HSV-1 Outbreak? Something else? or Just Anxiety?

[sguy30]

I was with 2 CSWs on Monday. I had protected oral sex and barely penetrated vaginally with just the tip of my protected penis (no pelvic contact that I recall). Prior to sex they both rubbed up against me naked, one grinding her genital area against my leg, touching my anus and both of them kissing me before and after cunelingus on each other, parted lips but no tongue, neither appeared to have any sores. It is now 5 days later, and I have general flu-like symptoms, night-sweats, fatigue and chills, achiness, loss of appetite, mild headache, scratchy throat but no fever or all out sore throat.  I have noticed little tiny white bumps on my lips. My lips also feel dry and a bit swollen on one side.

I think my risk was very low for most STDs but I am still concerned about possible infection from HSV-1, HSV-2 or HPV. Do my symptoms point to HSV-1 or anything else or am I suffering from anxiety and I am just now noticing the really tiny white bumps on my lips? They don’t look like the pictures of herpes on the web, it looks more like pictures of fordyce and they don’t hurt or itch, but I have also read herpes doesn’t present the same way on everyone.  From reading this forum, my risk should be low from the protected oral, but what about the grinding on my leg or kissing?

I know for a fact I did not have any STDs including HSV1/2 prior to this encounter. I plan on getting a full STD panel but I have read that you have to wait 3 months.

What STDs should I be worried about with this exposure or symptoms?

As this is only day 5, is it too early, what symptoms should I lookout for?

I am very nervous, how soon can I get tested?

[sguy30]

Did I use up my follow ups and should pay again? or just be patient?

[sguy30]

I went to an urgent care clinic, PA on duty. She said spots did not look like herpes, said they could possibly be from just irritation or inflammation. I asked if she wouldn’t mind culturing them anyway for peace of mind, she said they are way too small to culture/nothing that can be cultured and that it is nothing to worry about.  

Should I try to find someone else to look at this? Or follow up with blood tests in the future or should I just let it go at this point and assume I have been diagnosed correctly and put this to bed.

[Edward W Hook, MD]

Yes, a culture or PCR test taken from the sores on your mouth at this to me is the right thing to do.  I suggest you cal and state you need a herpes culture or PCR test before you go, just to make sure they offer it.  EWH

[sguy30]

Thank you for your help!

Should I go to get a culture or PCR test now? is 6 days long enough? Again the sores look more like fordyce and are really tiny, would that be enough for a culture or sample?

A Physicians Assistant friend of mine said it doesnt look like herpes, but I am still worried because I have read that symptoms are not always pronounced or recognized.

Can I walk into any walk-in clinic and ask for this to be done?  
Or do I need to go to the hospital?
The only STD focused clinic in the area is a planned parenthood, would that be better? Or doesnt it matter, any health care provider will do?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  Your protected exposures do not represent meaningful risk for any STD.   As I understand it however you and your partners were kissing however and the combination of your flu-like symptoms, possibly swollen lips, and possible sores on your lips sound like HSV-1 should be considered.  If this is HSV-1, a culture or PCR test of the lesions on your lips will be positive but a blood test will not be.  Alternatively, you may have just caught a coincidental non-STD sore throat and viral illness.  I would suggest you have a trained clinician take a look.  

HPV is not a concern.  Not only were your exposures low risk for HPV but your symptoms are not suggestive.  HPV infections are typically asymptomatic.

I hope this helps.  Have a health care provider take a look.  EWH