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Treatment for COLD SORE and stiff neck.

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My question pertains to oral Cold Sores.
On June 24(Tuesday) I started dating this girl named Tina. We made-out on our first date that day, and did so again on that Friday. Then on Sunday I hung out with a Navy friend of mine, who was still getting over her flu. We shared a drink, and that night I immediately started to feel like I was going to come down with the flu.
The next day(Monday) I awoke feeling terrible, and the muscles in my neck were sore...made it hard to turn my head. My Navy friend came over and cooked me dinner, since I didn't eat anything all day. I needed the food since I had taken pain meds, earlier on in the day, on an empty stomach.
I had a hard time sleeping that night due to trouble breathing/coughing. I didn't get to rest until morning.
I awoke sometime in the afternoon, and found that my lips were very dry. I had recently purchased a new tall fan, and the air was blowing directly into my face. Plus, the weather was quite warm and y windows were closed. Sometime during that day, or the next, I noticed there was an open gash on my lower lip. It was located on the center crease , and there was a tiny one directly underneath it(Looked more like a slit cut). I've always had a habit of biting and pealing my lips with my teeth, since I was a child, and I do remember biting the area where the small slit cut was.
The marks had a hard time healing due to food getting on them whenever I ate. It was scabed over, but would come off easily whenever I washed my mouth since my lip was still dry. It wasn't until my Navy friend bought me cold sore band-aids to block off any food from getting on them, that they finally started to heal. I recall blood and clear liquid coming out of the wound, whenever I removed the band-aid to clean the area; the band-aid would get stuck on the scab, pealing off it off whenever I removed it. She didn't think they were coldsores, but bought the band aids since she figured it would help with the healing.
Since I've never had Cold Sores, and I'm quite paranoid about STD's and things of that nature, I've come to my question -- Was what I experienced on my lip a cold sore, or just massive dry chapped lips that cracked open leaving a gash(Mixed with possible lip biting)? My Navy friend doesn't get cold sores, nor has she ever had them in her life. The girl I was dating, Tina, says she's had them since she was a child, but she doesn't experience them often. And she assures me she didn't have an outbreak when we were kissing.
I also didn't experience any of the "break-out symptons" that I've read on different health sites -- I didn't experience any tingling, burning, or itching around the area before hand; I did not notice any blisters on my lip before I discovered the open gashes; my throat wasn't sore, but my neck muscles were; and the sores were not painful, except for the little "slit cut" gash that only stung if I touched it.

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: HIV- AIDS Specialist
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Hello.
Thank you for your query at DoctorSpring.com
I understand your concern.
HSV-1 infection as you know causes the typical cold sores/ fever blisters and the outbreak can have either 1 single blister which discharges blood and clear fluid when peeled off, or a group of multiple such blisters which are acutely painful.
Now in your case, there are two possibilties. It can be due to dry lips and as a side effect of the medication. Mostly herpes outbreaks will manifest as multiple cold sores clubbed together. But since your partner has a history of cold sores and you recently had the exposure Herpes definitely can't be ruled out right away. Hence it is better if you can get yourself tested for the ( HSV-1 IgM ) antibody, which will give us the status of your recent infection. Herpes is extremely contagious and even without outbreaks in the affected partner, it can be spread to the susceptible partner. The outbreaks need not necessarily be associated with any tingling/ pain/ burning all the time. As i said the manifestations are varied, in most people it tends to occur in groups, some people remain asymptomatic for their whole life, apart from a few cold sores here and there, and in some people there can be only one cold sore coming every time the person is affected. It all depends on the immunity of that paticular individual.
So I'm not ruling out Herpes completely. I will suggest you get yourself tested for HSV-1 antibody.
Regards.


Patient replied :

Thank you for your response. I've gone ahead and made an appointment to get tested tomorrow afternoon. One thing I forget to mention is that Tina did give me oral sex, without a condom, for about 30 seconds. I'll get tested to make sure I didn't get infected down there also, but I've experienced no signs of an outbreak at all. I'm aware that most people who are infected with genital herpes have no symptoms, but would I have had an outbreak down there at the same time as I did orally? Assuming the outbreak on my lip was indeed a herpes outbreak from Tina.


Hello.
No the outbreaks can happen at different intervals.
Moreover two different strains of viruses are involved. While genital herpes is because of HSV 2, oral lesions are due to HSV 1. You're doing the most logical thing by getting yourself tested.
Hopefully it is just due to fever.
Still update me once your results are out.
Wish you good health,
Regards.


