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HSV initial outbreak after 3 days - on tongue?
(Apologies - I posted this (and paid) in the Herpes forum before realizing I wanted to post it here. Sorry for the double post - any way to remove the double charge?)
Hi doctor-
This past Tuesday night (3.5 days ago), I deep kissed/made out with a guy who had no visible cold sores. I, however, had a cracked/chapped bottom lip... noticed it when salt got on the lip at dinner - OW.
We continued to make out all evening.
The past couple of days (3-4 days past kissing), my lower lip - but mostly NOT where it was cracked - is hurting ocassionally, like a minor and momentary burning sensation...
...and this morning, I noticed an ulcer on my tongue. It's fairly flat, flesh colored, with just a bit of red around it. Not very painful at all... again, actually feels like I might have burnt it on hot food (although I can't remember doing that this week.) And it feels better if I wet it - so does my lip.
Went down to the walk-in clinic - have no fever and my lymph glands are fine, say the doctor. Took a viral culture of the ulcer and said "well, a culture won't do much for HSV on the tongue."
Considering this, any thoughts about whether my lip pain and/or tongue 'ulcer' might be an initial OB of HSV? I have never had one before (confirmed by repeated IGG blood tests) If an initial OB of HSV was on the tongue, would it start as a blister first, THEN become an ulcer, or could this still be HSV?
Also: the person and I had quite a bit of "outercourse" Tuesday night? Would you please comment on the HSV transmission risk, if the genital/genital contact was somewhat aggressive? There's a lot of info on these boards... and the skin/skin risk info is somewhat conflicting.
Thank you so much for helping out - believe me, you're doing the world a great service with your compassion and kindness.
Hi doctor-
This past Tuesday night (3.5 days ago), I deep kissed/made out with a guy who had no visible cold sores. I, however, had a cracked/chapped bottom lip... noticed it when salt got on the lip at dinner - OW.
We continued to make out all evening.
The past couple of days (3-4 days past kissing), my lower lip - but mostly NOT where it was cracked - is hurting ocassionally, like a minor and momentary burning sensation...
...and this morning, I noticed an ulcer on my tongue. It's fairly flat, flesh colored, with just a bit of red around it. Not very painful at all... again, actually feels like I might have burnt it on hot food (although I can't remember doing that this week.) And it feels better if I wet it - so does my lip.
Went down to the walk-in clinic - have no fever and my lymph glands are fine, say the doctor. Took a viral culture of the ulcer and said "well, a culture won't do much for HSV on the tongue."
Considering this, any thoughts about whether my lip pain and/or tongue 'ulcer' might be an initial OB of HSV? I have never had one before (confirmed by repeated IGG blood tests) If an initial OB of HSV was on the tongue, would it start as a blister first, THEN become an ulcer, or could this still be HSV?
Also: the person and I had quite a bit of "outercourse" Tuesday night? Would you please comment on the HSV transmission risk, if the genital/genital contact was somewhat aggressive? There's a lot of info on these boards... and the skin/skin risk info is somewhat conflicting.
Thank you so much for helping out - believe me, you're doing the world a great service with your compassion and kindness.
MEDICAL PROFESSIONAL
Welcome to the forum. Most users shouldn't expect immediate replies, but as for a message a little while ago, I was logged in when your question came in.
Glancing back at several other threads over three years, you have long been concerned about catching herpes, oral or genital. Anyway, I'm pretty confident that once again you weren't infected. Initial HSV infections, oral or genital, typically cause multiple painful lesions and, for oral infection, severe sore throat. Such symptoms are especially likely in people with true primary infection, i.e. those like you with negative blood tests for both HSV-1 and 2. A single rongue ulcer of the sort you describe is much more likely to be a garden variety canker sore or something else, but not herpes. Also, with a cracked or chapped lip, had you acquired HSV, I would expect that to be the most likely site of inoculation and therefore of the initial symptoms.
As for the non-insertive genital contact, herpes in theory can be so transmitted but it is rare. There are no data on this and I can't state a numerical risk. In heterosexual couples in which one person has HSV-2, the average transmission rate appears to be about 1 in a thousand for each episode of unprotected vaginal sex. It's fair to assume the risk of "outercourse" is a lot lower than that, but that's all I can say. In any case, low enough that it shouldn't be a worry, especially if your partner didn't have a visible genital herpes outbreak.
