[Question #6609] HSV-1 throat infection ?

12 months ago
Dear Dr.,

About eight days ago I went out with a girl and we kissed. She seem to have something on her lip but she said it was a birthmark.

A week later I felt discomfort in my mouth and throat. I looked inside and I saw some red rashes on the soft palate  of my mouth. I could also see some red rashes further back in my throat.   

No blisters but I do have a canker sore on my gum. This usually happens to me when I get sick. 

I haven’t been feeling very well and have been very stressed. Headache, fatigue, pain swallowing.

Any thoughts on what this could be? Herpes?
12 months ago
Hello. Just an update. Results came back and my doctor said it’s an acute herpetic infection (oral). Waiting to find out more. Would this diagnosis tell me when I was infected? Do you think it is HSV one or two? I don’t think the test differentiates
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
I'm curious about how this diagnosis was made - was it a swab test from a lesion?  A blood antibody test?  If a swab test, was it typed?  If you can provide more information, I can be of more help.  The only way to know if this is new or old would be to do a blood antibody test, IgG.  And you have limited time to do it if you want to know.  When an infection is new, there is no antibody to that type of virus, but in a few weeks or months, antibody will be made and you won't be able to know if this is new or old.

Terri
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12 months ago
Hello - 

I got my tests back and tested positive to HSV1, it seems.

I am on my last day of anti-viral medication and already it seems to have improved.

Questions: 

1) is this a recent infection? I kissed a girl with a sore a little over a week ago. 
2) what happens next? should I expect more outbreaks? 
3) what is the significance of me getting the infection inside my mouth, with no sores, as opposed to on my lip (which seems to be the more common version)
4) how will my sex life change? do I need to abstain from unprotected oral/vaginal sex all the time? or just when I have an outbreak?

HSV 1 SPECIFIC IGG0.959

HSV 1 and/or 2 Abs, IgM by ELISA1.19

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
So I am going to assume from your post that no swab testing was done from your mouth.  The IgM test should never be done to try to diagnose herpes as it has many false positive.  Your IgG test is not positive, it is equivocal.  So we don't even know if you have HSV 1 infection but I'm glad you are feeling better.  Based on the testing that you had done, we cannot know if you even have HSV 1, much less if it is new or old or if you should expect more outbreaks or how your sex life might or should change!
My recommendation would be to re-test in 6 weeks and see what your IgG test is doing - do NOT repeat the IgM test.  If you actually get a sore on your lip, you should have it swab tested (the rash in your throat should have been swab tested as well if the doctor was concerned that it might be herpes)

Terri
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