[Question #7451] HSV1 Question

5 months ago
Dear Dr. Handsfield,

I am a 30 year old male with a concern that I have recently become exposed to HSV1.

I have always been under the impression that I had cold sores as a child as I have a memory of this at around 8-9 years old. But only maybe 2-3 recurrences of this in a relatively short space of time.

However, recently I had an encounter which was potentially risky. About 1 week after post this encounter I experienced sores around my mouth. My doctor at the time was adamant  this was Angular Cheilitis and not Herpes as it started on the corner of my mouth. (Both sides at different times). However, I have had other sores showing since from being in long periods of sunlight. 

Though the latest episodes have looked more like Carbuncles which appear more like large pimples and have messed with my hair follicles in my moustaches area of my beard. Sometimes this has been very painful and crusts / takes over a week to fully heal... I am aware thst staph could be the cause here which may also have had something to do with the Angular Cheilitis looking appearence?

My IGg test showed that I was positive for HSV1 with a result of 11.2. But I wondered from your experience if you believe with a number like that could this indicate a very old infection from childhood or do people with long standing HSV1 and a history of cold sores as children generally show much higher numbers than this? (Like around 40+ )... I know with a great deal of certainty I am Negative for HSV2 as I have repeatedly shown negative on the IGg with my latest test being 20 weeks post this encounter.

But I am concerned that maybe I have mistaken my Cold Sores from childhood with canker sores and perhaps I have just been exposed?

Many Thanks for taking the time to read.




Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
5 months ago
I would absolutely believe that you are infected with HSV 1.  In our research, 90% of those who tested higher than 2.0 on the HSV 1 IgG test confirmed by western blot.  At 3.0, 100% confirm.  Your 11.2 makes it certain you have HSV 1 and your recollection of a childhood history of cold sores is very likely correct.

Terri
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5 months ago
Hi Terri,

Ok, thank you. I am in absolutely no denial of my HSV1 infection but just trying to establish if this is recent or from my long term history of having cold sores (ableit very few occurances from memory). 

So my questions are:-

1) If I was your patient and you conducted an IgG test then saw 11.2 for HSV1 would you be more convined this is from my childhood as opposed to me being recently infected, as the antibody count is very high? Or is it not beyond the realms of possibility for somebody testing after 3 months who has just been exposed still show numbers as high as the above and there is simply no way of telling if it's long standing or new.

2) Is it common for children who had cold sores only have a few flare ups and the virus to remain dormant throughout Adulthood not causing issues or should one expect to get cold sores as they're older on a more regular basis, perhaps due to a weaker immune system?

3) Have you ever seen cold sores appear as having Carbuncle like manifestations or this being a side symptom which messes with hair follicles in the beard?

4) Is it quite common for a Staph infection to have similar symptoms as herpes which can me mistaken for oral HSV?


5 months ago
Oh Sorry Terri - I didn't realise that I was allowed 2 follow up questions included in the initial payment and I placed a new order, as my last post with questions above was my final... please may I request a refund for order #9550 as this won't be used. Is that something you can request with the administrator for me?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
5 months ago

1) If I was your patient and you conducted an IgG test then saw 11.2 for HSV1 would you be more convined this is from my childhood as opposed to me being recently infected, as the antibody count is very high? Or is it not beyond the realms of possibility for somebody testing after 3 months who has just been exposed still show numbers as high as the above and there is simply no way of telling if it's long standing or new.

Someone who was infected 3 months ago could well have an index value of 11.2, correct.  I think that's what you are asking here.

2) Is it common for children who had cold sores only have a few flare ups and the virus to remain dormant throughout Adulthood not causing issues or should one expect to get cold sores as they're older on a more regular basis, perhaps due to a weaker immune system?

Good question.  Maybe, particularly if the person is undergoing something like chemotherapy or is taking steroids for any reason.  If nothing like that is going on, there still may be an increase in the frequency of cold sores as one's immune system functioning declines somewhat with age.

3) Have you ever seen cold sores appear as having Carbuncle like manifestations or this being a side symptom which messes with hair follicles in the beard?

Maybe.  Hard to say, but outbreaks of cold sores can happen on the chin, yes, but where there is hair growing, perhaps something bacterial is more likely

4) Is it quite common for a Staph infection to have similar symptoms as herpes which can me mistaken for oral HSV?

Yes, I think the two are not infrequently confused.

I will ask for a refund for you for your second batch of questions.

Terr
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