"My guess is that you're essentially going to tell me the new information doesn't really change your initial comments about it being an unlikely genital HSV-1 infection after having had HSV-1 antibodies since childhood. I apologize if the new info was irrelevant. I guess your questioners are typically in need of a lot of reassurance, and I was one of them."
You are right on every point. I will have no further replies.
Doctor, if possible, can you respond to my follow-up question in which I corrected corrected my original post (replacing "soft palate" with "hard palate" as the location of the sore I had in my mouth - although I'm technically not sure of where one ends and the other begins, and the doctor who examined didn't say).
Specifically, does this make it more like that what I was experiencing was somehow a primary infection with a different strain of HSV-1 than the one I had acquired previously in childhood (confirmed with previous blood tests) - since apparently recurrent intraoral herpes is rare - and that I then somehow autoinnoculated myself genitally during that episode? (Also, none of this episode involved any sexual contact at any time prior to the outbreak, and I was tested for HSV-2 which was negative.)
Thank you.
...Not to mention the doctor assumed that the bump I had on my hard palate was related to the cold sore I had, but understandably did no tests to confirm what it was.
Finally, I just realized how many "yes, but..." responses you receive to your initial comments and do appreciate your patience. My guess is that you're essentially going to tell me the new information doesn't really change your initial comments about it being an unlikely genital HSV-1 infection after having had HSV-1 antibodies since childhood. I apologize if the new info was irrelevant. I guess your questioners are typically in need of a lot of reassurance, and I was one of them. Thanks again.
Also as I mentioned in the first question, I was pretty run-down and sick at the time (congestion, sore throat, exhaustion, a sty on my eye, in addition to the obvious cold sore), so I guess that if there ever was a time for a *recurrent* in-mouth herpes outbreak, that would have been the time it was going to happen, although I don't specifically remember having those before (but can't rule it out).
Thank you for your response, Doctor.
I realized in my first message regarding the outbreak in question that I said I had an obvious oral outbreak on my lip and "soft palate", but what I meant was a bump on the inside of my mouth, on the bony part - so I guess that's the "hard palate". I read elsewhere that such outbreaks are more frequent during initial infections rather than as recurrences - and although I can't rule out having had a similar sore inside my mouth before, that kind isn't typical of the usual sores I'd occasionally get on my lip.
Does that information change anything regarding your initial answer? Specifically, does it make it more likely that I somehow caught another strain of HSV-1 orally and auto-infected myself genitally during that episode, or is that pretty far-fetched considering I've had HSV-1 antibodies since childhood? (By the way, this happened when I was visiting Italy, if that makes any difference as to what strains are common in different parts of the world.)
It is unlikely you have genital HSV-1. As you imply yourself, indeed your immune system is highly protective. There is strong immunity--in may people, probably complete immunity--to acquiring a second infection with either HIV type, either by auto-inoculation of one's own infection or by exposure from someone else. (Auto-inoculation can occur, but almost always occurs at the time of the initial HSV infection, before the systemic immune response is mature.) Of course, if you get another genital lesion someday, get it checked out. But that's unlikely, even if you in fact have it; recurrences of genital HSV-1 are uncommon and may not occur at all after a few years.
I hope this helps. Best wishes-- HHH, MD