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Oral HSV2 - very worried
Hello:
I recently made a poor judgement call in engaging in mutual oral sex twice with a man I have been dating. He was diagnosed with HSV2 two years ago and has had 1 outbreak. I have oral HSV1. After reading the low risk of oral sex, I made the poor choice of engaging in unprotected oral with him. Although I care for this man, it has been a tumultuous time in my life, and I am now considering reuniting with my exhusband. Im embarrassed to say, these encounters happened only one week ago and now I have the start of a cold sore and possible sore throat and fear I may have oral HSV2. We did not have genital sex. The following are my questions:
1) My cold sores in the past were all on the right side of my mouth. I thought all HSV1 sores erupt in the same area. This one is on the left side of my mouth. Does this indicate a new infection?
2) Could I have spread a new infection to myself genitally if I touched myself after having touched my mouth without realizing?
3) I think this man may have kissed me after I performed oral before he performed oral on me. Could I have been genitally infected this way?
4) Should I be tested? How long do I need to wait? which test?
5) What kind of doctor would have to test/swab the sore? when? does it have to be oozing?
6) I only have the sore on my lip...none inside? would this be unusual for an initial infection?
7) If the bump does not blister, can I assume it is not herpes? (although I'm almost positive it's a cold sore)
Sorry for so many questions. I am very worried. I appreciate any guidance you can provide me.
I recently made a poor judgement call in engaging in mutual oral sex twice with a man I have been dating. He was diagnosed with HSV2 two years ago and has had 1 outbreak. I have oral HSV1. After reading the low risk of oral sex, I made the poor choice of engaging in unprotected oral with him. Although I care for this man, it has been a tumultuous time in my life, and I am now considering reuniting with my exhusband. Im embarrassed to say, these encounters happened only one week ago and now I have the start of a cold sore and possible sore throat and fear I may have oral HSV2. We did not have genital sex. The following are my questions:
1) My cold sores in the past were all on the right side of my mouth. I thought all HSV1 sores erupt in the same area. This one is on the left side of my mouth. Does this indicate a new infection?
2) Could I have spread a new infection to myself genitally if I touched myself after having touched my mouth without realizing?
3) I think this man may have kissed me after I performed oral before he performed oral on me. Could I have been genitally infected this way?
4) Should I be tested? How long do I need to wait? which test?
5) What kind of doctor would have to test/swab the sore? when? does it have to be oozing?
6) I only have the sore on my lip...none inside? would this be unusual for an initial infection?
7) If the bump does not blister, can I assume it is not herpes? (although I'm almost positive it's a cold sore)
Sorry for so many questions. I am very worried. I appreciate any guidance you can provide me.
MEDICAL PROFESSIONAL
Thanks for the thanks. Happy fourth.
Thank you again doctor. I cannot tell you how much I refer to you and your site for guidance. It is very much appreciated.
MEDICAL PROFESSIONAL
With this more detailed explanation, I am doubtful this new lesion is a herpes outbreak of any kind. If it were, I would expect it to promptly (within a day or two) turn into a blister then to ulcerate, which is probably how your chronic oral herpes behaves. I would also expect more than one lesion. If it doesn't progess in this fashion, probably nothing need be done. There's no point in a PCR or culture for HSV unless the lesion becomes a blister or an open ulcer.
Thank you so much for the extensive response. I never expected a response on the holiday. I appreciate it. It's been about 12 hours since I noticed what I thought was the start of the cold sore. It hasn't manifested yet. It felt like a bump under the skin at the corner of my mouth but now I'm not sure. There is no blister yet...no fluid...just what may be a slight bump. Last night it looked red, now it doesn't. When I've had them in the past, I believe they appeared quickly. My sore throat is pretty much gone but my one gland under my neck is slightly swollen. As a general rule though I regulalry get swollen glands...have my whole life. I'm not opposed to testing at all. I'm just confused. When I wrote you, I really thought I had the start of a cold sore.
How long would it take it to turn blister-like if it is HSV2? If it doesn't, should I still be concerned? There's nothing really visible to show a doctor at this point. The slight bump is under the skin. If it doesn't transpire to be anything more, do you think I still need to be checked?
How long would it take it to turn blister-like if it is HSV2? If it doesn't, should I still be concerned? There's nothing really visible to show a doctor at this point. The slight bump is under the skin. If it doesn't transpire to be anything more, do you think I still need to be checked?
MEDICAL PROFESSIONAL
See above.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
I don't agree your decision to have mutual oral sex with a partner with known genital HSV-2 was necessarily a "poor choice" and you shouldn't beat yourself over the head with it. As you seem to understand (at an intellectual level if not emotionally) it was a low risk exposure.
