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is this my first outbreak

Hi,

about 3 weeks ago I had gave and received unprotected oral with a female sex worker and had protected sex. About 5 days later I had a  burning sensation on my tongue and in my mouth along with headache and feeling unwell. I went to see a Dr 12 days after the encounter and he could not see any blisters\lesions in my mouth. I didnt get tested as the Dr advised there needed to be blisters\lesions, I got tested for gonorrhea and chlamydia and that came back negative.

The symptoms continued for the next 10 days after seeing the Dr, the burning pain was persistent on my tongue but also seemed to move around my mouth, lips, back of the mouth, top of the mouth and I generally had a persistent headache and felt unwell. Only in the last couple  of days have the symptoms subsided, the burning pain seemed to disappear in the order of back of the mouth, top of the mouth lips, and under my tongue. my tongue still feels slightly raw and there is a residual dull burning\pain at the top of my mouth now.

I do get cold sores on my lips and assume I have HSV1, was this a HSV2 outbreak considering I gave oral sex to the woman or is it likely another STI?
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Avatar universal
I had similar symptoms and unfortunately it was herpes simplex 2, hopefully your results aren't the same.

- Kristin
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Thanks for sharing your experience Kristin. I am sorry you you caught HSV2. I would be lying if I said reading your experience didnt give me a huge reality check even though i suspected it I was always hoping it wasn't the case.

Just an update I have since discovered ulcers on the tip of my tongue. I will tryband convince the Dr to swab test it to confirm. I can only hope it isn't but am a little devastated

Did you get oral hsv2 and do you experience frequent recurrent outbreaks?
This isn't a "huge reality check". While Kristin may have hsv2, that doesn't mean you do, and we don't know any details about it - even if it's oral.

Getting blisters just on the tip of your tongue would be really unusual.
Hi auntiejessi,

So I got a swab of the ulcer/red bumps and hsv igg blood test at avout 5.5 weeks post exposure. Swab was negative for hsv and bacteria. Dr wasn't confident the swab would find anything when he inspected the ulcer which now look like red dots. Blood test was positive for hsv1 only as expected. I know igg is more accurate at 12weeks so waiting for that test

During the 5th week post exposure I began to experience abdominal discomfort and intense burning in my penis for about 5 days followed by itching and penis irritation but no blisters ever appeared. I did give and receive unprotected oral so have now experienced symptoms both orally amd genitally. Dr did prescribe 5 days acyclovir which I took. Symptoms did improve after days 3 of the treatment but did return slowly on the 5th day and the penis itching and irritation increased into week 6 and has eased off at the beginning of week 7 post exposure. But the tingling in my tongue has returned and become noticeable.

The Dr did mention it could be hsv1 that  I am experiencing both orally and genitally but can't know for certain. I have never had symptoms on my tongue only lip and top of mouth. Is it common for hsv1 when it infects a new location in the mouth or genitals of someone with an existing hsv1 infection to cause these symptoms I am having? I have read that it's rare but not impossible for someone to get hsv1 in a secondary location.

I guess I will need to wait for the 12 week mark to retest and for any blisters and lesions to appear both orally and genitally to know for sure. Any other thoughts about what this could be?

Genital herpes does not cause abdominal pain.

It is not impossible, but very unlikely for you to get a genital hsv1 after having an established oral hsv1 infection. I would be very surprised if that's what this is.

Also, it wouldn't just cause burning with no blisters.

How much of this could be anxiety? Did you go outside a regular relationship?

I am not currently in a relationship.  Understanding what is causing these issues/symptoms helps me with managing it so I don't spread it. I know my existing hsv infection triggers, prodrome symptoms and that i usually will have an outbreak in winter. So I can get on top of it early and ensure i dont spread it to anyone else. Understanding whether the symptoms i experienced was another HSV infection was so I could manage and deal with it.

I have only been with a sex worker twice since my last relationship and I can defintely say it doesn't make me feel anxious and it doesnt particularly make me feel particularly great either and after this experience I don't think it's am active I engage further in.

If these are symptoms of anxiety then it had me fooled!. The headaches, flu like symptoms, malaise, burning, itching and pain was nothing like any anxiety episode (twice) i have felt in the past. Those initial two weeks of symptoms felt the worst and wiped me out.

