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Amsterdam incident

Nov 9, 2004

Dr. Bob - you're humurous, a great soul and have the best of Karma lined up and I pray for people like you everyday. Readers of this forum - I've been a regular since July this year and your site is the most authentic and comforting (I've compared your data to numerous other sites like CDC, and yours is the best).

Long story short - had a protected oral (2 mins) and protected vaginal (30 sec) during a mild drunken stupor in Red Light Amsterdam on July 1st 2004.

Symptoms (days after exposure): (1) 3-7 days: Yellow tongue, tingling/itching/pricking on genitals and anus along with angiokeratomas on scrotum accompanied by lower limb myalgia-arthalgia/weakness, mild tenderness of inguinal lymph. (2) 7-30 days: Myalgia/arthralgia/intensifying pricking and symmetric pricking on eyelid border, lower lip border. (3) Day 30: Applied OTC NIX premethrin for 3 times and itching/pricking subsides by 90%. (4) 30-60: Headache begins and myalgia/arthralgia spreads to upper body. Headache correlated with minor nodule eruptions on scalp. Nodules and angiokeratomas over back(some with pus)/buttocks al charecterized by waxing - waning duration of 4 days. Second opinion physician prescribes Sulindac for arthralgia - pain decreases 50%. (5) 60-120: Got off Sulindac and occasional shooting pain (2-3 seconds/day) somewhere in limbs and occasional pricking sensation (2-3 seconds/day). (6) 1-today: No fever or significant rash

Labs performed: (1) CBC 1 week after incident when symptoms were peaking: WBC 8.5, Lymphocytes 2.7, Mid 0.5, Granulocytes 5.3 For comparison, baseline CBC during regular annual exam a year ago was WBC 5.1, Lymphocytes 2.1, Mid 0.3, Granulocytes 2.7 (2) 45 day STD screen: HSV (type specific EIA)/HIV/Syphilis (RPR)/Hepatitis A, B, C/Chlamydia/Gonorrhoea - all negative (3) Rheumatoid Factor: 9 (range < 14) - negative (4) 105 day STD screen: HSV (type specific EIA)/HIV/Syphilis (RPR)/Hepatitis A, B, C/Chlamydia/Gonorrhoea - all negative (5) 60 day: CRP high sensitivity <0.2 (range is 0 to 10.0), Creatine Kinase Total Activity 72 (range is 30 to 285), Sed Rate 1 (range is 0 to 15). All within range. (6) 75 day: Lipid panel: Cholesterol Total 132 (range 200), Triglyceride 151 (range < 150 - so borderline, HDL 30 ( range > 40) so this is bad, LDL 72 (range < 130) (7) 120 day: Xrays to see why arthralgia - orthopedic says normal. (8) Other: Otherwise healthy 31 yr. old, with 3 days/week gym, vegetarian and started to gobble up green tea/blueberries/garlic etc. to reduce toxicity (antioxidants) after this incident.

Questions: (1) Is it possible for these mites to carry a variant of a strain of an STD that the standard tests cannot detect (maybe mutations of STD pathogens after interaction with mite DNA) ? (2) Is it possible for these mites to have fresh blood on their mouthparts from another Red Light customer and hence transmit a pathogen (since this is a high-traffic area) ? (3) If I had scabies/lice and the answers to the above questions (1)-(2) is 'no', why did I have systemic symptoms - especially myalgia/arthralgia/headache, could it be because of high Triglycerides since COX inhibits prostaglandins that are lipid derivatives ? (4) Does the CBC variations from normal counts as mentioned in Lab(1) specific to my constitution indicate one of the following or a combination - only viral/only bacterial/only allergic response ? (5) What is the explanation for the Lymphocyte absolute count elevation from 2.1 - 2.7 (if significant) and what is the reason for the Granulocyte/Mid count elevation 2.7 - 5.3. (6) Am I at risk for any long term disease like cancer, multiple sclerosis, arthritis ?

BTW, before this episode that I will always regret, I had been to Champs Elysees and Bruxelles :-).

thanks, concerned Seattle'ite

BTW: I am a Computer technician by profession but with the help of google and this regrettable incident, I have become reasonably conversant in medical terminology.

Response from Dr. Frascino

Hi Concerned Seattleite,

Thanks for you kind words. Since this is an HIV information Web site specifically dealing with safe sex and HIV prevention issues, I really can't go into great detail on the many possibilities for your symptoms or mild laboratory abnormalities, as that would be well beyond the scope and purpose of this forum. Consequently, I'll answer your questions and then suggest you follow up with your general medical doctor for additional specifics on the non-HIV-related concerns, OK?

1. No, this is not possible.

2. No, this is not possible.

3. No, this is not related to your minimal elevation in triglycerides. I cannot diagnose the exact cause of past episodes of myalgia/arthralgia/headache over the Internet.

4. It does not indicate an only viral, only bacterial or only allergic response.

5. No, it is not significant. These transient changes in cell types can reflect a great number of transient medical conditions.

6. Not based on any of the information you provided.

Hope that helps! I, too, have been to Champs Elysées many times!

Dr. Bob

Second Hand Smoke and Sex?Can it be?
European S.O.S

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