STDs Expert Forum
Oral HSV2 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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Oral HSV2 Symptoms

I had 2 HSV Western Blots from the UofW years ago and was HSV1+ and HSV2-. I dated a nurse with GH (cultured and typed HSV2). When we broke up I waited 6 months and took the WB and again at 1 year. Both positive for HSV1 and negative for HSV2.

I then had the Herpes Select a couple of years ago results were HSV1 =  2.26 and HSV2 = .19.

Now, I am worried about a possibility of HSV2 again from "oral sex" with a woman on a Monday. I was drunk. Oral is all we did - not "sex".

I did have unprotected oral and genital sex with my new girlfriend 10 days before this encounter. So, this could also be a possibility with all the stuff below. We had both oral and regular sex for a week. Last sex she was just beginning her prior so there was some blood on the last day.

BUT, I have had no genital symptoms at all.

About 2 to 3 days after the "oral sex" on Monday - Thursday my nose starting REALLY hurting and turned red. Outside of the nose where it "flares out". It hurt and swelled for 3 days then I got a BIG sore on the outside of my nose - not around the nostril but on the side on lower side of nose where it flares. The sore on my nose then popped on Sunday (I popped it) and scabbed over. The scab then would come off every day after I showered and a new scab would form. In a week it healed.

I then got sick a few days later after the sore popped on Sunday. I started antibiotics (had some on hand) on the next day on Monday. Then on Monday I had night sweats and a sore throat. A few days later on Wednesday I became sick -- flu-like, sore throat, white spots on tonsils and inside of the mouth, red spots on tonsils and soft areas of the mouth, headache, 2 night sweats, etc,). Lasted about a week.

Then the nose sore came back a lot milder and 2 spots popped (I popped it) and then scabbed and healed quicker - about 3 days and then just dried skin that comes off. Still looks a little shiny even today - the last nose sore popped last Saturday the 4th.

So, from the onset of the nose swelling to now it has been 3 weeks and 3 weeks from the "oral sex" episode.

Now I am freaked about getting HSV2 orally. (Nose and sore throat.) Or even HIV. And HSV2 or HIV from my "new girlfriend"? Even though no genital signs in any of this.

So, had a Herpes 1 & 2 IGM to see if recent exposure or reactivation of HSV1. I have not had a cold sore for years. AND a Herpes Select IGG for a baseline since exposure 3 weeks ago with the "oral sex" person. It would be 31 days from "new girlfriend".

1.) Does it sound likely to have a new acquired HSV2 oral infection that gave me a huge sore on my nose 3 days after oral sex and then getting sick (sore throat) a few days after that?

2.) Does this sound like herpes: "The scab then would come off every day after I showered and a new scab would form."??

3.) HerpesSelect that I just took - does the value of the HSV2 mean anything if it different than the 2003 test which was .19? Or the HSV1 value?
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Questions 1 and 2: The symptoms you describe don't particularly sound like herpes, but probably are consistent with it.  The risk of getting facial herpes from a single episode or oral-genital exposure is extremely low.  You should not have had the IgM test; the results are worthless whether positive or negative. (Search the STD forum threads for more information).  All you can do at this point is await another HerpeSelect test a few weeks from now.

Question 3: Varying ELISA ratios are meaningless with HerpeSelect, as long as the result remains in a clearly positive or clearly negative range, as yours did.  Everybody always has different numbers on serial tests.

Yikes! I have searched all over the internet and have found very very little on HSV2 orally and nothing at all on HSV2 causing facial lesions. Most of the few things I read about oral HSV2 mentioned ulcers in the throat and mouth. Then nothing at all about facial lesions. Especially not outside the mucosa areas like mine was. And not one that was just one big raised lesion. It came from down deep. And it hurt and swelled for 4 days before it came to a head. Did not seem to just be on the surface like I have read about HSV. And my throat did not hurt until a few days after that.

I do realize that a true primary HSV infection (negative for 1 or 2) can be really bad orally in adults. Then reoccurrences are outside of the mucosa areas are and can be facially. Hmmm...

But, I had cold sores as a kid. So, this was not a "primary oral HSV" - it was a first time HSV2 oral if that is what it was. And those seemed to be confined to the inside of the mouth?

How long should I wait? Is 6 weeks good? Percentage who are positive at that time?

I just do not want to wait another 3 months and freak out.


"I do realize that a true primary HSV infection (negative for 1 or 2) can be really bad orally in adults."


"I do realize that a true primary HSV infection (negative for 1 AND 2) can be really bad orally in adults."
I was wondering if there is any stats or studies on non-genital HSV2 infection rates.

I've seen numbers on the Web from 5% to 30% non-genital
(facial,Whitlow, etc) but these numbers are probably suspect.

As a side note: Have you ever considering writing a book for sexually active persons concerning STD risk and how to manage it.  With all the mis-information out there, I think it would
be a very important work.
I've been reading everything out there regarding hsv2 and still am not sure if I've been misdiagnosed.  When I was 26 I had a sore/irritation on my labia which my gyn told me was herpes.  He never cultured it or did any blood tests .......just looked at it and diagnosed me.  This was in 1985.  In 1989 when I was pregnant and seeing a different ob/gyn she ran a "TORCH" screen on me and told me I was positive for cmv and herpes.  The cmv antibodies turned out to be from an old infection that she said I probably acquired from my job as a nurse on a micu.  I'm wondering now if the test done in 1989 was gG specific for hsv1 and hsv2.  I have never had another sore or lesion in all these years(20 years) and my (now ex-)husband still tests negative.  Do you think the tests done 20 years ago were specific to type 1 vs type 2?
A related discussion, oral herpes was started.
Yes. It is quite possible that these scabs on your nose are oral hsv. I was just recently diagnosed with hsv2. I have never had a genital outbreak. The outbreaks have always been just like the scabs on your nose...or scabs that look like shingles on the torso and the arm. The spots never get big but they are quite frequent since I got the virus. I'm not actually sure when I got the virus. I'm pretty sure my first outbreak was within the last 5 months...but it was almost unnoticable. I also have been getting sick easily. Swollen lymph, coughing, sweats, abdominal pain
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H. Hunter Handsfield, M.D.Blank
University of Washington
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