Male getting oral herpes through oral sex on female

[bigbabyQQ]

Since Jan 10, ie. 12 days after I gave unprotected oral sex on the female, I started to have noticeable symptoms (blisters/ulcers, yellow/grey in color surrounded by reddish border) inside my mouth.

These ulcers have been feeling painful, there are about 15 different 1-3mm ulcers found mostly under the tongue and inside lining of the lower lip. There were about 2 inside the cheek.

I spent a long time researching on the internet and I have got a lot of conflicting information. Some of them suggest that:

1) Oral herpes most commonly occurs outside the mouth on and around the kips and facial area. When Herpes occurs within the mouth, it will only occur on the non-movable tissue which are the gums adjacent to teeth and on the hard palate (roof of the mouth).

2) Oral herpes (herpes labialis) is most often caused by HSV-1 but can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth.

It's been 6 days now since this outbreak and all symptoms have been found inside my mouth; I have no symptoms at the corner of my mouth, on the lip and on the face.   Also, as of yesterday, there were still 2-3 new (very small) blisters found on the inside lining of the upper lip.

Here are my questions:

1) From all of the above information, does my symptom sound like oral herpes (caused by either HSV-1 or HSV-2) or something else?

2) Why am I still getting new blisters formed as I thought the primary outbreak should happen in one go?  When will it stop?

Please advise.

Many many thanks in advance.

[H. Hunter Handsfield, M.D.]

Twleve days is a little long an incubation period for initial herpes, and viral infections other than herpes can cause sores in the mouth (coxsackievirus, adenovirus, and others).  But herpes is a possibility.  If this is herpes acquired from the sexual exposure you describe, it could be either HSV-2 (from cunnilingus) or HSV-1 (from oral contact, if you kissed her).  Initial oral herpes can be entirely inside the mouth, on any surface, fixed or otherwise.  But don't get hung up on inside/outside the lips or fixed/moveable surfaces; those are trends, not absolutes.  If you do have oral HSV-2 infection, you can expect to never have recurrent outbreaks; recurrent oral herpes due to HSV-2 is extremely rare.  Initial herpes outbreaks can have a relapsing course over 2-3 weeks or even 4 weeks.

Too bad you didn't see a health care provider right away; if this is herpes, starting treatment (with acyclovir, valacyclovir or famciclovir) within a week would have settled it down by now--but at this juncture it probably is too late to make any difference.  Still, you ought to see a health care provider for proper diagnosis and advice.  If s/he thinks a herpes evaluation is worthwhile, and if there are no active lesions to culture for the virus, a blood test may be needed.  If so, make sure it is the proper test (see numerous other messages and replies on this forum).

Good luck--  HHH, MD

[bigbabyQQ]

Hi HHH,

Thanks very much for your feedback.  Would you please clarify one important thing for me?

I've read information about "site of preference" of HSV-1 and HSV-2.  If I indeed had an oral infection by HSV-2, does it mean that the HSV-2 virus will travel down the body and recurs as genital herpes infection in the future?  Or will the virus shedding happen in the genital area causing potential transmission to another person through genital-genital intercourse?

I guess most people would not think this can be the case but most oral herpes are caused by HSV-1, which tends to stays in the upper part of the body.  

I'm quite worried that my oral herpes will turn into genital herpes, which is going to be a nightmare.

[H. Hunter Handsfield, M.D.]

Herpes doesn't travel through the body to new sites.  Genital herpes stays genital and oral stays oral, regardless of virus type.  The only exceptions are when both oral and genital infection are acquired at the same time, by having both oral and genital sex with the person from one catches the infection.

HHH, MD