Patient replied :

My results came back as the following : HSV 1 Positive; HSV 2 Negative I was not surprised to see that I was HSV 1 Positive, for there was an event in my life that happened years old patientago, that I completely forgot about: Back in 2003, I was dating a girl from my High school named Jasmine. One Friday I came over to her house while she was sick with the Flu. I noticed she had a coldsore/Fever Blister near her mouth. I remember it looked blood red and dry(Though I can't remember what stage it was in), and it was about half an inch away from her lips. I didn't know what coldsores were back then, and assumed they were just a genetic defect that some people had. So me, being the dumb young teenager trying to be sweet and romantic, offered to make-out(kissing with tongue) with her in order to let her flu virus enter me so she wouldn't be sick anymore. We were kissing for quite a while; probably close to half an hour. I tried not to touch her sore, but there's really no telling if my faced brushed up against it or not. The next day I woke up feeling increasingly ill. I could tell I was coming down with the Flu caught from Jasmine. However, I didn't have a coldsore break out whatsoever. It wasn't until about a month or two later, that I had informed one of my friends what I did with Jasmine, and he quickly alerted me as to what coldsores really were -- a contagious form of Herpes Virus. I immidiately called Jasmine that night and yelled at her. In a panic, I tried looking up information on HSV-1. I was certain I was infected, until I called an STD Hotline. The person I spoke to told me that since I didn't get a coldsore break out after a certain time winodw of potentially being infected, then I didnt' have HSV-1 and probably just caught the flu from Jasmine. A month or so after that, I noticed a small white patch of skin on the upper center portion of my bottom lip. I tried getting rid of it by picking it off with the needle portion of an old saftey pin. I cut my lip open a little, and probably got it infected.I automatically assumed it was a coldsore, and treated it as such with topical creams. It took a week or so to heal, and during that time I was in depression thinking it was indeed a coldsore. It wasn't until sometime after my lip had fully healed, that I looked at a portrait of my High School Senior photo, and noticed that white patch of skin had always been there(Long before I ever dated or kissed Jasmine). So after I had relized that, I assumed I didn't have coldsores after all, and probably just cut/injured my lip with the saftey pin. Fast forward to present day, and I've never had a coldsore/feverblister since. So that's why I had always assumed I didn't have HSV-1. But last week, while I was waiting for my test results to come back, I did more reading into how HSV-1 can spread, and I determined that Jasmine more than likely infected me. Espcially since the virus can spread through saliva; and Jasmine and I did a lot of tongue kissing the day she had her coldsore. My father does get coldsores, on rare occations, so there is the possiblity that he might have infected me while I was growing up, but i've never had a coldsore as a child. As for the open gash/cut on my lip from this past June, I still cannot confirm or deny that it was indeed a coldsore either. My lip could have very well split open from being incredibly dry due to sickness; fan blowing in my face; and warm stuffy bedroom with the windows closed. And the location of the gash, being right on the center crease of the lip where there lots of movement when the mouth moves, has always had me wondering what it could have been for certain. My Navy friend who had come to see me while I was sick, Natoshia, didn't think it looked like a coldsore either. And she's seen other shipmates with coldsores; including the one of the ship's doctors. Tina, the girl who I worried had infected me with HSV-1 in June, still stands by her word that she did not have a coldsore on the week that we meet. I can say for certain though, that I did catch the Flu from my Navy friend, Natoshia, on the Sunday after meeting Tina. Natoshia was still getting over a really bad Flu that she had caught while her ship was on deployment up north; and she and I had drank out of the same straw when we shared drinks on the day before I got sick. So in my final conclusion: I probably have always had HSV-1 ever since I kissed Jasmine back in 2003. I may be one of many who don't show any symptoms of HSV-1, or at least rarely show it at all; given that it's been eleven years old patientsince I've had anything on my lips. What do you think? And on a side note -- On the day I first asked you my question, I became incredibly stressed and worried. I had never been so stressed out in all my life, and I continued to be so on the days waiting for my test results to come back. But one thing I notice now - I never had a coldsore break out during those intense levels of stress; and I know stress is one of the triggers for coldsores. It is for many at least. I thought you might find that interesting.


Hello.
Thank you for the follow up.
It is quite possible that you got the infection from Jasmine. As i told you, the issue with viral infections are that you never know when they suddenly show up. They can be triggered by fever ( due to some other infection ), intense levels of stress, other viral infections ( e.t..c ) And indeed HSV 1 is spread by oral secretions contact through kissing.
There is one definitel way of saying if you have a present infection or it happened in the past. Check your results. If it is positive for IGM HSV 1, then it indicates a present infection and not a past one. If it is HSV-1 IGG antibody present and the values are not very high, then it indicates past infection, that happened long back. Or otherwise you can upload your reports and i can interpret it for you.
Feel free to discuss further,
Regards.


Patient replied :

I do not have the results with me. I was informed of the results via telephone. Though I do recall the nurse saying that the results show that I've had it for "quite sometime".


Okay in that case you got it from Jasmine if there were no other exposures.
So the nurse meant to say you have HSV IGG antibodies present, which shows past infection.
Hope this was helpful,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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