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Avatar universal

Shot in the dark. Oral HSV1

14 months ago I kissed a stranger for a long time & gave him some oral. I am abstinent. But alcohol...never again. I noticed something that looked like Shingles (unilateral) on his genitals & all over his left inner thigh (he said it was eczema). I had already done about 20 seconds of oral. Before this I had gotten type specific blood tests & I was negative HSV1 & HSV2. We kissed for a while but he didn't have any visible symptoms of a cold sore. But I know about asymptomatic shedding. 2 days after this encounter (encounter was Fri night I noticed the "blister" on a Mon Morning). This single blister was about 3mm in diameter. I popped it thinking it was a pimple. A clear fluid came out & I knew otherwise. I got a throat infection at the same time. I know this sounds like a classic primary infection of HSV1. BUT: The blister grew & looked like impetigo for a while, oozing honey-colored. It wasn't painful & no tingling beforehand. It had a volcano or "dew drop on a rose petal" appearance. A week into this lesion I got it swabbed. It was extremely scabbed at this point so the GP ripped it off to take the swab. I'm not sure which swab test was performed. I was in Australia at the time.
Result: HSV. I asked what type and they said it was HSV1. I didn't see the results on paper myself.
I have had what I THINK were 3 cold sores since. But I burned them off w/in a couple days with salt, it creates a scab but heals overnight, so I'm not sure if my lips were really just irritated to begin with.
My question(s):
I had very MILD chicken pox when I was younger. I know people usually don't get it twice. COULD this have been 1 chicken pox lesion on my lip due to contact with Shingles?
Even though the swab was HSV1+, I have read this:
http://www.wardelab.com/13-1.html
Dermal Virus Culture- This procedure tests for the presence of HSV and VZV. This test is useful for vesicular lesions. Historical data indicates that approximately 30% of non-genital VZV cultures are positive for HSV.
5 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.

Your partner's leg rash does not suggest genital herpes.  I'm inclined to doubt it was shingles either, but that's irrelevant anyway.  Your positive HSV-1 viral test proves your oral infection is herpes simplex, not zoster/singles.  And you're immune (or at least highly resistant) to a new varicella zoster infection anyway, by virtue of your childhood chickenpox (no matter how mild or severe).

The "dermal virus culture" test on the website provided is just that lab's terminology for testing for both HSV and VZV at the same time, but separate tests are done for each virus and the two results would be confused for the other.  Anyway, ialmost certainly your lesion was tested only for HSV, not VZV.

So you can be very confident you have oral herpes due to HSV-1.  Almost certainly you caught it from kissing your partner, not performing oral sex.

Recurrent oral herpes usually involves the same spot (within a couple centimeters) of the lips or face every time.  Each episode will last a minimum of 10 days, and probably will heal with crusting.  "Burning" it with salt would not speed healing.  So from your description, I'm not sure you have had any recurrent outbreaks.  The next time something like that happens, I suggest you not treat it and see a health professional for confirmation of the diagnosis, perhaps with another test for HSV.

This really isn't an STD issue, since oral herpes is not viewed as an STD (and you should not view it that way, even if you caught it by kissing during a sexual event).  In any case, it is unlikely to be an important issue in your life, unless you make it so by excessive worry about it.

Regards--  HHH, MD
Avatar universal
Sorry, just to clarify:
I'm not sure if the rash was directly on the genitals but it was definitely on the inner thigh, in that area.
also:
Does that short 2 day incubation period (I know it's usually 2-14 days for HSV) raise any questions?
239123 tn?1267651214
MEDICAL PROFESSIONAL
I saw this before replying above.  The apparent incubation period doesn't change anything.
Avatar universal
I don't know why that showed up as an old user name. I marked it as spam, here is the post again:

Thank you very much for your help. Next time it occurs I will go to confirm the diagnosis.

One a couple more questions (promise):

I have read conflicting literature on the rate of asymptomatic shedding in relation to visual outbreaks.

If I only had the primary outbreak and no recurrences ever, do I shed just as often as those with recurrent visual outbreaks? On average of "18%" of the time (i.e. once per month)?

I read somewhere that individuals that had just the primary OB don't exhibit nearly the same shedding patterns as those with recurrent, even slightly moderate recurrent OBs. (I wish I could cite it).

Doesn't it stand to reason that the fewer outbreaks (especially just the one primary OB) = less frequent overall shedding?

Could you say that the healthier the lifestyle = the less overall asymptomatic/symptomatic shedding? Or is herpes not bias (based on overall health of an individual) as to when it sheds (like the cold virus that comes when you're more susceptible & not so "fit")?

I'm ok with having oral HSV1, just as most of the world does. It's just the stigma that other people like to zone in on–labeling those with cold sores as lepers, even though they'd probably have a positive HSV1 blood test themselves.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Since oral herpes isn't an STD, I don't really keep on on the details and cannot tell you the frequency of asymptomatic shedding in relation to frequency of symptomatic outbreaks.  In general, shedding is less frequent for oral HSV-1 than genital HSV-2.  It may "stand to reason" that shedding would be correlated with the frequency of outbreaks, and that's what all experts assumed for genital herpes -- until careful research showed there is no relationship at all.  Asymptomatic shedding is just as common in people with many, few, or no symptomatic recurrences.  And no, healthy lifestyle has no effect on it.

If you need more information, perhaps Terri Warren would be able to answer better on the herpes professional forum.  But as I said, you don't have an STD -- so thi is really off topic for this forum.  Sorry I can't help further.
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