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Herpes Whitlow - HELP!

My BF and I both have HSV2 genitally, I contracted it before I met him and unfortunately passed it on to him. He's had it for 1 year now and has had several outbreaks and so have I. A couple of months ago (not during primary infection) he shows me his finger which is swollen, red and has small blisters under the skin. They don't erupt and there is no fluid, they don't look exactly like the pictures on Google. They disappeared after a week or two BUT this morning he shows them to me again. Same finger, same place, same blisters. He has pain in the finger but says it's probably not herpes (he's in denial I think!!)

I do think it could very well be Herpes Whitlow caused by HSV2. I just don't understand the recurrence of this if it is herpes. I thought the HSV2 lies in the lower part of the spinal cord and therefor if you get an HSV2 infection above the waist, there are almost no OB's after the first - because HSV2 does not 'thrive' in the body above the waist. 

Can anyone inform me about this? I feel so bad and so responsible for everything he is going through :-(

Thanks!

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  • FelizCastus tina10337

    Any chance he can get his finger swabbed to know for sure whether it's HSV2 or not? Herpes Whitlow is usually HSV1, but that doesn't mean that HSV2 can't cause it. Not nearly as common, though. Does your bf have any autoimmune issues, btw? Not sure if I'm confusing you with another user on here, so just checking!

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    • tina10337 FelizCastus

      You have a good memory FelisCatus - that is me :-) Well I went to my own doctor and told him about my BF's disorder/virus he had 3 years ago. My doctor says that what my bf had/have should not affect herpes. Don't exatcly know what the criterias are for an autoimmune disorder but I guess my BF had a bad virus or something that affected his red blood cells. He hasn't had a genital ob in almost 3 months so that makes me so happy! He's not on antivirals, he's always busy, sometimes out drinking and is not concerned with his diet at all, so I'm happy that these things does not bring out an outbreak in him (so far). 

      I have of course googled A LOT about herpes whitlow and it says that 60% of herpes whitlow is HSV1 and the rest is HSV2 - but it is so rare that only 4-5 out of 100.000 will get it.. It just seems weird that it comes up on the exact same finger and symptoms looks like the first time he had issues with his finger. Now that I think back I think he has had issues with that finger maybe 3 times actually. 

      I'm worried because we both have small children in our families, and what if he touches them and they get it... 

      If it shows up again I will force him to go to the doctor and get it swapped. I think it might be too late now and my bf does not think it is herpes so he does not really care. 

      Thank you so much for your reply FelisCatus! 

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    • tina10337 FelizCastus

      Another question I have:

      He is currently having the infection in his finger as I explained. It started maybe 5-6 days ago and is better now. But he has no signs of anything on his genitals. No OB or anything (he usually get's blisters so his OB's are recognizable and symptomatic). I would know if he had an OB on his genitals which he does not have atm. 

      Let's assume it is actually HSV2 on his finger - the virus wakes up from it's dormant stage and becomes active = OB on his finger. But shouldn't that also cause on OB on his genitals then where the initital HSV2 infection was? 

      I know HSV is tricky but you would think that if the virus becomes active, it should bring an OB on the genitals where it initially brought on a first outbreak.

      What do you think?

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    • FelizCastus tina10337

      That's a very good question, and I don't know the answer for sure, but it would be reasonable to assume that systemic triggers (like the flu or other illness) might cause multiple site shedding and/or recurrences, whilst a local trigger (like surgery or trauma) in an infected area might cause a single site recurrence (at the same site as the surgery/trauma).

      In any case, definitely have him get his finger swabbed the next time, as it's always good to know for sure what you're dealing with, rather than speculating. If it's herpes, whether Type 1 or 2, he just needs to keep it covered up until it heals to prevent skin contact with others. Glad I remembered, by the way, and didn't have you mixed up with another! smile

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  • Jos66984 tina10337

    I would definitely get it swabbed. Could be wrong but that sounds like it could be a staph infection which tends to reoccur. Your BF should definitely have a check up and maybe some bloodwork done. 

    Jose

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    • tina10337 Jos66984

      Thanks for the reply Jose. I've googled staph infection and it could be that, but not sure. He has had the same infection in the same finger before which is why I think it is herpes.. 

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    • tina10337

      Sorry forgot the fact that you mentioned that staph tend to reoccur. I didn't know that! I will definitely send thim to the doctor ASAP the next time he has symptoms (which hopefully won't happen). The fact is just that blood work won't really help in this case. We know that we have the HSV2 and that it will pop up on the bloodwork. I think he has to get it swapped. Problem is just that doctors are so ignorant they will probably send him home and tell him it's nothing because herpes whitlow is not really that common. 

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  • jane80952 tina10337

    It could be, but I would be careful about making strong assumptions. I believe I have type 2 orally and genitally, and the mouth sores initially were worse than the others in fact for ages, I assumed it was type 1. There was a prominent story on this site last year of an individual who acquired type 2 only on his back and arm. Herpes in fact can appear anywhere in the body that it gets an entry point. If it is outside it's "home" spot where it evolved to be strongest (genital for type 2, oral for type 1), it will recur less but can still be bothersome. That's how my oral sores are. All of which to me should impress the truth that herpes is herpes, it matters little what type it is. If you find your outbreaks in any location are too frequent or bothersome, antivirals will help so have no fear!!

