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Herpes risk from one time protected oral sex - had a lots of symptoms
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Herpes risk from one time protected oral sex - had a lots of symptoms

Hello Dr,

I had a protected oral sex exactly 12 weeks back. I also fingered her while she was performing oral sex on me.
I touched her breasts with the finger I used for fingering and then sucked her breasts immediately. I dont know if
her vaginal fluid went inside my mouth through this enconuter. Then I ejaculated inside the condom while she was
performing oral on me. Then she gave me a "good bye" kiss on my lips for 1-2 secs. The total encounter lasts long
for just 10 min.

After this incident, exactly one week later, I feel weird symptoms on  my mouth. I had a small cuts or cracks like
1mm wide in my lower lips (around 2 or 3). It started itching when i eat some spicy foods. I went to the Dr and
he examined my lips and told me that was not looks like oral herpes. He was 100% sure and told me that
if you get oral herpes then you will get fever blisters or sores on my lips. I didn't develop any blisters on
my mouth and more over, these small cuts gone away in 2 days without any treatment.

I have tested for all STDs after 4 weeks including Herpes 1&2 using HerpeSelect and all came back Negative.
In the mean time, I had some genital itching that last for 1 week and had a mild headache that last for 1 week and
tingling sensation that last for 1 week and lower abdominal pain last for 4 days. I didnt't test for NGU
and visited urologist 2 months after that and he tested my urine and everything was normal and also examined
my penis and he told me that was perfectly alright. I asked him about the tingling and told me that I was
very anxiety about this encounter and my mind was playing a trick there.

In the mean time, those small cuts or cracks came back again 5-6 times in the last 12 weeks and went away in
2 days without treatment.

I also tested for all STDs (Gono, Chlamydia, Heb B&C, Syphilis, Herpes 1&2 (IgG type specific) and HIV after
10 weeks and all came back NEGATIVE.
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Welcome to the STD Forum.  The exposure you describe carried virtually no risk for STD (including HIV) acquisition and the testing you have had since confirms that you did not become infected through the exposure you describe.  Your vaginal exposure was condom protected and classical STDs are not transmitted by kissing.  HSV-1 can be transmitted by kissing but in the absence of a lesion on your partner's lips, would be most unusual.  Further, your symptoms are non-specific and the testing you have had is, when considered in context, definitive.  To address your specific concerns:

1.  If you had an initial outbreak of HSV-1, the lesions would have been more obvious and your tests would have probably become positive.  that the cracks have come back several times does make one worry about HSV but if this is what is going on it is more likely that you had HSV-1 before and these are recurrences.  Your negative blood tests make this less likely and suggest that something else, perhaps just dry lips, combined with anxiety, may be causing this.  Recurrences of HSV almost never come and go in only 2 days.  The only way to prove this is HSV-1 would be to have a positive culture or PCR test taken from the lesion and in the absence of that, I feel confident in saying this is not HSV.

2.  Yes it would. As I said above, that they were both negative adds to the evidence, along with the atypical nature of the lesions, that this was NOT HSV.

3.  There is some debate as to the best time for follow-up testing See Dr. Handsfield's recent comment to another client  http://www.medhelp.org/posts/STDs/HSV-Clarifications/show/1306350  ;) but in the context of your situation, a 12 week test should be sufficient to completely rule out HSV.

4.  All STDs, including HIV have now been ruled out.

Hope these comments are helpful to you.  EWH
6 Comments
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My questions are:

1) I had 2-3 small cuts or cracks in my lips and gone away in 2 days without any treatment. So far it happened 5 or 6 times in last 3 months. Do you think it is oral herpes outbreak?  Does oral herpes outbreak finish in 2 days?  

2) I started developing this symptom after 1 week of the encounter. If this was really a  oral herpes,  wouldn't it show up in the HSV test I took after 4 weeks and 10 weeks?
   My both HSV1&2 herpeselect tests were NEGATIVE after 4 and 10 weeks.

3) I have completed 12 weeks and 2 days as of now.
   Can I take one final test this week or do you suggest me to test at the end of 16 weeks?  What are the chances that this 11th week HSV test changes to POSITIVE at the end of 12 or 16 weeks?

4) As I have tested for all STDs after 10 weeks, What are the STDs can I ruled out 100% from my list?
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Avatar_n_tn
Hello Dr.

I forgot to ask one question related to NGU.

1) What are the chances of getting NGU from this one time protected oral sex? I heard 70% of NGU cases are due to Chlamydia. Then what are the remaining 30% of NGU causes? Do I need to really tested for those as well apart from NEGATIVE Chlamydia?

2) The CSW had some of the previous customer's semen on her finger which she used to open my condom and put the condom on my penis? what if the previous custumer's semen came in contact with my penis? what stds am i at risk for?

3) BTW, today I tested for Herpes1&2 with HerpeSelect (After 12 weeks and 3 days) and waiting for the result. If it come back as NEGATIVE, can I move on with my life?

Thanks Dr. for your feedback.
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300980_tn?1194933000
1, there is not a specfic number to give you regarding NGU from oral sex but certainly less than 5%.  Chlamydia is a common cause fo NGU associated with genital but not woth oral sex.  Chlamydia is not transmitted by oral sex often enough to worry about.  The diganosis of NGU is different thatn chlamydia and if you are worried, you should be tested.  

2.  Not a realistic concern.

3.  Yes, you should believe your test results and move on.  EWH
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Hello Dr.Ed, If you don't mind, Can I have some clarification on your answers?

1) What STDs are I at risk for over all from this exposure (Condom protected oral sex)?
2) What STDs can I get if the previous customer's semen came in contact with my penis?
3) The risk of NGU is less than 5% from either protected oral sex or unprotected?

Thanks Dr. I hope this will be my last questions..
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300980_tn?1194933000
These will be your last questions because you are repeating yourself.  These have been answered earlier and can be addressed by re-reading my original replies.  Last answers:

1.  See above.  Virtually no risk.
2.  Rediculous scenario which does not warrant an answer.
3.  Less than 5% from unprotected sex.  Zero with condoms.

End of thread.  EWH
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