As for "somewhat conflicting" information, you won't find that on this or the herpes expert forum -- and really not much on the community forums if you'll carefully distinguish between theoretical and actual or proved risks of HSV transmission.
Thanks for your kind words about the forum. I hope this has helped.
HHH, MD
Glancing back at several other threads over three years, you have long been concerned about catching herpes, oral or genital. Anyway, I'm pretty confident that once again you weren't infected. Initial HSV infections, oral or genital, typically cause multiple painful lesions and, for oral infection, severe sore throat. Such symptoms are especially likely in people with true primary infection, i.e. those like you with negative blood tests for both HSV-1 and 2. A single rongue ulcer of the sort you describe is much more likely to be a garden variety canker sore or something else, but not herpes. Also, with a cracked or chapped lip, had you acquired HSV, I would expect that to be the most likely site of inoculation and therefore of the initial symptoms.
As for the non-insertive genital contact, herpes in theory can be so transmitted but it is rare. There are no data on this and I can't state a numerical risk. In heterosexual couples in which one person has HSV-2, the average transmission rate appears to be about 1 in a thousand for each episode of unprotected vaginal sex. It's fair to assume the risk of "outercourse" is a lot lower than that, but that's all I can say. In any case, low enough that it shouldn't be a worry, especially if your partner didn't have a visible genital herpes outbreak.
As for "somewhat conflicting" information, you won't find that on this or the herpes expert forum -- and really not much on the community forums if you'll carefully distinguish between theoretical and actual or proved risks of HSV transmission.
Thanks for your kind words about the forum. I hope this has helped.
HHH, MD
MEDICAL PROFESSIONAL
Systemic symptoms often are present in primary HSV infections, but not necessarily. "Tingling", burning and similar sensations rarely accompany an initial HSV infection. This is an issue only for recurrences, in which case a neurological "prodrome" may involve such sensations for a day or two before the outbreak itself appears. The actual feelings, and the words used to describe them, are quite variable; I can't say how many people would complain of tingling, burning, or other sensations.
Don't over interpret minor symptoms. Without multiple painful lesions etc, you can move on with confidence you didn't acquire an HSV infection.
Don't over interpret minor symptoms. Without multiple painful lesions etc, you can move on with confidence you didn't acquire an HSV infection.
Sorry - or would tingling occur BEFORE a sore throat?
WOW that was a fast response - thanks!
And yes, it has helped, much. To anyone reading this - ONLY go to medhelp if you have STD questions. Truly.
Yes I do have HSV (and other) anxiety, and I'm absolutely getting treated for that, I promise. :)
If I heard you right, you're saying that most true initial oral OBs would be accompanied by the "systemic" symptoms like sore throat, and glandular swelling?
And, is the "prodome" more of a tingling or a burning? I don't know how to define "tingling," so it's hard to describe what I'm feeling.
Would it be common to experience that type of lip prodrome WITHOUT the other symptoms in a primary OB?
Also, please permit to explain what I meant about conflicting information - actually, I find that you and the other doctors are ALWAYS in agreement. However, there are some other long-time posters that have said HSV is transmitted by outercourse and skin/skin contact, and not necessarily theoretical. That's all I meant.
Thanks again!
And yes, it has helped, much. To anyone reading this - ONLY go to medhelp if you have STD questions. Truly.
Yes I do have HSV (and other) anxiety, and I'm absolutely getting treated for that, I promise. :)
If I heard you right, you're saying that most true initial oral OBs would be accompanied by the "systemic" symptoms like sore throat, and glandular swelling?
And, is the "prodome" more of a tingling or a burning? I don't know how to define "tingling," so it's hard to describe what I'm feeling.
Would it be common to experience that type of lip prodrome WITHOUT the other symptoms in a primary OB?
Also, please permit to explain what I meant about conflicting information - actually, I find that you and the other doctors are ALWAYS in agreement. However, there are some other long-time posters that have said HSV is transmitted by outercourse and skin/skin contact, and not necessarily theoretical. That's all I meant.
Thanks again!
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
