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Possible HSV1, or something else...confused.

Here goes. A couple weeks ago I kissed a guy for a very extended period of time. He had no visible sores around his mouth. He did, however, have alleged "eczema" on other parts of his body. 2 days later I developed what I had thought was a pimple right on the border of my bottom lip (2mm x 2mm). I occasionally get blemishes in this area so at the time I didn't think anything of it so I popped it in my usual manner. But this time it seemed more clear/liquidy but it wasn't painful. It did feel like I had pushed whatever it was deeper into the skin. 1 day later it developed a scab–at the same time I started to have pain in my throat. That night I ripped the scab off b/c I had to go to work figuring it'd be less noticeable with no scab and under makeup. I went to work and the following day it had an even bigger scab over it. 2 days after THAT I went to the doctor. At this point the lesion was raised w/ other lesions or blisters around it. The doctor ripped the scab open and took a swab. It had been about 5 days since initial development of the pimple/blister and by this time I had full-blown tosillitis or strep. She prescribed me penicillin 4 xs a day for 10 days. The total affected area was now about 1 cm in diameter and it continued to slowly ooze a honey-like substance out from under the scab for about 4 days. The substance crystallized and still no other blisters were present. So 8 days after the swab was taken the thing finally fell off, crystallized honey, scab and all with the use of some Betadine during the last few days. During this last week or so of healing I had convinced myself it was bacterial, a really irritated pimple. However I just received an email from my doctor saying that the swab Bacteria didn't grow, so it was normal. I am waiting on the viral analysis of the swab to see whether or not THAT grows. But here's where I'm a little confused–if it was negative for bacterial then the only other thing it COULD be is HSV1 right? Thank you for your help.
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Avatar universal
A related discussion, Hello again was started.
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55646 tn?1263660809
Your doctor is incorrect.  There is no evidence that taking medication with the first outbreak does anything to reduce future recurrences.  He is not appropriately informed about this topic.  So stop worrying about this.  When you get symptoms, start one day of treatment early for the best chance of shortening the outbreak or aborting it all together.

Terri
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Avatar universal
Ugh. I thought that would have been my last post. Sorry to be bombarding you with questions.

I just got the finger swabbed, went to a different doctor who poked a hole in it and swabbed a tiny amount of blood. I should know in a few days if it is herpetic whitlow. But NOW,

I told this 2nd doctor everything and asked if there was anything I could do to reduce my chances of ever getting another cold sore (I eat right, exercise, no caffeine, no nuts, no oats, no chocolate :( now, + lysine since I got the results 5 days ago) . Up until this point I thought it was left to chance, some people get another, some don't.

He said taking Valtrex during the initial outbreak will greatly reduce these chances. The previous doctor had prescribed me 8 tablets (w/ 5 repeats) 500 mg, to be taken (4 tablets twice a day) JUST IN CASE I ever get another cold sore. I told the doctor today that I had let the cold sore heal on its own and he said that that wasn't a wise choice if I never wanted to get another one again, that I should have taken Valtrex ASAP during the outbreak. And now that it's 24 days past the very first tingle, 11 days since the scab fell off, there's nothing I can do and I'll most likely get cold sores regularly.

Seeing as there's still red pigmentation in the area I ran home to get my prescription, filled it and just took 4. Is this second doctor correct? Is there a window that I can reduce my changes of recurrence with Valtrex? Is taking it at this stage in the game actually detrimental?

Again, thank you. I know it's not really a big deal but I can't help it. Very stressed.
Helpful - 0
55646 tn?1263660809
Well, it may or may not be your first infection, due to the insensitivity of HSV 1.  The only way to know that for sure would be to repeat the HSV 1 antibody test about 4 months down the road.  Hard to know about the fingers.  Herpetic whitlow happens, for sure, but is not common.  The only way to know for sure would be to have one of the fingers swab tested, like your mouth.  If it is herpetic whitlow, it will probably come back at some point.  I think you would demonstrate more dramatic symptoms than swelling and numbness, but definitely hard to say for sure.  

