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What Should my next step be? Night sweats
Feb 16, 2003

Hello Doctor,

Please give me some guidance on what steps I should take next.

History: Had sex with a female in which the condom broke (Nov 1999) Since that time I have had what I would describe as swollen lymph nodes, dry mouth and muscle aches. I have also had night sweats, not the drenching type but enough to dampen my underwear From Feb 2000 to March 2001 I had 3 Elisa tests and 4 western blot for HIV1, all negative. I asked my ID doctor to run a HIV2 test, but he stated that was not necessary because none of the bands on the HIV1 Western Blot test were reactive. The only blood work that came back that was unusual was a muscle enzyme that was ever so slightly elevated. And one of the three test for liver (not sure which) also came back out of the normal range. I have also been tested for TB and Hepatitis, both negative.

I have had two CAT scans, one of my chest and another one yesterday of my groin area. Both of these have come back as 'normal'. Is it possible to have a problem with the lymph nodes in my groin and have it not show up on a CAT scan?

Also, is there a blood test that would point towards a problem with the lymph nodes?

One more question, could please recommend what my next step should be. I know that

Response from Dr. Dezube

I'm not sure I can recommend to you an obvious next step. If 3 or 4 HIV tests were negative, then you don't have HIV. Modern HIV tests check for both HIV-1 and HIV-2. The two CT scans are reassuring. You mention that your liver tests were abnormal. I would need to know more about that. There may be a clue there. It is not uncommon to have symptoms similar to the ones you describe. Often, only after some time, it will become clear if anything is going on. Often, we ascribe your symptoms to a viral syndrome. The persistence of symptoms will guide your health provider in terms of further testing.


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