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HSV?
I am a 38 year old male in good general health. 31 days ago I visit a legal brothel in Nevada and received protected oral sex from and gave unprotected oral sex to her. She started her period during the oral sex and this was noted as blood on my fingers that I had inserted into her. We also kissed.
The next day (less than 24 hours) I developed two small ulcers on my lower lip (just on the inside of my mouth). The ulcers were small about .5 mm each. I feared it was HSV and treated with abreva. In two days the ulcers healed. They did not scab over and did not ooze or itch and they mere minimally painful. The same day as the ulcers appeared I developed a “fever, “my temp never was very high, 99.0 and was most noticeable by flushing and sweating for a short period.
I visited my PCP on the third day and the ulcers had already healed. She did not think it was HSV and did not order any tests. She did however give me a prescription of acyclovir just in case. About 3 days later I was really panicked and took the Acyclovir for about 3 days.
I have not had any other mouth sores but an intermittent very low-grade fever and body aches has persisted to this date. I also have 1 slightly swollen lymph node under my chin (the same side as the ulcers appeared.) I have not had a sore throat or rash and no swelling in lymph nodes anywhere else in the body. I had blood work done this week and all were normal. No STD testing was ordered. I also had a rapid HIV blood test (antibody) performed at 25 days past “exposure” and this was negative.
My questions is do my symptoms sound like HSV? I was worried about HIV but reading your many posts about the unlikely hood of catching HIV from giving or receiving oral sex has eased my mind. Never –the-less, should I repeat the rapid HIV test? Would the test at 25 days have likely shown an HIV infection? Would testing for HSV at this point provide any useful information? Should I be tested for oral gonorrhea and syphilis?
The next day (less than 24 hours) I developed two small ulcers on my lower lip (just on the inside of my mouth). The ulcers were small about .5 mm each. I feared it was HSV and treated with abreva. In two days the ulcers healed. They did not scab over and did not ooze or itch and they mere minimally painful. The same day as the ulcers appeared I developed a “fever, “my temp never was very high, 99.0 and was most noticeable by flushing and sweating for a short period.
I visited my PCP on the third day and the ulcers had already healed. She did not think it was HSV and did not order any tests. She did however give me a prescription of acyclovir just in case. About 3 days later I was really panicked and took the Acyclovir for about 3 days.
I have not had any other mouth sores but an intermittent very low-grade fever and body aches has persisted to this date. I also have 1 slightly swollen lymph node under my chin (the same side as the ulcers appeared.) I have not had a sore throat or rash and no swelling in lymph nodes anywhere else in the body. I had blood work done this week and all were normal. No STD testing was ordered. I also had a rapid HIV blood test (antibody) performed at 25 days past “exposure” and this was negative.
My questions is do my symptoms sound like HSV? I was worried about HIV but reading your many posts about the unlikely hood of catching HIV from giving or receiving oral sex has eased my mind. Never –the-less, should I repeat the rapid HIV test? Would the test at 25 days have likely shown an HIV infection? Would testing for HSV at this point provide any useful information? Should I be tested for oral gonorrhea and syphilis?
A related discussion, Follow up on HSV testing was started.
A related discussion, Just a follow up. was started.
MEDICAL PROFESSIONAL
There is no standard terminology. Most experts think of HPV according to the primary sites of infection, not the secondary ones -- i.e. HPV 6, 11, 16, and 18 are usually referred to as genital HPV strains even though other sites can be infected. But there is no official standard of any kind.
I am unaware of which HPV types are primarily oral (if any), or if such types can infect the genitals.
That will have to end this thread. You can't expect to keep returning with every additional question that comes to mind.
I am unaware of which HPV types are primarily oral (if any), or if such types can infect the genitals.
That will have to end this thread. You can't expect to keep returning with every additional question that comes to mind.
I am confused about the nomenclature used to describe oral vs. genital HPV. Is it described according to the sight of infection, i.e., if the genitals are infected is it called genital HPV, or is it described according the affinity of the particular strain of virus to infect the genitals or mouth?
Also, could a person have an HPV strain that prefers the mouth infecting their genitals? If so, would that infection be more or less likely to be passed to another person’s mouth while performing oral sex on them. Likewise, if a person had a “genital loving” strain of HPV in their mouth would it more readily be passed on to a recipient of oral sex.
Also, could a person have an HPV strain that prefers the mouth infecting their genitals? If so, would that infection be more or less likely to be passed to another person’s mouth while performing oral sex on them. Likewise, if a person had a “genital loving” strain of HPV in their mouth would it more readily be passed on to a recipient of oral sex.
MEDICAL PROFESSIONAL
In 30+ years in a busy STD clinic, I have never seen or heard of a case of oral warts except for rare patients with advance AIDS.
Thanks Doc,
I have been looking for info on the web and can find little about oral HPV warts with the exception of how it relates to those with advanced HIV/AIDS. Have you seen many cases of “healthy” people with oral warts.
I have been looking for info on the web and can find little about oral HPV warts with the exception of how it relates to those with advanced HIV/AIDS. Have you seen many cases of “healthy” people with oral warts.
MEDICAL PROFESSIONAL
Oral warts are rare and your oral symptoms probably have nothing at all to do with the sexual encounter you describe. But since your dentist couldn't diagnose them, seeing an oral medicine specialist (most likely not a pathologist) makes sense. I have no advice about specific questions you should ask. An oral medicine specialst will either recognize the lesions immediately or might do diagnostic tests to find out. You don't need to try to lead his or her thinkng.
