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Please assess - Oral Herpes?

The nature of the exposure is uncertain – too drunk. Maybe none at all.
after 2 days I felt a funny feeling inside my lower lip  -  the next day noticed a bump/ ulcer –swelling began – noticed it was whitish.
It looked like 2 eyes looking at me – ie. 2 black dots with white border. I messed with it a lot and it seemed to swell the lip and another one on the other side appeared – within hours the inside of my lower lip was huge. The doctor in ER said it was a mouth ulcer gone wrong. It went away in a few days – some lingering marks where they were  have remained, they are very faint.
I developed an nsu around a week later.  I took antibiotics and it seemed to clear up within 3 days. Whether of its own accord or due to the pills I don’t know. I had NSU about a year ago but was successfully treated. My std doc assured me this does not have to be related to a new exposure.
4 weeks after the first mouth ulcer – a single one around the same location (deeper in). It was red with a yellow centre. Std clinic said no point to swab as it didn’t look like herpes.
I had one on the inside of my cheek a week or so after that – which when its pain died down (1 day) left my jaw sore and a slight sore throat.
The only external "sore" – came around the 6 week mark – a pimple  feeling in the lip (upper corner)  and then a red area develops (mostly above the lip) – some hair associated  in it – it did pulse a little bit when pressured. Faded a bit then returned. Always just a red mark – 3 weeks later it is still very faintly visible.
At 8 weeks there has been another small ulcer in the lower lip again. Short lived.
Do you think I am having oral herpes? I was screened by blood test last year and negative.
Dr. H said it can be like this - inside going on for a long time if it is primary..
do you suggest testing? my anxiety level is huge.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
The theory about normal bacteria in a partner causing such symptoms is just that, a theory.  There's a lot that isn't known in this area.

In the UK, the NHS network of GUM clinics are among the best available STD services anywhere in the world.  If you're not under the care of a GUM clinic, that's where to go for excellent advice and care.

That's all for this thread.  Take care.
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Avatar universal
sorry one FINAL foloow up - if my partnert had some bacteria that irritated me - is it possibel for it to manifest itslef inthis way - as in not anytiome we have had sex - until now? been together 2 years.

sorry - I should of included this above.

dont worry - that will end the thread.
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Avatar universal
I will go tomorrow and have a swab and bloods done. I am in the UK and it is hard to get done here. some of the docs have said - theres no pointin testing for various reasons. ("what does it tell you - you have been exposed..")

I dont want to get into the percentages game but at 8 weeks I understand it is around 80%. also - igG tests...right..

thanks for the advise on NGU. I was very worried for my partner - but all docs have advise me to drop it - dont go looking for other bacterias. I need to take that seriously.
all symptoms cleared up within 3 days of pills.

she never really had symptoms - some lwr ab aches and worse period pains prior to treatment (it took her a few  weeks to be treated - hopefully not too much of a concern?) but her gyno examined her after all this and told her all appeared fine - and to drop this NGU issue thoughif it relaly concerned her to go and test for M genitallium and Ureaplasmas.. we are trying to avoid that though.. money...

I had 4 normal pills - she got 2 large ones - one dose in the clinic. presuming it was igram of Azythromycin each...

look doc - its a great service and I was really upset but feel more rational now. thank you - I think all my anxiety driven questions and fears have been reassured and I know what to do.

hopefully my tests will be neg.... I may post with results if thats ok?

Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
I doubt you have oral herpes, but the blood test will tell.  Usually it becomes positive within 6 weeks, but sometimes it can require up to 12-16 weeks.  I suggest you be tested now.  If negative, have another test at 4 months.

NGU that isn't due to chlamydia usually is not serious, either for the infected guy or his female sex partners.  If symptoms persist despite azithromycin, the usualy approach is to treat with doxycycline (or with doxycycline plus metronidazole, to cover the slight chance of trichomonas, which is hard to diagnose).  But in the meantime, don't lose a lot of sleep over it.  Serious consequences are very rare, if the occur at all.

