Dr. Holodniy, I was hoping you could help me with a problem I am having with a patient. A man in his mid 20's came into me office very distraught after having cheating on his girlfriend with a prostitute without protection. He told me that his penis was hurting him and I examined him to find he had a yeast infection. I gave a script and he said it cleared up. A few weeks later he came in complaining of leg pain. So I gave him a complete std panel, everything came back negative. I also gave him an HIV test at this time because he was showing symptoms of AVS (fever, fatigue, rash on top of hands and yeast in corners of mouth) The test came back negative. I asked him to come in at 3 months to test and referred him to a mental health speacilist. He came back at ten weeks and the rash on his hands was gone, but he was telling me his penis was still red and his upper body was in terrible pain. I gave him an antibody and another syph. test. I ordered an MRI on his upper neck.HIV test came back negative. MRI could not find anything. At 12 weeks he came back with thrush. So I ordered an RNA test. It came back <50 copies and his white blood cell count was high (2400). I told him it was his nerves wrote a script. and asked him to come back in three months. At 13 weeks he called and said that he had another antibody test done and it came back negative. At six months he was complaining about burning in his face and still had a sore penis. So I ordered another HIV1 antibody test and gave him a pockit test both came out negative. I called a fellow physician and we both agreed that this patient under alot of stress from this and he was manifesting many things. I tried to explain this to my patient and refuses to believe it. What more can I do? He refuses to see a health care speacilist and I am out of suggestions. I even ran him a complete CBC which came out normal. But his symptoms persist. I cannot refuse to see him and I admired the fact that he went to see me after this situation (explaining he did not want anything to happen to his girlfriend)

Thanks.

I can't tell you what it is, but I think testing for HIV infection has been sufficient.