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A Case History

This is a communication to me in response to my paper on HSV2 (name and identifying information removed):

Good day Mr Burton –

I read your Biochemistry article on Oral HSV2 and was hopeful you may be able to help!

I was exposed and infected with typical HSV2 as a young person. My occurrences were few and far between. However one year ago I began having symptoms of Oral HSV2. I am an otherwise healthy XXyr old. I have been married for 13years without any other serious diagnosis. I cannot seem to find a Dr. that will even listen to what is happening. I feel like the I have chronic esophagitis and when very uncomfortable even can feel it in my lungs. When this first happened a year ago it followed with a severe tonsillitis and then a rash all over my body. The rash was oval shaped red spots that took about 4 months to go away. I have tried 1000mg of acyclovir BID but that did’t help.

I am a (occupation—location). ANY recommendation for a Dr would be greatly appreciated. Obviously I am happy to travel to (location) if necessary. My biggest concern is that this will cause a secondary esophageal cancer or encephalitis.

Do you know if I am now at even greater risk of encephalitis with oral HSV2 than if I had HSV1 or just genital HSV2?

I apologize if I am coming across a bit desperate, but I feel desperate.

Thank you in advance for any assistance you may be able to provide,

 

My response:

 

Dear,

Unfortunately, I have no useful suggestion for access to better medical care at this time, although I am seeking this information, and will transmit it to you, if I can make this discovery.

Can I use your email (with your name removed) in communications on this subject? The depth of physician ignorance and denial on oral HSV2 cannot be overstated.

Have you tried sucking on 500 mg acyclovir per day to increase the local dose to the affected area (they taste terrible)? (I am not a physician, I’m a Ph.D., so I cannot legally make this prescription).

Possible beneficial effects will not be immediate.

Is your chin inflamed (i.e. noticeably hot to the touch)?

Acyclovir is absorbed through the skin and so can be applied directly to the chin and be effectively absorbed. This is more effective than swallowing pills or, I guess, intravenous whole body injection.

The virus pools in reservoirs, i.e. in the face, and, if not suppressed, spreads more freely to other places. If the reservoir is reduced by local application of the drug, this may alleviate other symptoms.

Injectable acyclovir is available and should be tested (or adjusted) for safety of local injection to local reservoirs of the virus. It appears that acyclovir is a low toxicity drug, particularly when delivered directly to affected areas.

Thanks very much for your communication.

Gratefully,

Zachary Burton, Ph.D.

Professor of Biochemistry and Molecular Biology

Michigan State University

 

Letter #2:

 

Thank you for your honest reply! Yes, you may certainly use my email (if you could just remove my name) as I would welcome any help and would be happy to validate this horrible disease. I have made an apt with an infectious disease Dr at UCLA. I hope he will be able to help get this under control. I just remember my micro teacher in school scaring me to death about ever getting oral HSV2 as it goes straight to the brain. She did have a flair for the extreme but still!! I feel like i’m living in the twilight zone…I just can’t believe this has happened to me!

I will ask about antiviral mouthwash when I see the UCLA guy.

Fingers crossed!!

Thank you again for your caring email. I hope you find some exciting information to share with me 🙂 If I learn anything from LA i’ll let you know.

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