Herpes kissing question

[Sherman85]

OK, so 5 days ago I kissed someone at a strip club a few times (did not see any sores on her mouth) and within a day I saw a red mark under my lip. I have acne but it wasn't a zit. It had no pain or tingling. I picked at it and I think it maybe tore away some skin. The next day it was red and there was some clear fluid on it. A little tingling then. The next day (day 3) it was still a little red and bleeding, but not much. Day 4 it started to crust over a little, and today it is mostly crusted. My question is, could this be a cold sore? I can't tell whether this happened because I picked at it or whether it's because I got herpes from kissing, since you can pass it on without any sores. Also, I had a mild sore throat that I still have. Do you think I should get tested? And if so, when?

Any help would be great, thanks!

[Fleetwood20]

What you describe does have a chance of being a cold sore. If it was, then it almost certainly sounds like a recurrent outbreak from a HSV1 infection that you have had from your youth.

Test if you want to confirm this, but really there isn't much to be gained. You'd just confirm you are amongst the 70% of people with an oral HSV1 infection.

[Sherman85]

Thanks for answering! To my knowledge, I've never had a recurrent outbreak before - I know that it can be triggered by a lot of things, such as a cold or emotional stress. So should I conclude that kissing this person is what triggered the outbreak? Or is it the fact that I kissed a person with potential HSV1? The reason I ask is that whenever I kissed someone in the past, I never experienced an outbreak, which I suppose could mean that 5 days ago is the first time I kissed someone with HSV1. Now that I've had an outbreak, will there be more viral shedding than usual? Just concerned about passing it on to people.

Also, if I've had HSV1 since youth, would that show up on a routine STD blood test, or should I ask for a different test? I was given an "all-purpose" STD blood test about a month ago and was found negative, but can't remember if HSV was part of it. I know that they are more reliable after 3-6 months (assuming it's a new infection).

The reason why I would test is just so I can confirm to potential partners whether I have it or not (even if it's safe to assume I do given the high rate).

And again, thanks for any answers you may have!

[Fleetwood20]

I doubt the testing you had included HSV. When you have HSV, outbreaks are a function of your own immune system and not whether you come into contact with the virus.

[Sherman85]

Thanks! OK. I'm just suspicious since the outbreak (first I can remember after multiple partners) happened under my lip, right after a strip club, a place known for spreading STDs. I will still get tested just for the peace of mind of potential partners. Also, since I believe viral shedding is more frequent after an outbreak, I will avoid kissing/sex with others for several weeks.

Last question: could a primary outbreak be as mild as I described (no pain, minor tingling just on day 2/3, fully scabbed over within 5/6 days)?

[Fleetwood20]

Much more likely that an adult receiving a primary HSV1 infection would get multiple lesions.

[Sherman85]

To follow up on this - I went to see a doctor, and he agreed that the incubation period for HSV1 would not be consistent with showing symptoms 1 day after exposure. I had also been out in the sun that day, so he suspected it was a recurrence from a prior infection.

However, I got tested (IgG) last week and my doctor told me the results were negative for prior infection for both HSV1 and HSV2! He mentioned that it could still be an acute infection from an exposure a few days prior. I did in fact perform oral sex on someone for the first time 4 days prior to my outbreak. However, I had been kissing this person for 2 months before the first outbreak. He recommended I get tested again at least 1 month from now.

So although my cold sore behaved like a recurrent infection, it seems that the more likely possibility is that it was a new infection, as I would not have had a negative IgG result. Also, since I had been kissing this other individual for 2 months, it seems more likely that I caught it from this person from the oral sex, and my body needs more time to produce enough antibodies for a positive result.

Do my presumptions seem correct? Any other theories as to what is going on here? Can a new infection show up 4 days later as one minor cold sore that resolves within 6 days (similar to a recurrent infection)? Is it likely that my results would still be negative 2 months after kissing exposure while still having an infection?  I'll admit I'm starting to get pretty confused. Any help would be much appreciated.

[Fleetwood20]

There are some possibilities (and more than one might be true):
- the lesion was not HSV related and you were not infected at the strip club (this is regardless of whether you do or do not have HSV1)
- you were infected with HSV1 at the strip club and will test positive for HSV1 by week 12
- you test again at 12 weeks after the incident and are negative, there is then a 10% chance that you do carry HSV1 owing to the accuracy level of IgG testing for HSV1. You will not know when you acquired HSV1 in this situation and it would be best to swab a future lesion or get the Westernblot test for verification.

All up there really is not any need to be concerned about having a HSV1 infection. But if you really need to understand then consider the possibilities and actions listed above.

[Sherman85]

Thank you. I agree that I could have been infected with HSV1 at the strip club regardless of the appearance of the lesion. But do you agree that it's more likely that the infection came from oral sex 4 days prior, rather than the strip club exposure 1 day prior? I just mention that since in the possibilities you outline, you do not mention the oral sex exposure 4 days prior, or the possibility that the lesion was HSV related. I am curious for my own peace of mind whether it's more likely I got it at the strip club or from the individual.

I am not concerned about myself in terms of the HSV1 exposure, as I know it's manageable. I am concerned about passing it on to others. Yes, most people have it, and if they don't have it now they'll likely get it later, but some don't, and I wouldn't want to knowingly infect the people who don't have it yet.