[Question #5336] Sores inside mouth

21 months ago
Hi Drs.,

Thanks for your response and help on the previous question # 5177.  
Since a week I had been feeling some sore inside my mouth, on the roof. I saw the Dr. today, and she swabbed it, but said it looked like Oral HSV to her. It only hurts when I am easting something.
I have tested positive in the past for HSV1(IGG), and have had it probably since childhood (I feel this due to the timing of testing and my exposures), but I have not had any "outbreak" with visible symptoms in the past, at least as far as I can remember. I am worried why I had this outbreak now, could this have been due to HSV2 or anything else I contracted recently ? I have not kissed anyone in more than 6 years. Only oral exposure I can think of is probably kissing the nipples maybe on 2-3 different occasions momentarily (last one of which was more than 1 year ago). I had some dental cleaning done couple of weeks ago, not sure if that makes a difference ?
Main reason for worry is the new outbreak, and my upcoming marriage later this year. I am from India, and not many people know about HSV, I don't know if this is something that will impact my sex life, and if this is something I should disclose or talk about?
21 months ago
Sorry, had one more question- If it is hsv, am I at risk of spreading it to other parts of my body? Since it's inside my mouth, should I be concerned that it will spread to my stomach while drinking or eating?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
It could be HSV 1 - hard to know as oral herpes doesn't often cause outbreaks inside the mouth.  The only way to know for sure would have been to have the lesion swab tested at the time it was present.  The dental procedure could have irritated oral HSV 1 in the nerve enough to cause an outbreak, that is possible.  If you have not had a recent new contact and you only test positive for HSV 1, I cannot imagine how you would have HSV 2 orally?  Once you have a well established infection in one location, it is EXTREMELY unlikely you would spread it to a new location on your body and  it won't go into your stomach.

Terri
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21 months ago
Hi Terri

Thanks for the response. The lesions were swab tested by the doctor but it came back negative today. (HSV DNA PCR Qual test). But the Dr. told me that it did look like oral hsv to her, though she said that other viruses can also cause ulcers in the mouth. Also, the test was done probably 5 days after I first started feeling some ulcer inside the mouth, I could not see them due to the location. But the lesions were still present when the swab test was done. 

I asked the question about HSV2 since I have not had any other oral outbreaks atleast in last 20 years or so, so I was just wondering what it could be.

Can you please provide your input if I need further HSV antibody testing for HSV2 (mostly worried about it since I have had some balanitis and folliculitis issues in the past):
Exposures: Unprotected vaginal more than 6 years ago;2X protected vaginal with unknown partners (last one more than an year ago);3-4 protected blowjobs received (last one more than an year ago) ; 5-6 times masturbation received (last one 6 weeks ago)
HSV IGG and WB negative for HSV2 - 6+ months after last vaginal sex

Thanks a lot.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
Thank you for this very complete history.  Given a negative western blot 6 months after last vaginal sex, no, I do not think that you need any further antibody testing for HSV 2. 

Terri
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21 months ago
Hi Terri,

Thanks a lot, I have a few final questions, I apologize in advance if some of them don't make sense:
1. With negative PCR result for lesions on roof of my mouth, is it possible to say with a degree of certainity that it was not HSV1 outbreak?
2. With your vast experience with HSV, have you come across a case where someone acquired herpes from receipt of masturbation (handjob) or kiss on the chest? This is regarding the masturbation exposure I described in Question # 5177
3. Can acquisition of new genital HSV infection lead to reactivation and outbreak of oral HSV1?


Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
1.  If the PCR was done while the lesion is new, then it is reliable
2.  I have never ever found anyone who has been infected through masturbation, no
3.  Research has been found that when HSV is activated in one location, it is often reactivated at the same time - whatever immune change  allows for an outbreak to happen, it happens for both locations

Terri
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