The virus is in all parts of your lips now.  The trigeminal nerve is infected, and that covers the face (including all parts of the lips) and the nares and the area around the eye.  It won't matter if you use lipstick or chapstick.  If it shows up in a new location, it isn't because your spread it, it is because it just moved along a slightly different branch of the same nerve group.


Terri
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Avatar universal
It was positive. I now have Oral HSV 1. Given the circumstances, my doctor figures it was the primary episode.

I think it has manifested in a couple of my fingers as well. (Didn't think to mention this when I was with the doctor–a bit shell shocked at the time). When I had the cold sore one finger was swollen, with a bit of white pus under the skin toward the finger nail (it wasn't a raised 'blister'). Keeping it under hot water a few times a day seemed to help.

2 days ago (the cold sore is gone, the area is just pink now) another finger became a bit swollen and numb toward on the side of the finger nail. No real pain though, no real blisters as of today.

I do have the tendency to pick at the sides of my nails when I'm anxious, as I have been for the last 3 weeks, obviously.

I was pretty careful about spreading this to my fingers as I was aware of herpetic whitlow before. But I don't think it could be anything else, given the timing of everything.

SO, is it likely I'll get recurrences of herpetic whitlow in these two fingers? Once the swelling is gone is it safe to touch other areas of my body (mucous membranes) or am I even more likely to spread it at any time since it's permanently in my finger tips?

One more thing. Is it possible to spread HSV 1 to other parts of my lips? For instance if I press my lips together or apply chapstick/lipstick?

Helpful - 0
55646 tn?1263660809
There is no relationship that I am aware of about age of acquistion and recurrence rates.  I would say about 70% of those with HSV 1 oral infection have symptoms.  They are highly marketed because they are inexpensive to make and so many people have infection.  

Let me know how your tests turn out, OK?

Terri
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Avatar universal
Well, she took 2 swabs; 1 to test bacterial and 1 to test viral. Still waiting on the viral results which supposedly should be in by the end of the week.

The "crust" looked like a majority of the impetigo pictures I've seen as opposed to the majority of HSV1 pictures I've looked at. I guess they're quite similar though.

I thought I should add that I'm in close proximity to many people on a daily basis, currently traveling, and in and out of hostels, sharing things . More of a case for impetigo?

But impetigo is bacterial yes? However since the bacterial swab didn't grow... I guess that can't be it. Unless due to the stage of the lesion when the swabs were taken even a bacterial analysis may not be accurate?... I hope?

Could the guy's "eczema" have anything to do with anything? Again, there was nothing on his lip.

Is it true that HSV1 can cause strep/tonsillitis?

I've never had a cold sore before.

And it may seem like a silly question but is it likely that I will have recurrent outbreaks since I am probably newly exposed to this (I'm 26) and therefore haven't had the opportunity to suppress it like many who acquired it as children (and whom no longer display symptoms)?

Why are topical ointments for cold sores so highly marketed if only a small percentage of people have recurrent outbreaks?

I've always avoided prolonged kissing, cup-sharing and am abstinent. Wouldn't you know the 1st guy I kiss in 4 years probably gave me HSV1.

Those are my last questions. Thank you so much for your time.


Helpful - 0
55646 tn?1263660809
Well, the things that come to mind for me are HSV 1, first, then impetigo, second.  Do you know if the swab test that she took included a test for HSV?  If it was a bacterial culture, herpes would not grown.  If it was only a herpes culture, bacteria would not grow.  I would recommend that you ask what you were swabbed for, exactly.  

The blood antibody test is not 100 percent sensitive for HSV 1.  In fact, it misses one out of every 10 cases.  It is too early to repeat the test so don't do it now.  I'm thinking that you've not had a cold sore in the past on your lip, is that right?

So your job is to find out what the swab was for, and if they don't call you tomorrow, call them and ask for results.  it shouldn't take this long

Terri
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Avatar universal
One more thing: I had a blood test done (IGG type-specific) for HSV 1 and HSV 2 about 7 months ago. At the time I tested negative for both and have had no sexual contact and little saliva contact since.... up until the night 16 days ago.
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Avatar universal
Corrrection: the following sentence should read: "At this point the lesion was raised w/ NO other lesions or blisters around it"
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