I am asking a question relating to oral lesions.

 

I’m a 29 year old male, non drug-user, heterosexual, sexually active. I have had cold sores (HSV-1) since I was a child. I get them on average 1 to 3 times a year, on my lips.

 

This May, I became very sick. I experienced night sweats, no appetite, fever, weakness, and pharyngitis. Concerned by my symptoms, I got tested for HIV and Mono. HIV test was neg. and Monospot test pos. The acute symptoms lasted 1 month, followed by 4 months of lingering malaise. However, 1 month after onset of my illness, I began having ulcers on my gums. I have gotten them 1 or 2 at a time, every 2 to 3 weeks, for 5 months. They were always located on the hard gingiva, at the border between my teeth and where the gum flesh begins. 2 notable exceptions were two ulcers I had on the hard palate of my mouth. All were small,  crater-like lesions, which did not bleed, but quite painful to touch and made it painful to eat. They lasted on average 5 days. They concerned me, and I decided to do a 2nd HIV test (4th gen) + hep and syphilis tests which were done more than 3 months after any sexual activity, and which were all negative and thus conclusively ruled those out. Nevertheless the sores continued until October. However, now in December I got a cold sore on my lip, which was unremarkable except for the fact that it was followed the next week by a 2^nd cold sore, and the week after that by a third! I have never in my life experienced 3 cold sores in a row. Considering the difficult year I’ve had regarding my health, I am now concerned again about what this means.

 

My questions are :

1)    Were these oral lesions likely herpes, or something else entirely?

2)    Should I get further testing done? Should I have any concerns?

I think the lesions sound more like canker sores, which are not caused by herpes.  We don't really know what causes canker sores, but they are not an STD. Sometimes they are a reaction to foods but sometimes, they just come and can be so painful and annoying and we don't know why they come.  I don't think you need any testing of these lesions.
If you are getting more cold sores than usual, you could try daily treatment for a while to see if you can get the virus to settle down a bit.
And no, I don't think you need more testing really - it sounds like your immune system has been a bit down this year and the herpes virus loves to come out when the immune system starts dropping balls periodically and is tries to juggle all the needs for immune response.  If you mean do I think you have HIV infection I certainly do not.

Terri
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Terri,

I have also read the information that you have, about the location of canker sores vs. cold sores.  And I do know people who have had intraoral herpes lesions, but not many at all.  The only way you can know if any lesion in the mouth is herpes or not is to have it swab tested, preferably using PCR instead of culture, as it is far more sensitive.

Terri
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