Antibody Blood Test

Dear Dr. Rob:

Here is the scenario. Come home from a trip overseas. Clammy, Itchy, Tingly, Sweaty everywhere. Notice a small half dollar size rash on my back. Call my GP… out of town… go see his associate he tells me I have Simplex 1, gives me Famvir… visual exam no swab, no blood. Go to Planned Parenthood (STD Doctor) tell her what he said, she takes a peek says shingles. I get blood tests for everything while I’m there… negative HSV1, negative HSV2… and the rest thank god… 3 weeks pass, rash heals… I am still tingling, itching, sweating, the lot… go see my GP, back in town now, takes a look at the remaining sore… says looks like Simplex to me… we talk, I tell him about the test, my symptoms, the whole deal. He said next time you get a gynecologic exam, we will swab it and test that way. I say next time???? Right so, here I am a month later still experiencing shingles type symptoms, worrying about every pimple, itch below the shorts, chap lip… thinking this thing is just ready to pop up everywhere… what the hell is going on?… can the anti body blood test come back negative when you have active first time… or should I assume this is shingles… Also on the internet, I have seen some talk of herpes neuralgia related to simplex… is this a possibility… could you refer me to a doctor in NYC that has a clue about all this…

Dr. Rob’s Response:

Dear Poster From NYC:

I can’t really refer you to a specific doctor in New York, although anyone in Infectious Disease or a good dermatologist would be able to answer your questions.  Firstly, this does not sound like herpes and I would suggest strongly that you get a Herpes Select Test to determine whether you do have Type 1 or Type 2.  In addition, given the fact that you theoretically have shingles according to your doctors, I would get a Varicella test, which is the antibody for chicken pox. That will tell you if you were exposed to chicken pox and whether this could be shingles.  A small rash on your back or itching are not typically simplex or zoster symptoms. Both of those are associated with tingling, and shingles is associated with pain on one side of your body or in one nerve distribution.  You do not mention any of the above.  A rash does not necessarily keynote herpes, and again I believe testing is of greatest importance, so you can figure out what is going on.


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