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Avatar universal

Oral or genital herpes worry

Please help as I am freaking out a little bit. I recently had unprotected sex and oral
sex with a female aged 30. I gave and received oral and then we had sex unprotected but not to
climax.

Three days after I developed a raging sore throat and now have a cluster, just on one side of back of my throat, of small red patches with a White blister in.  I have no blisters or symptoms anywhere else on my mouth or lips or penis. My doctor suggested because the White blisters were grouped it couldn't be canker sores but
likely to be cold sore virus (although not had cold sore for ages!). Is this true?

It's very painful an eating/swallowing is awful. Been there 6 days with no sign improvement. Been on 200mg aciclover for two days now but no effect. Please help with advice! Can this be hsv1 or hsv2 with just throat symptoms and no others?  Or could it be just coincidence and canker sores (I did feel it start post eating a crusty bread roll which could have scratched throat but I think that's clutching at straws!). Thanks
13 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
If the problem were due to herpes, the symptoms would have started to improve by now -- usually within 2-3 days.  So this is pretty good evidence that herpes isn't the cause.  If there is still no improvement by 5 days, for sure it isn't HSV.  At that point, there is no point in continuing the drug.
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
If the previous lesions on your lips truly were cold sores (i.e., recurrent oral herpes, almost always due to HSV-1), then your current problem is not an HSV-1 infection.  However, it is possible it is due to HSV-2, if your partner has genital herpes and you acquired it by oral sex.  Or this is something else entirely.  That your partner has no history of herpes is somewhat reassuring, but definitely not proof; most people with HSV-2 are unaware of their infections.  If your problem turns out to be herpes, your partner should be tested.

We do not examine clinical photographs on this forum. In our view, it comes too close to practicing medicine from a distance.  It is not this forum's intent to actually make a diagnosis, advise treatment, etc.  We only provide general advice; you need to get personal medical services from your own health care provider.

Acyclovir 200 mg 5 times daily is fine.  However, 400 mg 3 times a day is just as effective and somewhat more convenient; you could ask your doctor about it.  If after 3-4 days of treatment your symptoms are not clearly improving, it will be strong evidence against herpes as the cause.

You still say nothing about what lab tests your doctor has done for diagnosis. Was a swab taken from the oral lesions to test for HSV or other viruses?  Is a blood test in the works?
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.

From your description of your symptoms, a new oral herpes infection sounds like a definite possibility.  And your doctor obviously thinks this is a good bet; otherewise s/he would not have prescribed acyclovir.  It isn't certain by any means; other viruses can cause similar symptoms.  Almost certainly this is not a recurrence of a past oral herpes infection (cold sores); if you have HSV, it is a brand new infection.

The most important thing by far is to be tested for HSV.  Was that done?  If not, return to the office immediately and insist on it; or visit a different doctor or clinic for testing.  Make sure the test not only looks for HSV, but determines the type of the virus, i.e. HSV-1 or HSV-2.  Acyclovir is effective, but it takes at least 2-3 days before improvement begins.  Also, what dose exactly are you taking?  The normal dose for a new HSV infection is at least 400 mg 3 times a day.

While you wait for test results, it would also be a good idea to speak with your partner. Does she have a history of genital or oral herpes?  If not, you could ask her to be tested for it.  Obviously the chance you might have a new oral herpes infection depends a lot on whether or not she might have it.

Please return to report your or your partner's test results, and how things go over the next few days.  We should be able to sort this out.  In the meantime, don't be too worried about it.  Even if this turns out to be herpes, it probably won't be a serious problem for you in the future.  For now the most important things is to bring the infection under control.  

Regards--  HHH, MD
Helpful - 1
Avatar universal
A related discussion, Just diagnosed and confused was started.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
It is pointless to speculate like this until your own test result is available. Report that result and I'll have one last comment.
Helpful - 0
Avatar universal
Hi,
The person who I had the sexual encounter with has had their blood test results back and is double positive (both HSV1 and HSV2).  I get my results on Monday.
She was IgG negative and IgM positive (or whichever way round that the doctor said it wasn't acute and was asymptotic).

I have had cold sores previously in my life, so this acute outbreak (the acyclovir has now finished but throat has cleared and only one ulcer remains but fading) I have had would suggest I have a rare case of HSV2, correct?

I have questions, as this person is not my partner and I am single.  Please could you let me know your thoughts on:

- if exhibiting no symptons orally, can I still spread HSV2 by kissing or by oral sex (cunningligus)
- can this spread to my genitals or is this unlikely given outbreak (acute) has been in my throat?
- I now have lost the ulcers at back of throat but my gums (well not technically my gums, the are above by gums) is very sore, painful and swollen/inflammed.  It also feels very dry.  My tongue continues to tingle at tip (but no sign of ulcer).  Is this gum inflammation an effect of HSV2 or is this likely to be something else?

Thanks in advance for your help!
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Follow your doctors' advice about follow-up visits; if they didn't make it clear when you should return, call and find out.

No cancer causes symptoms like this.  Probably an infection of some sort and probably not serious.  But this forum doesn't get into problems other than STDs.  If this turns out to be HSV after all, let me know; but otherwise, I won't have any furhter comments.
Helpful - 0
Avatar universal
Thank you for response.  After five days should I return to the doctors then or just await swab results?

I'm quite concerned now as to what this is.  Could it be something serious like throat cancer, cancer of esophogus etc?

Thanks
Helpful - 0
Avatar universal
Hi.  Get my results in a week now!  Whilst waiting can you advise on following?  Been on acyclovir for three and half days now. The ulcers are the same, pain is the same and my Tongue is very irritable, tingly, feels almost like it's got cuts at back of it.

How long does the acyclovir take to start working? If it is herpes should it have lessoned things by now?  I only have a five day course, should I go back and get more?

Thanks
Helpful - 0
Avatar universal
I'm at the clinic now for swab and bloods. The doctor didn't suggest this first time round!  Thank you for your answer
Helpful - 0
Avatar universal
One last point, sorry to bug, but I've had cold sores on my lips before. Does this suggest if you think it's an initial attack that it is the hsv2 genital herpes virus and not the hsv1 virus as I've had cold sores in past? Thanks
Helpful - 0
Avatar universal
Can I send photo of spots to help? Basically they are just on right side of throat (no tonsils ad had them out). Are white in middle with red rings round. Look more flat than blisters with fluid in. Just don't understand why just in one area and no other signs elsewhere? Thanks
Helpful - 0
Avatar universal
Thank you for the response. I am on 200mg tablets five times a day. I shall go and get tested. Is the canker sore idea not feasible?  My partner has never had oral or genital herpes not even a sign of a cold sore. Does this mean less likely to be HSV?  I have no other symptons such as fever. Is it possible just to get on back of throat and not on penis if exposure was on both?
Helpful - 0

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