4 month continuous outbreak

[dluv1000]

I believe i have had herpes for about 4 years. I have only had symptoms in my mouth. Until recently i would get a soar throat swollen lymph nodes and flu like symptoms followed by lesions on both sides of my mouth (the cheeks) which would last about two weeks. This happened about twice a year. I have never been tested.

Then In september of 06 i got the flu and left on a six week trip, for the first two weeks I worked about 18 hours a day and by the end of it beat the flu and developed coldsores in my mouth (which i believe to be herpes) They have persisted lasting for a week or two then going away for 2-3 days and coming back. This has gone on for more than 4 months.

The lesions are kind of moving around a bit in my mouth from cheeks to the gums at the very back of my lower molars. But will not go away. I tried valtrex for one month, once a day it had no effect. I tried acyclover for 3 weeks 5 times a day, it had no effect.

At this point i am beyond frustrated and also concerned. I am not concerned about wether or not i have the disease, i am over that already. What i am concerned about is wether or not i have something else and that this outbreak is an indicator of a more pressing disease or infection.

I am currently the healthiest i have ever been. I exercise regularly and eat a healthy balanced diet. I dont drink or do drugs. I also quit smoking 6 months ago. I am not overweight and I have never been happier (my stress level is not very high)

I have a few questions:

1. is it possible to have continuous outbreaks for this long? or is this probably something else

2. This episode started after i quit smoking, could this have something to do with it?

3. Is it possible that this is related to something I am eating (i eliminated alcohol from my diet 6 weeks ago)

4. why are the medicines having no effect? Could it be a bacterial infection riding on top of the herpes infection or something like that?

5. Do you have any suggestions for me?

6. Am i contageious? i am confused after reading your other postings, if i kiss someone between or during symptoms will they get it in their mouth?

I realize i am asking a lot but i feel my case is atypical and my regular physician is not giving me any answers or effective treatments.

Please Help!

[H. Hunter Handsfield, M.D.]

Two main points.  First, recurrent or chronic oral herpes lesions do not occur inside the mouth.  Second, herpes simply does not cause continuous symptoms for so long.  Valacyclovir and acyclovir didn't help because the problem isn't herpes.  This sounds more like aphthous stomatitis (canker sores) or something else entirely.

This is completely outside my area of expertise, so I cannot speculate further.  My advice is to either return to your doctor and make shre s/he knows how much this is bothering you; or get a second opinion, perhaps from your dentist or an ENT specialist.  Even better, ask your dentist if there is an oral medicine expert (a dental specialty) in your area.

Good luck--  HHH, MD

[dluv1000]

I was just reading up on behcets syndrome. I have been having terrible knee pain latley. Behcets might explain both problems as they both have occured simultaneously. What do you think?

I also forgot to mention that my sores are never painful. Perhaps on the first outbreak but never since. Not even a little.

[H. Hunter Handsfield, M.D.]

Behcet's indeed is associated with aphthous stomatitis.  But it is rare, and knee pain alone--without other evidence of arthritis--is against it, and the lesions normally are very painful.  But if you are of Mediterranean origin (e.g., Turkish, Armenian, etc), perhaps it is a possibility; Behcet's is limited almost entirely to these and similar populations.

So the additional information doesn't change my advice.  Good luck.

[dluv1000]

Thank you! good to know I thought i had the worlds worst case. In your opinion (i realize this is outside of your expertise) do you believe this is contageous?

[gracefromHHP]

Canker sores aren't contagious.

You need to follow up with this with your doctor. It could be an allergy to food or even your toothpaste ( if you are using anything other than plain ole toothpaste stop - don't use the complete, total, whitening or tartar control - try the sensitive brand even for a few weeks to see if that helps ), it could also be a sign of other illness in your body - sinus infections and even reflux ( GERD ) can cause mouth symptoms.  There are so many things other than herpes that can cause these symptoms so it's well worth following up on so that your mouth gets back to feeling better soon :)

grace