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RE: Tonsils
Mar 9, 2002

Hi Doc,

Thank you for your continued patience in answering me.

Thank your previous reply. Unfortunately this wasn't really the answer that I was looking for. In recent posts various posters have enquired as to the possibilty of whether or not a SINGLE enlarged tonsil may be a symptom of HIV infection. I believe in your reply you stated that you would most likely expect both tonsils to be enlarged.

I'm by no means an expert unlike yourself, but the link I provided in my last post to you was suggestive to me at least that a SINLGE enlarged tonsil may well signal HIV infection.

Quote: "For the study, the research team examined tissue from 13 HIV-1-infected patients, aged 20 to 42, two of whom were female. Each had surgery between 1989 and 1995 to remove an enlarged tonsil. With the exception of one patient who refused testing, all patients had antibodies to HIV. Of these, two experienced AIDS symptoms, most denied high risk behavior and 11 did not know they had been infected."

The report mentioned that all 13 patients had only one enlarged tonsil as far as I'm aware. The tonsil of each patient was susequently found to be enlarged due to HIV which was discovered and confirmed further by 11 of the 13 patients agreeing to HIV testing and being found to be positive. The patients were not aware previous to this that they were HIV positive.

Response from Dr. Feinberg

For every general rule in medicine there are exceptions. While a systemic illness is more likely to cause swelling of both tonsils (or swelling of more than one lymph node), HIV can certainly occur when there is just one tonsil that is enlarged. I'm not trying to argue with the study you quoted, it just is a less likely scenario.

So, in this case as in ALL others where poeple are concerned about being infected with HIV, the only rational thing to do is to get tested. Just as you cannot 'see' that someone has HIV by looking at them, you cannot 'see' that someone does or does not have HIV according to how many tonsils or lymph nodes are enlarged. I hope this makes more sense now.


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