Herpes of the Throat

[Nick114]

Hello, I am a 25 year old male from North Carolina.  Approximately 6 days ago I had unprotected oral and vaginal sex with a girl from school.  I am very paranoid about such casual encounter because I am NOT in the habit of having high-risk sex; however, on this occasion, alcohol had a great deal of influence on the way things transpired.  About 2 days ago (4 days from the sexual encounter) I noticed that my tonsils were inflamed and had a few white spots on them.  Yesterday and today the white spots on my tonsils appeared to increase and I developed a fever and general malaise.  This morning I went to the doctor and tested negative for strep.  The doctor decided to do more throat cultures for gonnorhea, chlamydia, and herpes.  I was shocked when she bluntly stated that I have a "good chance" of having herpes.  Since then I have been absolutely terrified.  I had no idea it was so easy to acquire herpes from going down on a girl.  Regardless, my results should come back in 4 days and I was wondering if you could offer any insight on the issue.

Thank you  

[H. Hunter Handsfield, M.D.]

Your doctor's concern should be taken seriously. If she thinks your throat infection might be herpes, it's at least a fair bet that it is. On the other hand, most initial oral herpes has overt, painful sores in the mouth and/or on the lips, in addition to sore throat.  You might just have a garden variety respiratory virus.  Also, if you haven't yet been tested for infectious mononucleosis, ask your doc about it.  Aside from strep throat, mono is one of the most common causes for severe sore throat with white spots and fever.

Gonorrhea of the throat is rare from performing oral sex on a woman, and chlamydia is virtually never transmitted by oral sex, so you can expect those test results to be negative.  However, since you also had unprotected vaginal sex, you should have urine tests for both those STDs, if not yet done.

In the meantime, you should be discussing all this with your partner, if you haven't already done that.  She needs to know about your symptoms and should see her own health care provider for STD testing.  You should also ask her whether she has either oral or genital herpes.  This could still be herpes if she says no, but it would reduce the odds.

Bottom line:  My bet is on mono or just a bad garden variety cold virus infection.  But have the talk with your partner, discuss mono and other STD testing with your provider, and wait on the herpes test result.

I hope this helps.  Best wishes--  HHH, MD

[Nick114]

Thank you very much Docor.

I have since spoke with the woman in question and she firmly believes she does not have herpes.  She was last tested for STDs and HIV last month and all tests came back negative.  Also, I am wondering how I could have contracted mono.  The girl I had sex with is showing no signs of mono and I have not kissed anyone else.

What makes this whole episode even stranger is that I have almost no pain in my throat.  All that I am experiencing is fever, diarhea, appetite loss, swollen tonsils, and the white spots on the tonsils.

I am just freaking out.  Those results could not come quick enough.

Thank you for listening.

[gracefromHHP]

Ask the gal in question to get a copy of her std results to be sure that yes she was tested for herpes.  Also if this is herpes in your oral area it could be hsv1 - from kissing and not from performing oral sex.

grace

[H. Hunter Handsfield, M.D.]

Most people infected with Epstein Barr virus (EBV), the cause of mono, have no symptoms.  If you have, you could have caught from that partner, or by kissing or having sex wih anytone else in the previous 6 weeks. Please get tested for it.  In the meantime, don't worry so much. Even if you have herpes, it's just as good a bet for HSV-1 or HSV-2.  If HSV-1, you'll just be like half the population with oral herpes -- no big deal.  If it's HSV-2, you won't need to worry about recurrent hereps, because HSV-1 rarely causes repeat oral episodes, and probably will not be highly infectious for sex partners.

Mellow out, be sure you talk to your provider about mono, and stop worrying so much.  Whatever is going on, it's not likely to be a big deal in your life.

No more comments, please, until you come back to report your HSV and mono test resutls.