FROM OUR EXPERTS
There is no "typical presentation" of herpes. Some people after exposure will develop outbreaks or recurrences with a vesicular, painful rash. Others never see lesions or rashes. Even others - fall somewhere in between with localized pain coming first, followed by a rash. According to a recent study, some people with genital herpes may find that they have serious neuropathic pain (pain that follows nerve pathways) even if a rash or lesions never appear .
This study looked at 17 patients who complained of generalized chronic pain and had no signs of lesions. The majority of these patients were known to have herpes simplex virus. The researchers came to the conclusion that when some people get infected with the herpes virus, it may actually alter the pain processing mechanism in the central nervous system. Once these patients in the study were given anti-herpetic medication (like Acyclovir), the pain lessened considerably. So ...
Understanding Herpes Testing
The most important fact to know in terms of Herpes testing is that
blood testing with an IgG test is the BEST test for diagnosing the disease.
first see the doctor for a suspicious genital ulcer, your health care provider
may ask a lot of really personal and embarrassing questions. Know
that having an accurate sexual history as well as a description of your
symptoms is very important as your health care provider evaluates you. Be honest.
medical history and physical examination alone can not diagnose herpes.
I've seen a
lot of genital herpes, but it's easy to be fooled. I've had patients who had lesions in unusual
places or didn't have a typical story that I mistook for abscesses - only after
they failed antibiotics did I do the culture and verify that it was
On the other hand, I've seen some very typical appearing ulcers on the genitals
that turned out NOT to be herpes.
To provide some clarification, since so many of you write to me asking about herpes testing , here's a run down of the current available tests. They each have limitations, though I indicate which are the most specific. A doctor will quite often take your history/examine you and then "marry the history/exam findings to the test results" which can mean that even in the face of a negative test result, your medical history and examination might indicate presence of herpes. It's important to realize that false-positives can also occur during testing.
1- Clinical examination - since HSV can present without lesions or the lesions can be confused with other diseases, just diagnosis by examination is not a perfect option.
2- Viral culture requires that lesions be present so the fluid can be taken from the sores and tested. It can be wrong 50% of the time but it is still a viable test because it can differentiate between HSV1 and HSV2.
You should know
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