That said, I cannot guarantee you don't have a new oral HSV-2 infection. Given the timing of your new cold sore and its new location compared with your earlier oral HSV-1 outbreaks, and the association with sore throat, I agree it would be wise for you to be examined and tested for oral HSV-2. I recommend you visit a doctor or clinic ASAP (maybe difficult today, July 4, assuming you're in the US); or tomorrow for sure. The point is to have a swab of your new cold sore and perhaps your throat for testing for HSV-2, preferably by PCR -- although culture would be OK if that's the only test offered by your doctor or clinic. You also could have a blood test, as a baseline: if the PCR or culture don't show HSV-2, then you could have a second blood test in several weeks to see if there is any change.
To your specific questions:
1) Cold sore location isn't set in stone. As noted above, this could be a clue to a new HSV infection, but most likely it's your old one despite the location. If your PCR/culture is positive for HSV-1, it will confirm it's just an atypical recurrence.
2) Autoinoculation (self infection of new body parts) is theoretically possible but very rare. As a common sense approach, I would advise you to wash your hands before using the toilet, in case you have (unconsiously) recently touched the cold sore. But even if you forget, the chance is exceedingly low.
3) Passive transfer of his virus to your genital area by this mechanism would be very rare as well. No worries.
4,5) As noted above, I believe you should be tested. Most gynecologists and dermatologists should be up to speed on the necessary tests, but so are many internists and family medicine doctors; or your local health department STD clinic (although many don't have direct HSV testing available); or a Planned Parenthood clinic. I suggest you call ahead to see whether the tests I have recommended are available.
6) Absence of sores inside may be slightly reassuring, but nonprimary initial infections can be very mild; and you do have sore throat. This doesn't influence my opinioin one way or the other.
7) You are a better judge than I can be of the likelihood you are in the early stage of a herpes outbreak. If it is behaving like your previous cold sores, that's enough for me to be suspicious.
8, below) I suggest crossing this bridge if and when you come to it. However, i indeed you turn out to now have oral HSV-2, you can assume that in the future you will be highly resistant -- perhaps completely immune -- to yet another HSV-2 infection anywhere on your body.
I hope this has helped. Thanks again for an interesting question. I'll be interested in hearing how it all shakes out after you have been examined and tested.
Best wishes-- HHH, MD
I don't agree your decision to have mutual oral sex with a partner with known genital HSV-2 was necessarily a "poor choice" and you shouldn't beat yourself over the head with it. As you seem to understand (at an intellectual level if not emotionally) it was a low risk exposure.
That said, I cannot guarantee you don't have a new oral HSV-2 infection. Given the timing of your new cold sore and its new location compared with your earlier oral HSV-1 outbreaks, and the association with sore throat, I agree it would be wise for you to be examined and tested for oral HSV-2. I recommend you visit a doctor or clinic ASAP (maybe difficult today, July 4, assuming you're in the US); or tomorrow for sure. The point is to have a swab of your new cold sore and perhaps your throat for testing for HSV-2, preferably by PCR -- although culture would be OK if that's the only test offered by your doctor or clinic. You also could have a blood test, as a baseline: if the PCR or culture don't show HSV-2, then you could have a second blood test in several weeks to see if there is any change.
To your specific questions:
1) Cold sore location isn't set in stone. As noted above, this could be a clue to a new HSV infection, but most likely it's your old one despite the location. If your PCR/culture is positive for HSV-1, it will confirm it's just an atypical recurrence.
2) Autoinoculation (self infection of new body parts) is theoretically possible but very rare. As a common sense approach, I would advise you to wash your hands before using the toilet, in case you have (unconsiously) recently touched the cold sore. But even if you forget, the chance is exceedingly low.
3) Passive transfer of his virus to your genital area by this mechanism would be very rare as well. No worries.
4,5) As noted above, I believe you should be tested. Most gynecologists and dermatologists should be up to speed on the necessary tests, but so are many internists and family medicine doctors; or your local health department STD clinic (although many don't have direct HSV testing available); or a Planned Parenthood clinic. I suggest you call ahead to see whether the tests I have recommended are available.
6) Absence of sores inside may be slightly reassuring, but nonprimary initial infections can be very mild; and you do have sore throat. This doesn't influence my opinioin one way or the other.
7) You are a better judge than I can be of the likelihood you are in the early stage of a herpes outbreak. If it is behaving like your previous cold sores, that's enough for me to be suspicious.
8, below) I suggest crossing this bridge if and when you come to it. However, i indeed you turn out to now have oral HSV-2, you can assume that in the future you will be highly resistant -- perhaps completely immune -- to yet another HSV-2 infection anywhere on your body.
I hope this has helped. Thanks again for an interesting question. I'll be interested in hearing how it all shakes out after you have been examined and tested.
Best wishes-- HHH, MD
...and I forgot to ask...8) If I do have HSV2 orally, how protected am I from getting it genitally if I begin having vaginal sex? I know it provides protection, but is it 100% and how long does it take the antibodies to build up to have this protection.
Thank you again.
Thank you 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.