    During an outbreak, try to avoid touching sores and then touching other body parts, particukEjy mucosal skin or anywhere skin is broken or compromised, as you can definitely transfer it to other body areas inadvertently.

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    • tina10337 jane80952

      Oh sorry to hear you have troubles with this virus too.. Have you had the sores on your face swapped for sure so you know it's HSV2? It does sound against all odds that HSV2 breaks out on the face or reccurs like yours does/did. 

      The fact is that my bf has and had OB's on his genitals with HSV2. If his thumb was the only place the broke out during primary infection I would maybe understand. But his "home" place for the initital infection is the genitals. Seems so odd to transfer HSV2 to the thumb AFTER initial infection. Chances are like so slim.. 

      Thanks for your reply Jane, it's great to have all this support and makes me feel like I am not alone in this. It's a struggle sometimes having this virus. I was just getting to a point where I had accepted that I had HSV2 and I had given it to my bf too. Never felt so guilty in my life and I worry every day that he has another ob. And now he struggles with that finger and I'm SO scared that it is HSV2.... 

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    • jane80952 tina10337

      No, the mouth sores aren't near big enough now for swabbing. They were initially but the dr never swabbed them and I assumed I was dealing with type 1. The sores around hemhorroids that you would think would swab positive have swabbed negative, even when timely, three times. So I doubt the oral sores that are weaker would swab positive. Swab only picks up around half of true positives.

      I am not skeptical that you could transfer it to a finger, but it is confusing that the finger and genital sores don't come at the same time. There are a lot of factors around why and to what extent it recurs in various body areas dependent on type, this is because presumably the body developed locally driven defenses that may also be specific to body area through evolution. Animals get herpes too, it evolved with us so far back, since we were chimps. I believe even oysters get it. They think the 1/2 split came at some point a looong time ago, evolution-wise. Prob impacted by when we started having sex differently. Biologically it's all v interesting.

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    • jane80952

      P.s. Encourage him to consider antivirals since you're worried about the children. I have a young child too, and frankly that was the main reason I went on them. The doctors said if it is type 2 oral, it is likely not during enough to transmit from that location but I'm not taking chances. I am on another stimulant med that increases outbreak frequency everywhere, and I do not think the doctors know to what degree that might impact transmissibility from any given location. The antivirals do t have significant side effects, so why not....

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  • tina10337

    So back again with more info. I looked at my bf's phone because I remembered that we took pictures of his thumb the 1 time he had symtoms. I don't have them right now so cannot post them..

    The pictures are taken the 22 of May 2016. I always write down in my calendar when we have our OB's and I can see that he had a genital OB that began the 18th of May 2016. So a few days before the infection in the thumb.

    First genital HSV2 OB began in the beginning of January 2016 and lasted like 4 weeks or so, so his body has had at least a couple of months to build antibodies (from January to May should be long enough for the body).

    And then 7 days ago he shows me an infection on the same finger, same place, same 'blisters' - that does not look exactly like the one's on Google though.

    The blisters he had/has looks like they are deep under the skin. Some of them looked purple. Never formed a lesion or a real looking blister like the ones HSV produces. Never popped open or anything. But then again the skin is so thick on this fingers so don't know if thats why the blisters can't break through. He does not bite his nails or the skin on his fingers. It's just scary how the symptoms look so similar to the first episode, this time around. I can't think of anything else than herpes. A reocurring infection the exact same finger, same location on the finger and exact same symptoms as the first time... it can only be herpes in my mind.

    Anyway, it does seem scary that his first infection of the thumb was a few days into a genital OB. But autoinculation should be almost impossible after 3 months or so or at least difficult to get on the finger. I just don't get it. Even if he did touch his genital OB with his fingers, the odds are still low.

    I'm even more worried now... I know the best thing would be to have it swapped by a doctor. Hopefully it won't come back. I'm pretty sure it will though. Right now I just feel hopeless. I read that herpes whitlow is so rare that it happens in 2,5-5 people out of 100.000 people. Don't know if that is true though. I just feel sad right now...

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    • FelizCastus tina10337

      Most whitlow cases are bacterial, and since you say his look different, maybe it's bacterial, not herpetic, and the recurrence a coincidence. Where exactly did the blisters start, did they cause swelling, and were they clear fluid or pus-filled?

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    • tina10337 FelizCastus

      The finger started to swell a bit and became red and sore/tender. Then small blisters underneath the skin started showing. My bf told me he popped them and there was clear fluid coming out and a bit of pus. Mostly clear. The blisters look clody.

      We talked about it last night because I have been going crazy about it but he just said: i don't think it is herpes, but even if it is, it does not matter now. I'll have to wear a bandaige if it happens again.

      I still don't know what to think...

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