Confused About Diagnosis

Question

Asked by Confused12

Confused About Diagnosis

Background: My husband and I have been together for 3+ years, and have been entirely monogomous throughout this time. When we first started dating, we both went in for STI screening, and were given clean bills of health (though I don't believe we had IgG tests, and we both suffer from HSV-1 - cold sores on mouth for him, and nasal mucosa for me). Neither of us has had an outbreak of genital herpes EVER. Approximately three weeks ago, I was diagnosed with shingles, but did not know they were shingles (assumed they were bug bites on my abdomen and back from being at the beach) for approximately 3-5 days - during which time I was being stupid and scratching at them. I was diagnosed and given a 10 day course of Valtrex that I stopped taking on Sept. 15th. The shingles are pretty much healed at this point, with just red areas remaining.

On Tuesday, I woke up with an slightly uncomfortable itching sensation in my vulvar region. I looked, and my labia seemed red and irritated and I saw a good deal of discharge. I've had pretty bad yeast infections in the past that don't respond to OTC treatments, so I made an appointment to see the doctor the next morning. (I've always been a little overprotective of this area of my body. If the slightest thing seems abnormal, I'm off to the doc sheepsih grin).

On Wednesday morning, I awoke to find dark (as in very dark red or blackish) sores on my labia - they didn't exactly "hurt," but they were uncomfortable. I, of course, went to the doctor visibly upset (and confused) that I had somehow contracted HSV-2 during my monogomous marriage.

My doctor did an examination, and diagnosed me with severe yeast infection (based on a test of the discharge), Her analysis was that it did NOT look like any herpes infection she had seen, and the fact that (1) this would have to be a primary outbreak (based on the severity - both labia are involved now with multiple sores); (2) the sores arrived and developed so quickly (today is day three and they are full blown sores, i.e. no blister stage); (3) there has been no sexual activity in the past three weeks (because of the shingles); and (4) I have not been suffering from fever nor swollen lymph glands ANYWHERE (I have a headache, but I also have a head cold right now - sneezing, congestion, runny nose, the works) that she did not believe it is possible that this could be HSV-2.

Her final statement was, again, that this was an extremely bad yeast infection (she gave me diflucan, and told me to mix ketocozonale with neosporin to place on the sores). I asked that she do a herpes culture just in case, and she did. However, she said that if the culture came back positive for herpes, that it is possible that I self-infected by scratching my shingles sores (before I knew they were shingles) and transferring the virus to my genital area (perhaps by using the restroom).

Is there anything else that this could possibly be, given the ulcers?

Thanks in advance for you insight.

Final note: I have had one other severe yeast infection in the past that resulted in ulceration (fifteen+ years ago before I was even thinking of being sexually active), but the ulceration then looked "different," (the ulcers were larger and fewer in number), and the symptoms were more severe, i.e. INTENSE pain an itching. Now, I am experiencing some itching, some discomfort (when friction occurs), and a little more discomfort upon urination.

Answer

First of all, let me just compliment you on giving details in a complete and comprehensive way - it helps us 'experts" to get information completely. I have never heard of a situation where someone had shingles and actually transferred the active virus to their vaginal area but i suppose anything is possible. I would still think this would not come up at HSV2 or herpes simplex 2 but rather a different viral strain.

That being said, more than likely you do have a raging yeast infection and the therapy should help to eradicate the infection. My only recommendation is to stay on top of it so that if the treatment does not eradicate the infection, you get re-evaluated. I'd also be sure to allow the area exposure to air as much as possible and use cotton underwear and a very mild cleansing agent like Cetaphil till it resolves.

Answered by Amy Hendel, P.A.