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Is this an ARS-like rash or a fungal infection?
Jan 12, 2001

Sorry for this long question but your erudite answer would be greatly appreciated. I am an extremely HIV-aware individual and tested negative for HIV week-6. No encounters after this. Week 0 at an executive bash in Bangkok had a protected sexual encounter at a high-class Bangkok escort agency. Girls have monthly STD blood tests - I verified this too. Intentionally, no kissing, oral contact/fluid contact, no skin contact in the 'fluid zones' - breasts / vagina etc - but a careful less than a minute-long protected vaginal insertion and that was that. Celibate since and no illnesses. End of week 15 (Christmas), went to waterpark and spent some time in various spas. Was not particular with washing and cleaning very well after these dips. Week 16, had a stinging and dry and itchy feeling in the back and front of my torso, and ignored it thinking it was chlorine from the spa. End of week 16 developed an upper body rash (upper and forearms, bit on the chest, around the clavicular area beneath the neck, back shoulders and some around the right tummy) with various subtypes. (I had a body rash only once in my lifetime before this). (Others in my family did not contract this.) Type 1: Itchy. Not red. 3 mm bumps with a 'center. This was usually situated in areas where the bigger ones were located. The ones on the forearms itched the most - when itched the head flaked off and left a whitish spot behind. That scrathed area would become red temporarily. Type 2: Sometime itchy. Darker. 3-5mm. The insect-bite types. Darker and with a raised center. Situated around my shoulder region and back. Also around the right-side of my tummy. UnliOnly some flaked mildly with repeated scratching. Type 3. 8 mm 'spots'. Fainter. 'Harmless' flats. Located around below my neck around the clavicular region. Would not flake or itch. I suspect these also had a faint center. Beginning of Week 17, got worried and went to the doctor who asked my 2 week medical history and immediately jumped on the word 'spa'. Said this was clearly a fungal infection. Embarassed to mention ARS - I asked her if this was like Rubella or anything viral and the answer was a laugh and a 'no'. She recommended Lotrisone worked wonders in a couple of days. End of week 17 Had a three day bad cold - extreme nasal congestion, hacking cough no chills or headaches or body aches or extreme malaise - just a half-day mild fever of 99.5. Q1. Can ARS hit someone at the end of 16 weeks? I guess not. Q2. Is such a rash consistent with ARS-like infection? I mean, different sub-types, all with a 'center'. Is a fungal rash visually different from a ARS-type rash? Q3. Is a rash followed by a cold a sign of ARS? Q4. Did not want to suspect the medical profession - but can a root canal treatment at the dentist's at Week 14 be considered a possible source of HIV risk? I guess not and hope not! Thanks in advance for your answers.

Response from Dr. Holodniy

1. NO

2. NO, from what you describe. YES.

3. Several cold viruses cause rashes in addition to cold/flu like symptoms. Nasal congestion, runny nose, blocked ears, etc, are not ARS symptoms.

4. Extremely unlikely. Of all the thousands of dentists and millions of visits per year in the US, only one alleged small case cluster from a Florida dentist.

MH



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