[Question #6484] Did I contract primary oral HSV?

13 months ago
I received a mouth-to-mouth kiss and saliva from an acquaintance.  Six days later, I felt a fairly rapid onset of pain in the floor of my mouth and discovered one round (5mm), yellow-white, slightly raised bump on the side of my tongue about midway back and just beneath the bite line.  Before I could look at it in more detail, the top surface broke down during eating and it became a red, raw sore.  There was a little evidence of blood and drainage.  I did not see if it was classically blistered like HSV.  Four hours later it was no longer red and almost blended back into the surrounding tissue.  By the next morning (about twelve hours later) a smooth white cap had developed in the same shape/location where it had been sore.  It did not appear to be concave/hollowed-out.  The mouth soreness subsided after about 24 hours.  There was never a red ring around the sore at any point.  The white cap gradually disappeared over a handful of days.  I had no other unusual symptoms inside or outside my mouth including no fever, lymph node enlargement, headache, fatigue, etc.  I believe I have had aphthous ulcers on the side of my tongue in the past but it has been a very long time and they have been few in number over my lifetime.  Is my description consistent with contracting primary oral HSV?  Should I get tested (when/which one)?  Should I refrain from oral contact for a while?  Please provide any conclusions or recommendations you have.  Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
Your description is much more consistent with apthous ulcers than with primary herpes.  If you've had this same presentation in the past, why do you think that this is something different than what you've had in the past.  You don't describe any blisters on your lips or down your throat which would be far more typical for new herpes than what you are describing.  If you do decide that you want to test, you should get an IgG test and it should be type specific and you should not do it until 8-12 weeks have passed since you first noticed the lesion on your tongue.  But I have no reason to think that this is any different than the apthous ulcers that's have had in the past, really.

Terri
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13 months ago
Thank you, Terri.  To answer your question, I agree the presentation seems like it could be an aphthous ulcer.  I don't recall the exact development process for me in earlier instances where I had an ulcer--maybe because I didn't pay attention at the time and/or it has been many years ago.  In this particular case, the reason I thought it might be primary herpes is because the surface of the tissue seemed to break down as if it had been blistered or ruptured, although I didn't see a classic blistering because I didn't get a chance to look.  My understanding based on internet reading is aphthous ulcers don't have a vesicular stage, hence the concern.   Does that detail change your opinion at all?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
So the thing here is that when herpes lesions are oral, the blister stage comes and goes really quickly and it is easy to miss.  So no, that doesn't really change my opinion.  But honestly, if you really want to know if this symptom was herpes is to have an antibody test OR if it comes back, have a swab test of the lesions, looking for herpes virus. 

Terri
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13 months ago
Thank you, Terri!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
You are most welcome

Terri
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