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Herpes possibilty
Aug 24, 2006

Hi Dr Bob!

Hope you're well babycakes! A friend of mine is concerned about a recent flu like illness with new partner....that is no longer around. Before bothering you with this question, I searched the forums and found an answer to my question by another doctor (good boy aint I!), but was also wondering something else...... (I will post the response first)

"Just before visible symptoms appear, the infected person will notice a tingling sensation at the site of the infection. At this point in time, the virus is highly infectious. Within a day or two, a painful, blistery lesion will appear, that can have a yellowish fluid coming from it. This is also highly infectious. The lesion eventually crusts over as it begins to heal. After a week or two, the lesion will usually fully heal and the person will no longer have symptoms. During a persons first outbreak, flu-like symptoms (muscle aches, fever, headache, body aches etc.) may accompany the lesion. This is called Acute Viral Syndrome, and is very much like Acute Viral Syndrome seen with recent HIV infection. However, a lesion will occur (in addition to the flu-like symptoms) when Acute Viral Syndrome is due to the herpes virus. Acute Viral Syndrome is not usually seen during subsequent outbreaks. Once the lesion heals, the herpes virus is no longer very infectious. However transmission can still technically occur, only it is not nearly as infectious as when symptoms are present. Again, the key to transmission of the herpes virus is direct contact of the lips, penis, vagina, or rectum, to the herpes lesion or the infected area. Herpes is a lifelong infection, and symptoms can recur at any time, but are most likely to recur when a person is under physical or emotional stress. Once symptoms re-appear, the virus is once again highly infectious"

My questions being... 1) My friend had a "huge" swollen gland under her right armpit about 5 months after getting first outbreak. She has since then had tenderness in her right armpit that comes and goes and also small little lumps (me unsure if they are swollen glands or not). Would herpes have continuing symptoms like this between any outbreaks? She has never had one since? She at times thinks she has fevers through the day?

* Also is CMV associated with hepres? As she seems to be having increased floaters? Checked with an opthamologist who said it was normal but to come back if it increases.

She has messaged you, but maybe seems a bit "fragile" in her emails, so you may not have answered them. We have spoken on a few occassions (I'm your biggest fan - YES your BIGGEST fan) so I'm hoping now that if I simplified it a bit you could help me out here? I'm having trouble getting her to get tested...and am very worried about her.

I for some reason,. think this could be a herpes diagnosis, hopefully not hiv. Mostly because there was an outbreak around the time of flu symptoms...but I'm no doctor :-)People seem to think the ongoing symptoms point more at herpes, cmv or mono than hiv?

Thanks Bobby...still loving your work!

James xoxoxoxox

Response from Dr. Frascino

Hello James,

My biggest fan??? Hmmm . . . well there was that guy a few months back who wrote in with a multitude of problems, including tipping the scales at 485 pounds. He also said he was a fan. So he just may have you beat as my "biggest" fan, Jimmy Boy.

Regarding your questions, it's always difficult, if not impossible, to truly evaluate a symptom over the Internet. What seeks like a "huge" swollen gland to a non-medical person may turn out to be something totally different when examined by a physician. I'm always reluctant to give anything other than general advice about symptoms, OK?

1. No. Herpes symptoms subside completely between episodes. Thinking you have a fever and actually having a fever are two very different things.

2. CMV is a member of the herpes virus family. I agree the vast majority of "floaters" are completely normal.

Your friend obviously needs some help with being so "fragile." I suggest you get her started with some counseling to help her cope with her fears, anxiety and "fragility!" She'll need to have that "huge" swollen gland evaluated by a physician. She'll also need to get an HIV test, if she's placed herself at risk for HIV infection, whether or not she has symptoms. Being a fan of this forum, you already knew I'd say that, didn't you? Of course you did!

Stay well, Jimmy Boy.

Dr. Bob



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