Thanks for listening and the advice. I will retest at 12 weeks and see how if indevelop any blisters. If i experience the burning sensation either orally or genitally then i can at least rule out hsv
Those symptoms could have been caused by so many different things. Covid comes to mind, as does the flu.

Testing at 12 weeks is a good plan.
I have just noticed 3 distinct separate red patches on the inside of my foreskin and burning appears localised there now. It's just reddish spots that no bumps or fluid filled blisters have appeared in them yet.

When is it best to get these swabbed? Do I need to wait until the bumps appear for them to burst and swab?

I just need a plan to help manage my anxiety. Haven't been able to think about much else since finding these red patches today.

Go get it looked at today, even if you have to go to an Urgent Care. If they think it might even possibly be herpes, ask them to do a swab - preferably a PCR swab - on it. Make sure it's a type specific swab.

If they say it isn't herpes, trust that. It's unlikely to be herpes at this late date.

You need to see a therapist. You need help with your anxiety.
Hi Auntiejessi,

An update to close this saga out

Short story
You were right it wasn't herpes for the penis symptoms. It was gonerrhea and trichomoniasis. Hopefully it's the same for my mouth symptoms

Long story
It felt like a bit of a journey, I went to a walk in sti clinic to investigate the spots. They did full sti tests and looked at the spots, they suggested it was fungal after examination. The full sti test they did came up negative. I still experienced mouth amd penis symptoms. A third Dr advised I take the urine sample again first thing in the morning and bingo I ended up testing positive  for gonerrhea and trichomoniasis. Had false negatives on multiple previous tests.

Been treated with antibiotics for both and the pain is slowly subsiding.  I am hoping the antibiotics treat both the mouth and penis symptoms. I was experiencing. Fingers crossed.

Ugh all those weeks of burning pain that came and went!!!! I was really, really, really confused and hating on my genitals!! I wanted a divorce from them so bad!. During that period symptoms got worse too with pelvic pain, radiating cold
feelings/ tingling down legs and arms and just feeling unwell. I was ready for the therapy path to sort out my brain!!!!. It might still be a good thing though, because I really hated myself, my decision to take a high-risk encounter and the pain. Need to understand my choices and not do this again!!.

Thanks so much for the advice and this service. It was invaluable and great to talk to someone when the anxiety of the unknown was too much. I maybe in touch if the mouth symptoms don't go away but I am hopeful they will with the antibiotics. But thanks once again
I hope the meds clear it up. I'm not sure why you had false negative tests, unless you hadn't waited an hour to urinate before giving the urine samples, or you had been on antibiotics within a couple weeks of the tests.

What medications did they give you? Take them as directed, and don't stop even when you start feeling better.
To be honest I don't recall any prior instruction to wait 1 hr before doing the urine test. The only instruction I do recall  was it had to be the first pass captured. The 3rd Dr was  the only person clear in his instructions which I followed. I would have followed the medical advice i dont stuff around with medical advice from professionals. I am kicking myself for not remembering or at least looking up how to take the urine test. It's highly possible I didn't wait 1 hr. If I had known it would have saved a lot of pain, time, anxiety and issues. But this was all because I chose to have a high risk encounter, this whole situation is on me.

Medication I took  was
Gonnerhea - 1 dose of  Ceftriaxone 500 mg shot plus Azithromycin 1g.
Trichomoniasis - 1 dose of Metronidazole 2g

Dr advised it would take up to 7 days after the medication for the symptoms to alleviate.  I am on day 5 and the penis symptoms are subsiding and feeling better as each day passes. I still feel slight/tingling and burning. For my mouth the tingling and burning was still quite noticeable on my tongue especially today. To the point I wasn't hopeful it would be fixed by the meds. But going to wait it out for the week or 2.

I have looked up the oral symptoms of gonnerhea and trichomoniasis and it mainly mentions throat symptoms not so much the tongue. I will have to wait and see.

If the meds  don't work for my mouth then my research into burning mouth/tongue circles me back to hsv1 via this case study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401976/

I already have hsv1 that occurs on my lips or gum (not at the same time). The likelihood of me catching hsv1 again is unlikely especially orally as it's already there right? It would only occur if the person I caught it from was having an outbreak which i dont recall seeing. But that's not saying much.






