiating uninfected (seronegative) persons from those with past HSV-1 or HSV-2 infection. But seroconversion during primary HSV-1 or HSV-2 infection takes time and there is no reliable IgM method for defining acute
HSV infection .
Hence a person tested during the phase of sero-conversion will test negative as IgG titre will not be adequate for detection.This must have happened with your partner who was initially negative and then turned positive.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
HSV infection and detection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
HSV transmission can result from contact with persons who have active ulcerative lesions or with persons who have no clinical manifestations of infection but who are
shedding HSV from mucocutaneous surfaces.Asymptomatic seropositive persons shed virus on mucosal surfaces almost as frequently as do those with symptomatic disease.
HSV infection is best confirmed in the laboratory by detection of virus, viral antigen, or viral DNA in scrapings from lesions.The sensitivity of all detection methods depends on the stage of the lesions (with higher sensitivity for vesicular than for ulcerative lesions), on whether the patient has a first or a recurrent episode of the disease (with higher sensitivity in first than in recurrent episodes), and on whether the sample is from an immunosuppressed or an immunocompetent patient (with more antigen or DNA in immunosuppressed patients). But your partner must have undergone serological assay for HSV infection.
Serologic assays [measure antibodies to glycoprotein G of HSV-1 (gG1) and HSV-2 (gG2)] are useful for differentiating uninfected (seronegative) persons from those with past HSV-1 or HSV-2 infection. But seroconversion during primary HSV-1 or HSV-2 infection takes time and there is no reliable IgM method for defining acute
HSV infection .
Hence a person tested during the phase of sero-conversion will test negative as IgG titre will not be adequate for detection.This must have happened with your partner who was initially negative and then turned positive.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Raju A.T
My question was how could he have had the virus and been negative when I did not have the virus until after him and mine showed positive (an high at that)within a few weeks of his negative result but he had an outbreak and I did not even have an outbreak at that time, just flu like symptoms and was sick? He said that he did not know that he had had the virus and I don't believe him . Are you saying that we both had a first time outbreak at the same time and how is that possible? It had to have came from one of us and I was tested with a vaginal pool sample which is suppose to be the most accurate months before I date him. I need to know with out a doubt that he indeed infected me and I can not see that anywhere in your answer. I need clarity in why his was negative and mine was positive .
Brief Answer:
HSV infection and detection
Detailed Answer:
Your partner was in 'window period' when his blood sample was collected and hence he can be tested negative i.e. before sero-conversion in spite of having the virus and sheeding HSV from mucocutaneous surfaces .Once the window period is over your partner tested positive (IgG) and you acquired the infection presumably from him as there is no other source stated and you tested positive(IgG of 8.4) after acquiring the infection.
HSV infection cannot come from out of the blue and is highly possible in unprotected ( without condoms )sex.
Herpes simplex viruses (HSV-1, HSV-2; Herpesvirus hominis) produce
a variety of infections including Genital Infections.
While staining of scrapings from vaginal mucosa (vaginal pool)to detect
giant cells or intranuclear inclusions of Herpesvirus infection is a well described
procedure, few clinicians are skilled in this technique, the sensitivity of staining is low (<30% for mucosal swabs).
HSV DNA detection by PCR is the most sensitive laboratory technique for detecting mucosal HSV infections and should be used when available.
You have not mentioned what kind of test you have undergone from vaginal pool for HSV screening.Please upload your and your partner's report serially date-wise if possible.The reports will have mention about the techniques used and their sensitivity and specificity.
That vaginal pool sample is the most accurate method for HSV detection has not been mentioned in any Standard Textbook of Medicine.
HSV infection and detection
Detailed Answer:
Your partner was in 'window period' when his blood sample was collected and hence he can be tested negative i.e. before sero-conversion in spite of having the virus and sheeding HSV from mucocutaneous surfaces .Once the window period is over your partner tested positive (IgG) and you acquired the infection presumably from him as there is no other source stated and you tested positive(IgG of 8.4) after acquiring the infection.
HSV infection cannot come from out of the blue and is highly possible in unprotected ( without condoms )sex.
Herpes simplex viruses (HSV-1, HSV-2; Herpesvirus hominis) produce
a variety of infections including Genital Infections.
While staining of scrapings from vaginal mucosa (vaginal pool)to detect
giant cells or intranuclear inclusions of Herpesvirus infection is a well described
procedure, few clinicians are skilled in this technique, the sensitivity of staining is low (<30% for mucosal swabs).
HSV DNA detection by PCR is the most sensitive laboratory technique for detecting mucosal HSV infections and should be used when available.
You have not mentioned what kind of test you have undergone from vaginal pool for HSV screening.Please upload your and your partner's report serially date-wise if possible.The reports will have mention about the techniques used and their sensitivity and specificity.
