"Chloe’s been divorced for about twelve years and though she admitted she’s not a man-hater (both divorces were dirty) the 41-year-old has pretty much given up on marrying again.
“Good morning,” I said, as I entered the room, glancing at the chart and calling her by name. I held out my hand.
“Yes, good morning.” We shook.
“How are you today?” I said as I took my seat at the small table.
“Not too bad.”
“Good. How can I help you today?”
“Well,” she said, “I’m here for a second opinion. About three weeks ago I developed a spot on my vagina. I went to the County Family Health Center and the doctor told me she thought it was from shaving, or perhaps an ingrown hair or something. But she did a test and said it was positive for herpes.”
“So, did she say you had herpes or that you had something else?” I asked.
“She didn’t think I had herpes because I only had the one spot, had never had it before, and have never had any breakouts like people get with herpes.”
“Was this solitary lesion painful?” I asked.
“No, it was never painful.”
“So, you’ve never at any time ever had a cluster of tiny ulcers, or pimple-looking, or blister-looking things on your vagina?”
“No, never.” She paused. “But I need to tell you this. I’m in a relationship with a married man. And have been for about two years. And about three weeks ago he told me he had a spot on his penis. He said it was from scratching or something. But he didn’t go to the doctor and said that he had never had herpes and that he and his wife only had sex with each other. That he was sure she wasn’t having sex with another man and that so far she wasn’t having any problems.”
“But he never got tested?”
“Right. And his spot has cleared up,” she said.
“Was it just the one spot, on him, or did he have a cluster of spots?”
“No, he only had the one spot.”
“Ok, so the other doctor says you tested positive for herpes but she thinks this one particular lesion on your vagina was the result of something other than herpes.”
“That’s right,” Chloe said. “Like maybe from shaving.”
“So, if I hear you right, you and he pretty much developed a single lesion at about the same time.”
“Well, huh, yes, that’s pretty much how it happened.”
“And he didn’t get examined, or see a doctor.”
“So, what is it you want a second opinion on? Confirmation of the previous herpes test?”
“Well, that, plus I don’t know how I could’ve gotten herpes if I’ve never had an outbreak before and he hasn’t either. Never had any pain with any lesion or anything.”
"If you have more than one sex partner then you could've picked up something from them."
"No," she said, "I haven't had sex with anyone since before two years ago."
"And you said the other doctor said you didn’t have herpes. Have you ever had an STD, ever?” I asked.
“Never,” she said.
"Have you ever had a fever blister or cold sore? That's caused by HSV-1 herpes virus and it's possible the other doctor tested that positive."
"No, I don't ever remember having a cold sore."
“Okay, well we can do a test that differentiates whether you’ve had HSV-I or HSV-II. It won’t tell us who you got it from or when but we can surmise that from your medical history and sexual contacts sometimes. If you have any kind of lesion present today we can culture that directly and have it tested for the herpes virus.”
“No, I don’t have anything at all on my vagina. But yes, I would like to do the blood testing.”
To Be Continued