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STDs (Expert Forum)
Strange Situation
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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Strange Situation
by Dot1997, Jan 25, 2007 12:00AM
Hello Doctor,
I believe that I am a one in a million herpes case. In Jan. 2005, I had unprotected oral and vaginal sex with my ex-bf. 12 days later, I came down with a fever that included chills and vomiting. This fever went away within a few days. Five months later, I just randomly began having horrible vaginal (inside and outside) and anal itching. I also noticed that there was pain in my legs down to my toes in addition to tingling in my vagina and thighs. Never any sores. This irritation has been continous until today.
In addition, sometimes I noticed "flare ups" during my period which included horrible itching and tingling in the vaginal area, and redness on both sides of the labia.
I have since had 4 Herpeselects done for HSV-1 and 2 at 6, 7, 13, and 18 mos. and all have been negative. I have been to numerous gynos who all say they see nothing, and that this is not herpes, two of which worked at STD clinics. Medications for yeast, BV, etc. have not worked.
Now here is the strange part. I asked the last gyno in Aug. to prescribe me some Acyclovir to see if it would work. After using it for about 3 weeks, I feel like I did notice some changes. The itching on the outer labia decreased although the vaginal tingling and inner labia itching remained. I stopped taking it after a month and a half and within 3 weeks, when I came down with a flu, the tingling, pain, and redness in the vagina came back and remained for 2 days, until I popped some Acyclovirs and the symptoms all but went away. I have tried this experiment about 3 or 4 times, taking the meds. for a week, or 5 days, or 2 days, and stopping and each time within 12 hours of cessation of the meds., I get horrible symptoms.
In addition, in December 2006 I had a Western Blot that was negative for both types as well as one from Jan. 9, 2007 that was also negative.
I must tell you that Benadryl cream on the vaginal area as well as oral Benadryl taken three times a day have helped me a lot, but I still get these "outbreaks" while on the Benadryl.
Yesterday, I began having horrible tingling in the legs and today had very bad red pain and itching on my vulva which the Benadryl cream and oral meds. did not seem to work. When I came home, I took one Acyclovir pill and the symptoms seem to have disappeared.
My questions to you are?
1) What do you make of this situation
2) Have you ever seen herpes manifest this way in a chronic manner with no sores?
3) If this is not herpes why is the Acyclovir working?
4) What percentage of people do not seroconvert on blood tests even when they are positive for herpes?
5) What do you believe my next test should be?
6) Can one dose of Acyclovir 400 mg. clear symptoms of an outbreak within a few hours?
7) Does it makes sense that after taking Acyclovir for only a few days or a week at most and ceasing it would have caused me to have an outbreak?
I am just very confused and would like your opinion on this matter. Thanks a lot Doc!
I believe that I am a one in a million herpes case. In Jan. 2005, I had unprotected oral and vaginal sex with my ex-bf. 12 days later, I came down with a fever that included chills and vomiting. This fever went away within a few days. Five months later, I just randomly began having horrible vaginal (inside and outside) and anal itching. I also noticed that there was pain in my legs down to my toes in addition to tingling in my vagina and thighs. Never any sores. This irritation has been continous until today.
In addition, sometimes I noticed "flare ups" during my period which included horrible itching and tingling in the vaginal area, and redness on both sides of the labia.
I have since had 4 Herpeselects done for HSV-1 and 2 at 6, 7, 13, and 18 mos. and all have been negative. I have been to numerous gynos who all say they see nothing, and that this is not herpes, two of which worked at STD clinics. Medications for yeast, BV, etc. have not worked.
Now here is the strange part. I asked the last gyno in Aug. to prescribe me some Acyclovir to see if it would work. After using it for about 3 weeks, I feel like I did notice some changes. The itching on the outer labia decreased although the vaginal tingling and inner labia itching remained. I stopped taking it after a month and a half and within 3 weeks, when I came down with a flu, the tingling, pain, and redness in the vagina came back and remained for 2 days, until I popped some Acyclovirs and the symptoms all but went away. I have tried this experiment about 3 or 4 times, taking the meds. for a week, or 5 days, or 2 days, and stopping and each time within 12 hours of cessation of the meds., I get horrible symptoms.
In addition, in December 2006 I had a Western Blot that was negative for both types as well as one from Jan. 9, 2007 that was also negative.
I must tell you that Benadryl cream on the vaginal area as well as oral Benadryl taken three times a day have helped me a lot, but I still get these "outbreaks" while on the Benadryl.
Yesterday, I began having horrible tingling in the legs and today had very bad red pain and itching on my vulva which the Benadryl cream and oral meds. did not seem to work. When I came home, I took one Acyclovir pill and the symptoms seem to have disappeared.
My questions to you are?
1) What do you make of this situation
2) Have you ever seen herpes manifest this way in a chronic manner with no sores?
3) If this is not herpes why is the Acyclovir working?
4) What percentage of people do not seroconvert on blood tests even when they are positive for herpes?
5) What do you believe my next test should be?
6) Can one dose of Acyclovir 400 mg. clear symptoms of an outbreak within a few hours?
7) Does it makes sense that after taking Acyclovir for only a few days or a week at most and ceasing it would have caused me to have an outbreak?
I am just very confused and would like your opinion on this matter. Thanks a lot Doc!
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 25, 2007 12:00AM
, Jan 25, 2007 12:00AM
I'll go straight to your questions.
1) You don't have herpes, regardless of the apparent influence of acyclovir on your symptoms.
2) No, I have never seen herpes behave this way. Despite what you seem to have come to believe from reading the web or other sources, your symptoms really are not suggestive of herpes anyway.
3, 6, 7) I don't know whether it's all placebo effect or simply coincidence. In any case, acyclovir cannot start to improve HSV symptoms within hours, and stopping it cannot result in reappearance of symptoms within 12 hours; simply impossible. And there is no "rebound" after acyclovir or other anti-herpetic drugs, i.e. stopping treatment does not trigger outbreaks.
4) Almost nobody with HSV remains negative on both WB and HerpeSelect. I have never seen or heard of such a case.
5) Follow up with your own provider about other causes of your symptoms; or if uncertain about your own provider's expertise, ask for referral to a specialist for consulation--e.g., an ObG infectious diseases expert.
Bottom line: Genital herpes is not the explanation.
Best wishes-- HHH, MD
1) You don't have herpes, regardless of the apparent influence of acyclovir on your symptoms.
2) No, I have never seen herpes behave this way. Despite what you seem to have come to believe from reading the web or other sources, your symptoms really are not suggestive of herpes anyway.
3, 6, 7) I don't know whether it's all placebo effect or simply coincidence. In any case, acyclovir cannot start to improve HSV symptoms within hours, and stopping it cannot result in reappearance of symptoms within 12 hours; simply impossible. And there is no "rebound" after acyclovir or other anti-herpetic drugs, i.e. stopping treatment does not trigger outbreaks.
4) Almost nobody with HSV remains negative on both WB and HerpeSelect. I have never seen or heard of such a case.
5) Follow up with your own provider about other causes of your symptoms; or if uncertain about your own provider's expertise, ask for referral to a specialist for consulation--e.g., an ObG infectious diseases expert.
Bottom line: Genital herpes is not the explanation.
Best wishes-- HHH, MD
Member Comments (2)
by Lunker1, Jan 25, 2007 12:00AM
To: Dot1997
Please give us an update if you learn anything about your condition. I am having similar symptoms, especially the leg pains, redness and tingling (except male and tested positive for hsv1).