As for exposure history, I would not necessarily assume a new sexual exposure in all patients in this circumstance.  Your regular partner may be carrying something that irritates your urethra.  For example, NGU sometimes appears to result from oral sex, probably due to bacteria that are entirely normal in the mouth but irritate the urethra.
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Avatar universal
oh  -symptoms and diagnosis for NSU -

very typical - clear discharge, mild dysuria at 10 days
swab - the WBC was 5 even.

thanks again doc.
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Avatar universal
sorry doc - just went and had alook there is a fresh ulcer inside the mouth  - looks the same as the 4 week mark one red inflamed with yellowy centre..... I will have it pcr tested.

at 8 weeks - still coming inside the mouth - ? I suppose anything is possibel with this.
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Avatar universal
thanks doctor...let me give you a little more background. I am hetro male.

am very concerned about oral herpes at this point.

I was tested for hsv 1&2 last year. and was negative (in correct window periods) - since then no exposure apart form the suspected one I mentioned.

I have a regular partner (2 years) - who is also assuredly negative - she has been in contact with my mouth and has not developed anytthing. we had sex hours after the suspected exposure (I never imagined I had done anything at that time) she is still ok.

its been over 8 weeks now since that frst ulcer appeared. can I chance a blood test?

during this past 8 weeks-  the ulcers have come and gone inside the mouth always.
the doctors here are not convinced but as you say possibly because it is atypical.

is there any way it could be anything else? sorry - anxiety is killing me as this would confirm I have messed around on my girl.

the NSU - yes, appearing in the this time frame has me worried - I was tested for chlam and gon - negative.

both me and my girlfriend weere treated with Azythromicin a few weeks back.

my friend who was with me on the night assures me it is really unlikely anything happened. (it was in a night club)

in your clinical experience - would you assume there had been new expsoure with my sorry tale if I presented in your clinic?
do I need to go on the mycoplasme/ureaplasma test trail now?
NSU - I have read so much and am quite well informed - but is there any realistic way it could be coincidental in your experience with patients etc?

blood tests for syph and hiv - neg at 6 weeks.

thank you so much for your thoughts... sorry if I appear to be grasping at straws - its an upsetting time.


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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll try to help.

Based on your description, I would describe your oral ulceration as consistent with an initial oral HSV infection, but not typical of it.  However, recurrent oral herpes rarely causes lesions inside the mouth, which probably explains why the STD clinic didn't think herpes was a likely explanation for the second occurrence.

Ideally a test for the virus (culture or PCR) would have been collected on one or both occasions when the ulcers were fresh, but apparently that wan't done.  But you are in an excellent position to sort this out with a repeat blood test.  If it has become positive for HSV-1 (or HSV-2, but that's extremely unlikely), it will mean you had a new infection in the past year; logically, that would explain the oral symptoms you describe.

Another thought is syphilis. That would be a rare cause for oral ulcers like you describe, but still a possibility -- especially if you are gay and your (unknown?) sexual exposure(s) could have been with other men.

Nongonococcal urethritis (NGU) is the preferred term for nonspecific urethritis (NSU), but it means the same thing.  NGU does indeed recur fairly frequently, but usually within a few weeks; a new episode a year later suggests (but doesn't prove) an entirely new infection.  You don't say your symptoms or how the diagnosis was made, which would help sort it out.  If you were intoxicated enough to not know about exposures that could have resulted in oral herpes, perhaps there was a sexual exposure you blacked out on.

Presumably tests for gonorrhea and chlamydia were done, and presumably with negative results, or you would have mentioned it.  If not, it's probably too late now -- although that depends in part on what antibiotic you were given.  As implied above, a syphilis blood test might be a good idea as well.

I hope this helps. Best wishes--  HHH, MD
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Avatar universal
I understand they have been looked at by doctors - and this is the first opinion that will count.
I am just concerned about the timing... ok the exposure is iffy - maybe a kiss - dont remember. The odds are that nothing happened. I have been STD clear up to this point though.
the NSU - I have had them in the past and yes they were treated with lots of antibiotics. So I dont see how this could be recurrent  - and far too coincidental with a drunken night out/ black out if so.

sorry for anxiety follow up before you answered! I am being told its nothing  - but that conflicts with what I read... and also my mouth has been healthy up until this point.

I was very ill around the time the ulcer appeared. (a little too much beer..) and a lot of vomiting and no liquids food etc.. for a couple of days... maybe this could contribute - maybe not.

anyhow  - your assessment is eagerly awaited.
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