Yes, it would be really unlikely for you to get genital hsv1 after having it orally.

Oral hsv2 is also uncommon, so I wouldn't worry about that, either.

It could be from an allergy. Burning mouth syndrome is most often due to allergies.

The meds you were given were perfect. I'm glad you're feeling better.

I'm sorry you had the false negs, though. That's frustrating.

So it's been about 1 month since I was treated for gonerrhea and trich and I have not had any sex with anyone.  After treatment the genital symptoms only really went away in the last 1.5 weeks. The burning symptoms have returned this week. Due to all the symptoms I have experienced in the last 4 months my sex drive has been non existent and last weekend would be the first time in a while waking up with erections. So I suspect that has irritated things and caused my symptoms to return.

I have gone and got retested at the sti clinic and will have to wait 1 week for the results. I have read that the treatment I received is extremely effective and unlikely to fail. Do you think this is another infection causing this? Possibly related to my burning mouth symptoms seeing as they never went away with the gonerrhea and trich meds?

I asked the sti nurse about the possibility of hsv and he said for my mouth it's not possible to get hsv if I already have it orally and that I would have had lesions or blisters by now.

Any thoughts one what i possibly might have? I really am at a loss and these latest genital symptoms have dashed my hopes that I had resolved my genital infection
As I've said before, I don't think this is an STI causing the burning. I think at this point, you need to continue to work with your doctors to find the cause.

An STI doesn't cause burning mouth, so maybe start there. Maybe it's something you're eating or drinking that's irritating your mouth and bladder.

I agree it's not hsv orally.
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No STI causes burning mouth.

That could be from an allergy to a food or drink, toothpaste, etc., or anxiety, but it's not an STI symptom.

If you have hsv1, and it sounds like you do, you can give someone genital herpes type 1 with oral sex if they don't already have hsv1. Do you let your partners know that you have this?
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Hi Jessi. Yes I do,  i mentioned it to the person I had unprotected oral with when she was doing her health checks. She didn't disclose her status and said nothing when I mentioned it. In hindsight I should have asked her as well.

In terms of my symptoms it is now isolated to medium light burning/pain/tingling on my tongue and it was  sore on my lingual frenulum. This is going into week 4 now and I haven't had sex with anyone else. is it worth me asking the Dr to do a swab test of my tongue and frenulum? He was not concerned without visible blister/lesions.

This feels like a cold sore outbreak but I am used to blisters appearing if I don't manage it with creams quickly. Is it possible I may have missed seeing them in my mouth?  Usually they are very obvious when they occur one me. are they different when they occur in the actual mouth?



You wouldn't have missed it, and you can try a swab, but it will probably be negative. Using swabs without sores is tricky.

I'm not sure why you are focused on an STI being a cause here. Have you started using a new toothpaste? Eaten any new foods? Has any food or drink recently changed its formula - like it might say "new improved taste" or "less sugar" or something on it.

Did you give oral sex? If you didn't, you wouldn't be at risk for an STI. In theory, kissing can transmit syphilis, though that rarely happens, and can transmit oral hsv2, but oral hsv2 rarely transmits.

Could this be anxiety?
The only thing out of the ordinary I have done recently was the unprotected oral sex, which is why i suspected STI. I haven't tried anything new to trigger an allergy response since the encounter.

I  cant say I remember being anxious and experiencing symptoms like this in my mouth before or after giving oral sex before. At its worst talking made the pain in my frenulum worse so it felt like there was something reacting physical. With all the other symptoms it felt like my body was fighting something off. I expected i would have broken out in blisters/lesions by now,

Is hsv2 a strain presents without rash than say hsv1 or do people who catch hsv2 and already have hsv1 present less symptoms?

I wasn't tested for syphilis and i haven't seen a sore on my mouth. But will get tested



You don't need to be tested for syphilis, or any other STI. The only reason you'd need to test is to let this go.

Syphilis wouldn't cause burning mouth, either.

Both hsv1 and 2 can be asymptomatic, but you wouldn't have some symptoms of it without an outbreak. Herpes doesn't cause burning mouth.

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