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Very Swollen Lip and Sore Mouth

28 y.o. male.I had chapped lips and I pulled 2 pieces of loose skin from my lower lip on 3/9 which caused 2 small sores located roughly where my upper and lower lip meet. Sores became raised with white, loose skin around the scab, no blisters.The sores did not really heal over the next days.3/11-Had fever and sore throat. No congestion, runny nose, coughing.3/12 Felt achey, tired, fever, sore throat, swollen tonsils.Rapid strep test negative.The Dr believed it to be viral but still prescribed Zpac.3/13 Felt tremendously better.Left side of neck was a little tender/sore.3/14 Felt better no changes to sores.3/15 Felt well. Peeled away some loose, white skin around sores and was in the sun most of the day.Some fluid and blood seep from under the sores where a crack was. Sores on lip were dark red but no blisters around them.3/16 Last day on I took Zpac.Woke up in the morning with shivering/cold chills and a fever and my lower lip was very swollen.The sores had joined into a large scab and were weeping blisters around the perimeter.I have never had a cold sore before.I went back to the Dr and asked if this could be a HSV-1 infection.Dr didn't think so that it was viral and stomatitis. Prescribed valacyclovir, which is for cold sores. I don't feel like he was very clear with what was happening. 3/17 Lip was still very swollen and weeping clear/yellowish fluid and some blood around the perimeter from small blisters.Have a few more white or yellow lumps on my tonsils and now small spots on the back of my throat. I had taken all 4 pills of the valacyclovir (2 doses of 2 pills 12 hrs apart) the day before. Roof of mouth became sore. Went to ENT Dr. Was told it's viral and prescribed the same vala. but for 4 days with prednisone. HSV-1 and HSV-2 blood test came back negative but if its a primary infection there may not be enough antibodies for a positive? I have never experienced a cold sore or anything like this before. Possible reaction to Zpac and the sun?  
1 Responses
563773 tn?1374250139
Thanks for posting your query.
I can understand your concern for these weeping sores from the lips along with swelling of lips, fever and sore throat.
The first possibility that comes to mind is of cause of cold sores caused by HSV 1. This virus lies dormant in the body and can return. A fever, a cold, stress, cold or windy weather, and strong sun exposure are triggers for outbreaks and you were having fever, sore throat as well as sun exposure.

It is possible to get a false negative test for HSV1. False-negative (testing negative when herpes infection is actually present) results can occur if tests are done in the early stages of infection and if you get the tests done when you were taking oral antivirals.

Hence you need to get it retested if the symptoms persist. This includes two tests: ELISA (enzyme-linked immunosorbent assay) or Immunoblot. They are both highly accurate in detecting both types of herpes simplex virus but immunoblot is more specific and sensitive in testing than ELISA. Other than that get a bacterial culture of the fluid seeping from the sores as well.

Depending on the type of infection whether it is bacterial or viral, treatment can be decided and includes antibiotics or antivirals respectively.

It is less likely to be an allergic reaction to the Z pack because the symptoms would have appeared after the first dose only. Angioedema is due to an allergic reaction and may cause swollen eyelids, lips or face and occurs mostly within 1-12 hours of coming in contact with the allergen.

Hope that this information helps and hope that you get better soon.

Wishing you good health.

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