That vaginal pool sample is the most accurate method for HSV detection has not been mentioned in any Standard Textbook of Medicine.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
I had a test ran from gen path and it says source : vaginal pool and specimen : thinprep and the sti molecule regular profile came back negative for all 6 stds that were tested and it stated that this test is an in vitro test for the detection of sexually transmitted infections (STIs) In clinical specimens . The test ultilizes amplification of target DNA by the polymerase chain reaction (PCR) based on dual priming oligonucleotide technology and detects STI DNA. I had the test done on the correct date was 6/23/15 and it was all normal. I had not had another partner until him and he had an outbreak late October and his blood test IGG was 8.4 but when I went on 11/1 and had a blood test mine was 35.9 and I was sick with flu like symptoms . if he transmitted it to me why did my IGG react before his is the question and he actually had an outbreak and I only had flu like symptoms and I thought a rash that turned out to be nothing and negative on the swab . I can't upload from my iPhone and hope I described my question better this time . But I'm just confused because I know he was the source and i don't unstand why my IGG reacted so quickly and his didn't and it took his a few months .
Brief Answer:
HSV infection and detection
Detailed Answer:
Seroconversion provides proof of primary infection to HSV-1 or HSV-2 .
Serological tests are more accurate when done 12-16 weeks after exposure.Hence window period may be between 3-4 months. Hence a month variation of sero-conversion might be there between individuals after primary infection. You showed IgG re activity so quickly and his took a few months . Another factor might be administration of antiviral drug (?) and delay in rise of antibody titre.
Current antiviral agents do not prevent the release of small amounts of HSV antigen into the genital mucosa and hence reactivation/shedding may continue in spite of antiviral drug.You however did not mention any details of antiviral therapy to self or partner.
Primary HSV infections (i.e., first infections with either HSV-1 or HSV-2 in which the host lacks HSV antibodies in acute-phase serum) are frequently accompanied by systemic signs and symptoms (which include fever, malaise, myalgias, inability to eat, irritability i.e flu like which may last 3–14 days).You were sick with flu like symptoms.
HSV infection and detection
Detailed Answer:
Seroconversion provides proof of primary infection to HSV-1 or HSV-2 .
Serological tests are more accurate when done 12-16 weeks after exposure.Hence window period may be between 3-4 months. Hence a month variation of sero-conversion might be there between individuals after primary infection. You showed IgG re activity so quickly and his took a few months . Another factor might be administration of antiviral drug (?) and delay in rise of antibody titre.
Current antiviral agents do not prevent the release of small amounts of HSV antigen into the genital mucosa and hence reactivation/shedding may continue in spite of antiviral drug.You however did not mention any details of antiviral therapy to self or partner.
Primary HSV infections (i.e., first infections with either HSV-1 or HSV-2 in which the host lacks HSV antibodies in acute-phase serum) are frequently accompanied by systemic signs and symptoms (which include fever, malaise, myalgias, inability to eat, irritability i.e flu like which may last 3–14 days).You were sick with flu like symptoms.
Above answer was peer-reviewed by :
Dr. Yogesh D
We both were started on antiviral-acyclovir 800mg as soon as he developed his out break. I was on the anti viral about a week before my testing and I am not sure how long he was on is, probably just a few days . So what you are saying is that he could have carried the virus for any amount of time but would not show positive until after an outbreak ? If he would have had a prevoius outbreak and knew that he carried the virus then his IGG would have been positive when he was tested ? I am trying to determine whether or not that he knew he had it and he said that he didn't know but I just feel that he has lied to me and he had an idea that he had it before he dated me. I just want to make sure that he didn't intentionally give me this with him knowing that he carried it . I don't know how to figure that out .
Brief Answer:
HSV infection and detection
Detailed Answer:
Both of you have undergone anti-viral therapy with Acyclovir ( the agent most frequently used for the treatment of HSV infections).
It is difficult to make out the exact date of exposure from the serological assay in an individual.
As I said during the window period a person can shed virus from mucosal surfaces,even he tests negative and infect partners.
If a person has potential exposure say unsafe sexual practice,he should be cautious and can be declared negative for HSV infection only by serological test (if necessary repeat test,if initial test negative) after 4 months following an exposure.
One need to be honest on that.
I hope I have been able to sufficiently clarify the issue.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
HSV infection and detection
Detailed Answer:
Both of you have undergone anti-viral therapy with Acyclovir ( the agent most frequently used for the treatment of HSV infections).
It is difficult to make out the exact date of exposure from the serological assay in an individual.
As I said during the window period a person can shed virus from mucosal surfaces,even he tests negative and infect partners.
If a person has potential exposure say unsafe sexual practice,he should be cautious and can be declared negative for HSV infection only by serological test (if necessary repeat test,if initial test negative) after 4 months following an exposure.
One need to be honest on that.
I hope I have been able to sufficiently clarify the issue.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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