[Question #1048] Question about high igg level for hsv-1

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100 months ago
About 4 weeks after a kiss, I had a canker under my tongue along with a headache for 2 days or so. I had a full panel of std tests (overkill) and came back positive for hsv-1, with IGG level of 41. 

Details - I have had canker sores in my mouth as long as I can remember. I have also had what I thought were minor small boils or acne on nose and under my nose once in a while. I have never attributed them to hsv-1 since there are other things which can cause these and I've never had tingling that I've noted or remember...
However, 1 week after I learned I was positive, I suddenly had what seemed like prodrome symptoms on my nose and around my mouth followed by one tiny pus filled boil on my nose and one under my nose, with occasional waves of tingling on my face and legs. After the boils were gone in 2 days (no crusting) I continued to have tingling for 2 weeks with no blisters, boils, or cankers that I could notice. 
I have wavered between "recent infection" and "anxiety + acne" as the cause of the tingling and 2 boils.

From such a high IGG  test result, is this likely to be a new infection from my recent exposure or is it more likely a long term chronic infection?
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Terri Warren, RN, Nurse Practitioner
100 months ago
Since you didn't take the test until 4 weeks after the possible infecting incident, there is really no way to know for certain if this is new or old infection. 
Canker sores are not caused by the herpes virus. However, small boils under your nose could certainly be herpes - many people who have oral sex manifest with symptoms in or around the nose.  It's pretty common once a person has been diagnosed with herpes by a lab test to start recognizing symptoms. 

Since I don't know exactly what you mean by "boils", my suggestions would be if they come back, get right in and have someone do a swab test from these kinds of lesions to see if they might be HSV 1. Remember that all you have is a positive antibody test - the test doesn't tell you the infection is oral or genital.  If you've received oral sex in your lifetime, there is also a possibility that the infection is genital so keep an eye on both locations for lesions.

Terri
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99 months ago
Thanks for the response. By boil, I meant what seemed like a pimple filled with whitish fluid - not large.

I actually have another very tiny one that came out near my lip. This one happened without any prodrome that  noticed. I'm going to stop by a clinic and see if I can get it swabbed.

Regarding the Igg level - based on what you say - I understand that a high antibody count can happen soon after an infection... is that correct?

As a follow up question (one I've tried to get answered on a couple of forums without success) - does a blister always have to happen after prodrome symptoms? Or can it just pop up without any tingling or itching? And does it always appear near where the infection occurred? Or can it appear in various places (sometimes on nose, sometimes on lips, sometimes somewhere else)?

Thanks in advance!
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Terri Warren, RN, Nurse Practitioner
99 months ago
No, many people have prodrome without a lesion.  Very common.  And a blister can pop without any tingling or itching.  yes, it can move to various places within that nerve group.  For the face, that would be nose, lip, chin most commonly. 

Terri
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