Dr. Handsfield,
Just an update on the exposure described above. I tested negative at 7 weeks (IGG) for both HSV1 and HSV2, syphilis and HIV. I feel much better with these results and will repeat the HSV testing in a few more weeks (once I past the 3 month mark.) I realize this may not be necessary but it will help to put my mind at ease.
I have now developed some white lesions or growths on my gums between my lower teeth and along the gum line. I saw a dentist last week and she was unsure what they might be and referred me to an oral pathologist (?) and I will see him in two weeks. Since then they have gotten larger and are also in my throat and my inner checks. The lesions look very much like some pictures I have seen of oral warts (oral HPV). From reading the various posts I know that this is uncommon to rare in healthy individuals and may be rarer yet from performing cunnilingus. Do you have any suggestions as to what these might be? Any questions I should ask of the specialist I will be seeing? Thank you again.
Just an update on the exposure described above. I tested negative at 7 weeks (IGG) for both HSV1 and HSV2, syphilis and HIV. I feel much better with these results and will repeat the HSV testing in a few more weeks (once I past the 3 month mark.) I realize this may not be necessary but it will help to put my mind at ease.
I have now developed some white lesions or growths on my gums between my lower teeth and along the gum line. I saw a dentist last week and she was unsure what they might be and referred me to an oral pathologist (?) and I will see him in two weeks. Since then they have gotten larger and are also in my throat and my inner checks. The lesions look very much like some pictures I have seen of oral warts (oral HPV). From reading the various posts I know that this is uncommon to rare in healthy individuals and may be rarer yet from performing cunnilingus. Do you have any suggestions as to what these might be? Any questions I should ask of the specialist I will be seeing? Thank you again.
MEDICAL PROFESSIONAL
That continuing symptom does not suggest herpes, nor does it make me concerned about oral gonorrhea. My understanding is that sex workers in legal brothels in Nevada are tested very frequently for STD and in general are at pretty low risk for STD anyway, because of consistent condom use for vaginal sex. So the chance your partner had gonorrhea is very low. On top of that, gonorrhea is rarely transmitted by cunnilingus; much less easily transmitted than during fellatio or vaginal sex.
See a provider if the throat tickle continues. But I doubt it has anything to do with your Las Vegas adventures, except perhaps related to anxiety about those events.
See a provider if the throat tickle continues. But I doubt it has anything to do with your Las Vegas adventures, except perhaps related to anxiety about those events.
Thank you for your post, it is reassuring. I do have a follow-up question/comment. Since my exposure I have had an itching/scratchy sensation on the side and back of my tongue and my throat. It is not painful just an annoyance. Do these symptoms at all change you mind about the possibility of herpes? What about gonorrhea? I have read that oral gonorrhea is often a symptomatic, but what symptoms might one suspect to have.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
Almost certainly your oral lesions were not herpes. No HSV lesion can heal within 3 days; 7-10 days is the minimum. (Pain can resolve in 3 days, but healing simply cannot be complete before 7 days.) Second, this problem was too mild to be suspicious for a new HSV infection. Third, 99 degrees doesn't count as fever. 98.6 is not the maximum normal temperature, but the average; everybody's normal temperature varies between around 97 and 99.5. In any case, initial herpes is unlikely to cause fever unless there are multiple, highly painful lesions -- and in the case of oral herpes, usually a severe sore throat.
Could docosanol (Abreva) made herpes heal more quickly? No way. Despite marketing claims, docosanol is ineffective against herpes lesions. It's not quite quackery, since there are theoretical reasons the compound might inhibit HSV, but research shows it to be no more effective than placebo creams.
If you remain skeptical or concerned, you could have a blood test. Since your exposure included cunnilingus, HSV-2 is the virus to be most concerned about -- but it is very uncommon as an oral infection. You could well have a positive blood test for HSV-1, since half the adult population of the US (more in some countries) have positive results, whether or not they have a history of oral herpes. In any case, a blood test for both viruses around 3 months after the event probably would be negative for HSV-2 and perhaps for HSV-1, in which case it would definitely disprove herpes as the cause of your symptoms. However, if you were my patient, I would recommend you not be tested and just go forward in confidence that you don't have it.
I hope this helps. Best wishes--- HHH, MD
Almost certainly your oral lesions were not herpes. No HSV lesion can heal within 3 days; 7-10 days is the minimum. (Pain can resolve in 3 days, but healing simply cannot be complete before 7 days.) Second, this problem was too mild to be suspicious for a new HSV infection. Third, 99 degrees doesn't count as fever. 98.6 is not the maximum normal temperature, but the average; everybody's normal temperature varies between around 97 and 99.5. In any case, initial herpes is unlikely to cause fever unless there are multiple, highly painful lesions -- and in the case of oral herpes, usually a severe sore throat.
Could docosanol (Abreva) made herpes heal more quickly? No way. Despite marketing claims, docosanol is ineffective against herpes lesions. It's not quite quackery, since there are theoretical reasons the compound might inhibit HSV, but research shows it to be no more effective than placebo creams.
If you remain skeptical or concerned, you could have a blood test. Since your exposure included cunnilingus, HSV-2 is the virus to be most concerned about -- but it is very uncommon as an oral infection. You could well have a positive blood test for HSV-1, since half the adult population of the US (more in some countries) have positive results, whether or not they have a history of oral herpes. In any case, a blood test for both viruses around 3 months after the event probably would be negative for HSV-2 and perhaps for HSV-1, in which case it would definitely disprove herpes as the cause of your symptoms. However, if you were my patient, I would recommend you not be tested and just go forward in confidence that you don't have it.
I hope this helps. Best wishes--- HHH, MD
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.
