[Question #5591] HSV1

20 months ago
Hello,    I have worked with Terri previously and she has helped tremendously, but i would like to describe my situation and see if any of the other two experts can comment. I know we aren't allowed to choose but I would appreciate a 2nd opinion. 8 months back, I had a sexual encounter with a girl. A week later I felt kindve sick/tired. Then approximately a week after that i noticed a lesion below right lower lip. it looked whitish, did not itch, burn or tingle. I did not see a doctor for it until almost a week later, where I got it swabbed and was negative. Since then, I've had lesions come back in the same area 4 times.  One after miami, that started off as red, this one scared me the most as the sun can trigger cold sores. It seemed to stay there for weeks, and I eventually took the medicine. The medicine seems to help when taken. Each time is different, the two recent ones have started as a kindve red area with a little pimple like white bump that goes away in 2 days. I've had 2 viral cultures swabs, negative, 1 PCR swab (the day that redness appeared) negative, and 3 blood tests, including a Western Blot test. Also negative. I am very anxious about this and truly believe this can be nothing esle than HSV1. ALso to note, during this time, I got infected with mononucelosis. Idk if this affects results. Questions: Do i tell partners I may have it? Is there ANYTHING else it can be? Do i consider taking 2nd western blot?  Recent ones are near bottom middle not bottom right, will I shed under my whole bottom lip/did it spread to this area now?

Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
Welcome to the Forum.  At Terri's request I have agreed to look over your question.  I have also tried to review your prior interactions with Terri but an unable to find them- was this on this forum?, did you use a different screen name?, do you know the number of your question?

Irrespective, let me say that while the initial appearance of the lesion and its tendency to re-appear certainly sound like HSV-1, you have been tested quite well and the negative tests indicate that this is not HSV.  You have been repeatedly tested with multiple different test types and the fact that they are all negative argue that this is not HSV.  Tests are important in modern medicine because clinical appearances can be deceiving and there are numerous processes which can mimic one another.  While a single test can be incorrect, the combination of tests you have had argue strongly that this is not HSV.  This leads to several conclusions:
1.  This is not HSV-1.  As to what it might be, if important to you, I would suggest you see a dermatologist.  While it might be difficult, it would be best to see them at the time a new lesion is beginning.
2.  Whatever is recurring on your lip is not HSV infectious to others.  If it had been, the culture or PCR test would have been positive.

If you can provide me with a link to your earlier posts, I'd be pleased to review it.  Unless your Western blot test was too soon after your lesion initially appeared, I see no benefit for further HSV testing.  EWH
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