what to expect

I'm certain I acquired herpes through open mouth kiss from a stripper about one month ago. Later that evening my lips tingled and I awoke with tremendous sinus drainage. Felt ill from sinus for about a week and a herpes sore appeared around lip. Went to doctor said it could be herpes gave me Famvir. During this time or soon after the headache became worse and I have ringing in my ears. Took meds for 10 days and sore cleared up. During this I had a little discomfort in butt and thighs, thought it was over all but the ringing and headache. A week later  have some burning in my lips periodically but no sores. The pain and tingling in butt and thighs is more painful and goes down to feet and has been on and off for about a week. Headache and ringing in ears persists. My question is what can I expect? Will the symptoms persist, get worse stay the same? Do you think the pain and ringing in ears is related to herpes? How likely is a chronic case with constant symptoms. Thanks for your help I need it.

[H. Hunter Handsfield, M.D.]

I doubt you acquired oral herpes from that exposure.  It is much more likely that you caught a garden-variety cold virus, you could have acquired during the kiss you describe, or from someone else.  That infection caused the "sinus" symptoms and also triggered an episode of oral herpes that actually existed previously.  (Oral herpes often is triggered by an upper respiratory viral infection.  That's why they're called cold sores, after all.)

HSV simply cannot cause symptoms within hours ("later that evening"); it takes at least 2-3 days and often up to 2 weeks.  When initial oral herpes causes symptoms, generally there are multiple lesions inside the mouth, not a single sore outside the mouth, such as "around the lip".  "Sinus drainage" would be an unusual herpes symptom.

Most likely you have had oral HSV-1 for years, probably acquired in childhood.  If your doctor had done a blood test for HSV-1 when you first presented, and if it was negative, and if a later test became positive, that would prove recent acquisition.  But a blood test done now probably will be positive, in which case you'll never know when you acquired it.  (On the other hand, it is possible that a blood test would be negative for HSV-1, which would mean that none of your symptos was due to herpes.  So it still might be a good idea, although it's optional.)

Regardless of when you got it, herpes is not causing your continuing lip burning, headache, ringing in ears, or pain/tingling in your butt; HSV never causes symptoms like those.  You should check back with your doctor if they persist.

Good luck--  HHH, MD

[gracefromHHP]

Oral herpes is very common. Over 60% of adults in the US are infected with hsv1 orally whether they've ever gotten an obvious cold sore to know it or not.  You might've gotten hsv1 orally from this gal from your kiss or you might've just contracted a viral illness that caused your upper respiratory symptoms and then triggered a reoccurance of a prior hsv1 infection in your body.  It doesn't sound like you were ever tested to figure it all out at this point.  Famvir can/does cause headaches and they should stop once you are done with the medication.  Ringing in the ears from it would be very unusual.  Oral herpes would not cause symptoms below the waist.  Symptoms would be limited to the facial nerves area - the virus won't travel all over your body.  You should follow up with your doctor for all your symptoms and look beyond this kiss as the cause of all your symptoms.  

[glass0330]

Thank you for your reply. Can you please make it clear for me. I should have no symptoms in my lower body if I contracted facial herpes even if I find I'm infected with hsv2. I thought that the viruse settled in the base of your spine? Thanks again.

[gracefromHHP]

If you have hsv2 genitally it's not from just a kiss on the lips from this encounter you posted about.  Any herpes you acquired thru a kiss on the lips would infect that area - not travel to your genitals.

[glass0330]

What I meant by symptoms in my lower body was the pain and tingling in butt, legs, and feet. Sorry for the confusion. I thought the viruse could move from inoculation area the mouth and move down the spine where it would lay until next outbreak. Is this not the case. thanks again

[glass0330]

Thanks, Dr. HHH So I'm clear if I acquired oral herpes there is now way lower body pain or tingling is related. The viruse resides in the nerves around head or face. Thanks

[glass0330]

Thanks, So I'm clear there is no way oral herpes can cause pain or tingling in lower extremities. Oral herpes virus resides at the nerves at face or head is that right? Sorry if this seems repeditive. Please reply this is last question.

[H. Hunter Handsfield, M.D.]

That is correct; oral HSV could not cause those symptoms.  Probably not genital HSV either.

HHH, MD