Herpes Expert Forum
Worried about possible herpes infection
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Worried about possible herpes infection

Situation:
• Day 1 – Noticed a small ulceration on top of the lower lip near the corner of the left side of my mouth.  It was white, jagged and a little below the skin surface.
• Day 2 – Accidentally poked myself next to the small ulceration and caused bleeding.  Noticed what appeared to be irritated skin in the area.
• Day 4 – Three ulcerations in a row now present on the top of the lip extending about 15mm from the corner of the mouth, each slightly larger than the other.
• Day 5 – Ulcerations peaked.  A line of red, irritated, slightly ulcerated skin appeared on the upper lip directly above the ulcerations on the lower lip.
• Day 6 – Began to heal with a yellowish/honey colored crust.
• Days 7 – 9.  Clearing up with scabbing getting smaller and less yellowish.
Why it could be herpes:
• Dermatologist said it looked like a herpetic outbreak (on day 6)
• Sores were painful
• Yellowish/honey colored crust during healing
Why it doesn’t seem to be herpes:
• No history of herpes and negative tests for HSV1&2 within the last 12 months.
• Ulcerations emerged over 3 days, not one.
• There were no noticeable blisters during the outbreak.
• Ulcerations were in a fairly straight row on the lip and were not scattered like a typical primary herpes outbreak.
• Dr. examined mouth and found no other lesions that would be typical for a primary herpes outbreak.  No other symptoms of a primary outbreak presented.

I am scared by my Dr's "herpetic" comment.  I told him about my negative HSV tests and not finding any other signs of herpes, he presribed mupirocin and clortrimozole.  The one risky recent contact I had was a massage therapist licked my ear 10 days before the outbreak.  It was an unwelcomed advance and there was no mouth to mouth or sexual contact.  The massage proceeded as normal.  Could saliva from that contact passed HSV to me?  Can you pass HSV through other means other than direct contact?  Do my symptoms sound like herpes to you?  
55646_tn?1263664409
I agree that this presentation sounds like herpes.  Was any swab testing done of the lesions?  It should have been.  

The problem with the traditional herpes testing is that it isn't very great for HSV 1 - it misses about 1 our of 10 infections.  If these come up again, I think you should definitely ask that they be swab tested if they weren't this time.

The massage visit is NOT a risk for acquiring HSV.

Terri
6 Comments
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Avatar_m_tn
FYI - I am a 52 year old male
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Avatar_m_tn
The Dr. didn't swab because there wasn't a blister present.  He said he would typically lance a blister to do a culture.  I never noticed any blisters throughout the breakout, which is still in process and seems to be healing slowly.  He said I could have a blood test in a few weeks or come back and see him if and when I had another outbreak.

My anxiety is that other than the massage, I can't figure out where I might have contracted HSV on my mouth.  Other than my girlfriend of 13 years, I haven't kissed anyone directly on the mouth.  I haven't performed oral sex on anyone else during that period or had any other contact that would seem to be of high risk.  I did kiss a woman's breast/nipple once, but know that is extremely low risk.  I guess I'll wait a few weeks and have a blood test to confirm or refute what is going on.
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55646_tn?1263664409
The herpes PCR swab picks up virus in situations where culture might not.  Too bad it was not available to you.  If you get another one, please go in right away and ask for PCR swab test for HSV.

Terri
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Avatar_m_tn
Hi Terri,

One last question: Should I be at all concerned about HSV1 vs. HSV2 and get a blood test.  If so, how long should I wait?
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55646_tn?1263664409
If your HSV 1 and 2 tests were negative before then you were either 1) uninfected with neither  or 2) infected with HSV 1 but the test missed it .  Again, the massage does not present a risk.  If you are infected with HSV 1, and the test missed it, it will likely miss it again so I'm not clear that testing for antibody offers you any additional information.

Terri
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55646_tn?1263664409
Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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