[Question #4801] HSV Testing

27 months ago
I had what i would consider to be a risky encounter almost 13 weeks ago where i could have been exposed to HSV2 and contracted it orally. I performed oral sex on a dance for roughly 5-10 minutes. I tested for all possible infections 2 days later for a baseline. I tested again 6 weeks later for HIV, HSV 1&2, and Syphilis just to confirm no infection and everything came back negative. Since then i have had no visible oral lesions or anything suspicious just what i would consider "guilty conscious" symptoms. One day before week 11 i woke up to a white bump on my lip, it looked like a white head. I pushed on it, it did not hurt, nothing came out of it, my wife saw it and said it looked like a canker sore on my lip. I was freaking out and tried to get an appointment with my Dr. to get it swabbed but i couldn't get in at the time. By that afternoon the white head had gone away (i had put abreva on it throughout the day) but you could still see the spot where it had been and still can. It never crusted up and was never painful, it didn't look like anything i had unfortunately looked at on the internet. I had an appointment with my primary today (10 days after the spot showed up) and showed him a picture of it and he thought it looked like a swollen gland on my lip and not HSV. I know the odds of my even contracting anything from the one time encounter and the type of activity (cunnilingus) are slim.
My questions are....
1. Do you think it could have been an HSV2 lesion given the timeline and description? 
2. Would you recommend retesting via a blood test at this point?  My primary thought the 6 week test should have been pretty conclusive and did not see a need to do another test, just keep an eye out for any suspicious sore and have it tested right away if need be. 

If I did another test it would be at 14 weeks but I know you all say that testing without symptoms is not recommended as there are some issues with the blood testing. 

What would you do, test or no test?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
1.  What you describe sounds nothing at all like herpes to me.  Herpes on the lip would appear as a water blister or group of water blisters that would eventually break open and form an ulcerated area and then scab over.  This is nothing like what you describe.
2.  I would not recommend retesting at this time, about this incident.  HSV 2 uncommonly infects the oral area - it is a "site preference" for the genital area that is quite strong.  And second, as you already know, a single encounter presents a low risk, just statistically and though not certain, 70% of HSV 2 infected people will be positive at 6 weeks.  3% of people who test for HSV 2 have a false positive which would need to be clarified with a western blot.
I know you are worried but I think the real risk here is very tiny.