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RE: Dr. Bob, you misunderstand! The consultant *does* think HIV
Jul 6, 2003

> Sorry but I have no way of retrieving and reviewing specific questions that have already been > > posted. As I recall, you had repeatedly negative HIV tests. Please note symptoms, even > > "verified" symptoms, do not equal disease. Painful ulcers of the throat and anus can be caused by > several different types of infections. Hopefully, an infectious diseases and/or dermatologist will > be able to sort this out for you very soon. Keep me posted. Good luck.

Hi Dr. Bob,

Thanks for your reply. Sorry about my request for you to review my previous email. Yes, I have negative HIV tests at 8, 12 and 16 weeks. I have been advised to test at 6 months (in a couple of weeks time).

I have a referral with a dermatologist and infectious diseases specialist lined up just in case that is negative. Ill be sure to let you know how it goes.

I have done a lot of searching and unfortunately cant really find a differential diagnosis for painful ulcers on the pharynx of 3 months duration. Herpes clears in about 14 days I read. The ulcers arent the half of it either! There are actually vasculitic scars and grossly altered sensation in the fingers and toes, recurrent rashes on abdomen/arms/palms and swelling/intense heat behind the knees and in the groin. Several other things besides.

I would characterise it as feeling like I have a very bad flu that wont go away (lasted nearly 5 months now). Have had to go part time at work.

Have tested for many other things: Hep B, syphilis, gonorrhea, EBV, CMV, Parvovirus, vasculitic diseases (lupus etc.), bacteriology screen, stool culture. Standard bloodwork shows no anomalies. All they've found is an old EBV infection!

Was thinking if not HIV, maybe Lyme disease, atypical mycobacterial infection, Hep A or false neg for syphilis or lupus. No idea really, Im no doc, but my docs are stuck!

Anyhow, Ill keep in touch.

Thanks for listening, Ben

Response from Dr. Frascino

Hey Ben,

There are a variety of ulcerative conditions. I would have to write a whole chapter. But, why are you waiting to see the dermatologist and infectious diseases specialists? Your repeatedly negative HIV tests out to 16 weeks makes HIV extremely unlikely. A small biopsy from the edge of an active ulcer should be able to identify any infectious agent. Trying to self-diagnose (Lyme Disease, atypical Mycobacterium, Lupus false positives, etc.) is unlikely to be helpful. There are relatively simple ways to check for these conditions. So why guess? See the specialists now. Get the evaluation and treatment you need. I'm still betting HIV is not the problem. Keep me posted.

Dr. Bob



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