I’ve been on a rollercoaster the last week.
Background – I had sex for the first time in years a couple weeks ago. This was the day after I went on a long, strenuous hike in hot, humid weather and was wearing tight yoga pants the whole time. Within a few days, I felt yeast-infection type symptoms (itchy all over, which progressed over a few days and then I felt raw and itchy). I self-treated with MONISTAT 1, then got in touch with a provider who prescribed fluconazole. Swabs came back negative for chlamydia, gonorrhea, trichomoniasis, BV, and yeast.
A couple days later I went in for a physical exam and was told it was definitely a yeast infection – not in the canal, but on the exterior instead. It was the result of being sweaty and wearing tight yoga pants for 12 hours. I was given anti-fungal cream. The next day I went to the bathroom and as I pat myself dry (carefully, because it was tender) I feel a very painful spot. I look in the mirror and have a single lesion, it looked almost like a cyst, and was firm and tender to the touch (I have photos if needed). I kept using the anti-fungal cream and took my second fluconazole pill. Second swab came back negative, I’m told it’s because I’d already used two anti-fungals.
The next day, the pain was much worse in that location so I went to urgent care. I’m told it looks like herpes. They do a PCR swab on the lesion. She uses a decent amount of force and was thorough to make sure she got a good sample. I’m given Valtrex.
Next day – I get a call from the nurse, the PCR swab was negative. I’m told it was highly unlikely that it was a false negative because it was taken from the lesion, but PCP wants me to come in for another evaluation. I’m told to stop Valtrex.
I go into PCP yesterday. I ask him to test me for a plethora of things (infected cyst, strep b, mycoplasma, urealplasma, etc), including more resistant yeast infections (I ask for a culture instead) he says no. He does a bacterial swab (pending) and syphilis test (negative). He does the exam and is convinced that my single lesion must be HSV because it is tender. He said he didn’t know why my PCR swab came back negative. I explain that everything I’ve read says that PCR is highly sensitive, highly accurate, the nurse was thorough with the swab, and that I had it done within the “right” timeframe for accurate results. I read it was over 90% accurate and another doctor said it was 95% accurate. He said well that still leaves room for error. I ask him to repeat the test, he says no. He tells me to take valtrex and start doxycycline (which I was due to start for a facial rash I’ve had since long before this all started).
Now I’m confused – different practitioners are telling me different things. As I said, everything I’ve read says PCR swab is the gold standard for testing and it’s highly sensitive, highly accurate, highly reliable. My PCP says it isn’t sensitive and that it was not reliable. But he wouldn’t repeat it even though I still have the lesion (which looks worse). He wants me to do antibody testing in 4 weeks (which is a LONG time to wait for results?) and I've heard the blood tests can be unreliable. When I got my syphilis blood draw, my neurologist had randomly already ordered HSV 1 & 2 tests so I got those done as well (and another set in 4 weeks from PCP).
Does anyone have insight into this? How likely is it that a thorough PCR swab is a false negative, especially when I had it done within the “right” timeframe? I’m lost and having a hard time navigating this on my own. It’s been a rollercoaster and causing a lot of anxiety. I asked the nurse if I could see an OBGYN and she said “what for” and wouldn’t refer me. Thanks.
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