Confirm and Combat HSV2

[Erik48]

Dear Terri,  I have posted the full version of my questions on the regular forum area would you PLEASE read it before you answer me? 16 months ago I was exposed to HSV2 virus on my face. The next day I noticed a cold sore like) on side of lower lip. I also had an area of raised aggravated skin above lip on face. Also had a very thin linear open crack on forehead. I have had Genital HSV2 for 25 years.  I unfortunately gave it to my wife about 23 years ago (Genital HSV2).  We have never had oral symptoms. Ever since this time I have been dealing with various symptoms little blisters in the corners of my mouth, small red ulcer type areas on face, acne type of bumps I get on my chin, cheeks, forehead, crease of nose and just out side the lip line near lips. These areas are accompanied with tight, burning, itching, tingle sensations. When the skin symptoms come on I also get strange pain in my throat (more to one side) that I had never had in my life before as well as pain in the ears. My ears and eyes also itch like they have never done before during these episodes and there is no change in my environment that can account for this (allergy wise). I have at times seemed to respond well to anti virals with this and at other times have not at all. I have seen multiple Dermatologist, ENT doctors, Infectious disease doctor and have not been able to get any firm answers. I want to confirm somehow what I am dealing with and don't want to take Valtrex everyday not knowing for sure. Because I have had HSV2 genital for 25+ years it is showing up in blood test.  Is there a test that can verify re-infection of HSV2 16 months ago? Now I can't even go outside anymore because the sun seems to trigger all these problems to a worse level, even if I go at 7 to 8 am with full sunscreen. I no longer kiss my wife for fear of spreading it to her. I am extremity depressed and losing hope.  I have tried almost everything.  Any info you could share with me would be so appreciated. Thanks Erik

[Terri Warren, RN, Adult Nurse Practitioner]

PCR swabs pick up virus from a variety of kinds of lesions, it doesn't have to be oozing.  

I did read your other post and my opinion is exactly that same as Dr. Handsfield.  I have never in 32 years of practice seen HSV 2 be first genital then later be oral.  Never.  

You seem so focused on this!  My suggestion would be after you see the dermatologist, you should consider seeing a good Cognitive Behavior Therapist to deal with your obsessive thoughts about this.  99.9% certain you have HSV 2 orally from giving your wife oral sex when you both have HSV 2?  Really?  Not only do I think that you don't have HSV 2 orally but I'm also wondering if you are depriving your wife of receiving oral sex most of the time because of this concern?  That is a huge shame.

Terri

[Erik48]

Dear Terri,

I am going to the Dermatologist today and I am going to request PCR swabbing.  Do the lesions need to have actual oozing fluid to be effective. or does PCR swabbing a newer lesion alone work?

If you would be kind enough to read my slightly longer version (link on previous question) of the symptoms I have been experiencing and give me any of your thoughts of what other medical conditions could be causing these facial/mouth skin, throat and ear issues that seem to come and go together?

I would greatly appreciate your advice

[Terri Warren, RN, Adult Nurse Practitioner]

So if you've been tested for HSV 1 and it was negative, then my only suggestion is to continue to get the areas swabbed that you believe are caused by herpes.  You can ask your health care provider to give you PCR swabs to take home and you can swab at the first sign of a lesion that you think is herpes and return the swabs to the provider.  This will allow you to gather swabs when the lesions are much fresher.  You don't want culture, you want PCR, far more sensitive.  We, at my clinic, routinely send out swabs to people to gather at home if your provider is unwilling or unable to provide you with these swabs.  They are very stable in transport as they are not growing anything, rather they are using gene amplification technique.  Let us know if we can be of help with this process.

Terri

[Erik48]

Hello Terri, thanks for your reply. I was not allowed due to character restrictions to post my whole question here so I put it on the regular Herpes area in medhelp titled "Nurse Terri Confirm and Combat HSV2 (long version)".  There is a little more detail of what is going on with me there.  Here is a direct link below.

http://www.medhelp.org/posts/Herpes/Nurse-Terri-Confirm-and-Combat-HSV2-long-version/show/2124349#post_10096342

I have been tested for HSV1 and it was negative. I do not know if my wife has HSV1.  I had one of the dried up areas (no fluid) swabbed and that did not show HSV, but without fluid my understanding is that it is hard to get an accurate result.

Your thoughts?

[Terri Warren, RN, Adult Nurse Practitioner]

I don't know what you mean by the "regular forum".  This is the only place that I look for posts from people, so this is my regular forum.

I'm guessing that you might have had some information about HSV 2 so please forgive me if I am repeating what you already know (but may have chosen not to believe).  Once you have HSV 2 in one location on your body, it is extremely unlikely that you would subsequently acquire it in a new location on your body.  I have seen this happen perhaps once in 32 years of practice.  It is possible, certainly, to acquire HSV at more than one location on your body at the same time - one might have given oral sex to someone and had intercourse with them at the same time and acquired it both orally and genitally at the same encounter.  However, this doesn't seem like what you are posting here to be the case.  

Also, HSV 2, for reasons we don't know about, dislikes the trigeminal nerve area and so if someone does get HSV 2 orally, it rarely recurs there.  

I need a little more information.  So you've seen multiple doctors about the issues around your face, has anyone done PCR swabbing of the lesions that you describe?   Also, do you know if you also have HSV 1 infection?  Do you know if your wife has HSV 1?  

The principle that you would be very unlikely to acquire HSV 2 in a new place also applies to your wife.  Even if all of these symptoms are HSV 2 orally, which I seriously seriously doubt, she would be very unlikely to get HSV 2 orally.  Someone I think giving up kissing your spouse would be more troubling than getting HSV 2 orally.  

Please let me know the answers to these questions.

Terri