Oral HSV2, symptoms and testing

[momo2727]

Hi Terri! I hope you’re doing well.

Almost 3 weeks ago, I woke up with what felt like a sore throat. Swallowing anything caused a lot of pain. My tongue was greyish and I couldn’t taste whatever I was eating. My symptoms started on a Sunday (August 14th). The next morning, I noticed little “bumps” or lesions showing up on the roof of my mouth, towards the soft palate. I can´t fully describe the lesions because I could barely see.

For context, I have performed oral sex without protection on different people in the past but never had any symptoms. The Friday night before the symptoms showed up, I performed oral sex on the guy I´m dating. The next day, I had a party and drank more than I usually do, so I initially thought any discomfort I had on Sunday, the day the symptoms started, was due to me heavy drinking the night before, and I discarded the possibility of catching an STD since I had also performed oral sex on this same guy the week prior and didn´t feel anything afterwards. He also didn´t have any lesions present.

The doctor told me I could have herpes 1 or herpangina. I was told there were these “bumps” on the roof of my mouth and the back of my throat. They told me to take the IGM and IGG tests. I´m a student and don´t have a lot of money. I was told to take the IGM test if I couldn´t afford to get the IGG, because those antibodies showed up first. My IGM test showed negative for Herpes 1 and positive for Herpes 2. I´m Mexican, so the test was done in a Mexican lab and we have a different index system, I couldn´t tell u the equivalent to the US system.

The symptoms subsided after a week, I never had fever or fatigue. I felt my lymph nodes slightly swollen the first few days but nothing major. I’m now taking acyclovir just to reduce chances of transmission in case I do have it.

I now know I shouldn´t have taken the IgM test. My question: how long before taking an IgG test should I drop acyclovir? what are the chances this is an OHSV2 primary infection?

[Terri Warren]

The chances of an oral HSV 2 infection are very low but not zero. Was any swab testing done of the bumps? On what did he base his diagnosis of herpes, please?

I would say you being off acyclovir for three months would give you a more accurate HSV 2 test. Please only test with a lab that will give you an index value on the IgG test, not just positive or negative.
Terri

[momo2727]

There was no swab testing done, he based his diagnosis on the appearance alone of the bumps. Later he thought his diagnosis was confirmed by the positive igM test. I have also never experienced any lesions or symptoms on my genitals.
1. Is there any chance that it could have been a cross reaction where the test actually mistook HSV1 for HSV2?
2. Do the symptoms sound like it could be a primary infection? I know it’s extremely difficult to tell without seeing the lesions yourself but based on the symptoms maybe you could make a proffessional guess? It just seems weird that I didn´t get any fever or lesions on my lips or on the tongue, only on the roof of my mouth and my throat.
3. Is there any chance that it could have been something bacterial instead of herpes? The tongue symptom (greyish tongue, no taste) really threw me off.

[Terri Warren]

1. Is there any chance that it could have been a cross reaction where the test actually mistook HSV1 for HSV2?
The IgM test is non-specific – it cannot accurately separate HSV 1 from HSV 2 and never should have been done,as you know.

2. Do the symptoms sound like it could be a primary infection? I know it’s extremely difficult to tell without seeing the lesions yourself but based on the symptoms maybe you could make a proffessional guess? It just seems weird that I didn´t get any fever or lesions on my lips or on the tongue, only on the roof of my mouth and my throat.
That does seem a bit weird. I’m afraid I’m not able to even offer a professional guess on this one. Swab testing should have been done to give you an accurate answer. But I will say it is quite unlikely that this is HSV 2.

3. Is there any chance that it could have been something bacterial instead of herpes? The tongue symptom (greyish tongue, no taste) really threw me off.
Yes, certainly it could be something bacterial!

Terri

[momo2727]

Lastly,

1. When I tried suggesting that it could be something bacterial to my doctor he said that sometimes the virus could attack the tongue and display symptoms like the one I mentioned before or that it could be thrush that coincided with the viral infection. What is your opinion on this?

2. What are the odds that I had contracted OHSV1 or OHSV2 sometime in the past and that it randomly got triggered just now and that it presented atypically?

3. Should I take the IgG test for HSV2 separate from the test for HSV1 as to avoid cross-reactivity?

Thank you for your time, Terri.

[Terri Warren]

1. When I tried suggesting that it could be something bacterial to my doctor he said that sometimes the virus could attack the tongue and display symptoms like the one I mentioned before or that it could be thrush that coincided with the viral infection. What is your opinion on this?
A gray coating on the tongue could be thrush, but without any swab testing done, which is so disappointing, it isn’t possible to know

2. What are the odds that I had contracted OHSV1 or OHSV2 sometime in the past and that it randomly got triggered just now and that it presented atypically?
Unlikely

3. Should I take the IgG test for HSV2 separate from the test for HSV1 as to avoid cross-reactivity?
The type specific IgG tests are supposed to do that. However, sometimes there is some cross reactivity with the IgG test giving false positive on the HSV 2 in someone who already has HSV 1.

Terri

[Author]

Posts