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From "Scared Dad" - oral white streaks - Thank you!!
May 8, 2006

Doctor Frascino,

I thank you for your timely answers. I agree with you that I probably do need to seek some sort of counseling for the HIV fears that I've been having. I guess it just scared me when these weird symptoms starting occuring in my mouth so soon after my french-kissing encounter with the bar girl. I just got my p24 antigen test results back yesterday afternoon. As you had predicted, they were negative. The doctor told me, just as you had advised, to follow up with a standard elisa at the 3 month mark just to be absolutely sure. My p24 antigen test blood sample was taken exactly 18 days after the suspected exposure...that is within the normal window period for that test? And it's a fairly accurate test? Thanks again Doctor!! You're the best.

Scared Dad

Response from Dr. Frascino

Hello Dad,

You are welcome! But are you back again so soon with yet another question?!?

I do not recommend antibody tests or p24 antigen tests prior to the three-month mark. That yours was negative as predicted is encouraging, but not definitive.

I'm now cutting you off! No more questions until you have your three-month ELISA. OK? I do hope you'll get counseling soon, very soon.

Good luck. I'll repost your previous question below. My advice remains exactly the same!

Dr. Bob

HELP!! From "Scared Dad" - oral white streaks, now sublingual ranula cysts??? Apr 30, 2006

Doctor Frascino,

Please help...things seem to be getting worse from my previous posts....here's an estimated timeline: 4/6/06: deep french kissing with bar girl - 4/15/06: sex with wife with french kissing - 4/17/06: wife complains of severe redness, burning, and itching in and around vagina and older 5 year old son develops small white blister on tongue tip - 4/21/06: I first notice chapped crusting on my lips and oral white streaks on inner cheeks - 4/24/06: my doctor thinks I may have thrush or fungal infection and gives me mycelex and younger 3 year old son gets severe whitening of tongue with small white blister on tongue tip - 4/25/06: STD specialist doctor agrees it might be thrush and gives me one dose of fluconazole and gives me Oraquick test which comes back negative and draws blood for p24 antigen test - 4/28/06: my wife seems to have also developed mild white streak on one inner cheek and corresponding lip corner and I start to notice that my tongue is also getting very white with granular/nodular appearance - 4/29/06: today, I feel mild pain under my tongue and look in mirror and see 2 small symmetrical cyst-like growths on the connective thin muscle which connects to underneath my tongue...after searching some websites, it looks similar to sublingual ranula cysts, which they say is associated with HIV/AIDS...and my white streaks still have not responded and gone away from the fluconazole or mycenel......doctor, I am so sorry, but please, what do you think is going on??? I really need an answer...I'm going nuts right now....p24 Antigen test results are not due back until at least 5/3/06 or later.

Scared Dad

Response from Dr. Frascino

Hello Scared Dad,

"Sublingual ranula cysts"???? What??? Now remind me, what medical school did you graduate from that would qualify you to make such a diagnosis? However, despite not going to medical school, I do believe you correctly diagnosed your real problem when you wrote ". . . I'm going nuts right now . . . ." I agree! You need to seek help for that without delay. Your HIV fears are unwarranted. My assessment of what's going on hasn't changed. My advice also remains exactly the same with the addendum that you should see a psychologist or psychiatrist to help you cope with your irrational HIV fears and anxiety. Bring copies of your questions and my responses to your visit and show them to your therapist. HIV and/or sublingual ranula cysts are not your problems! I'll reprint your original question below.

Dr. Bob

oral white streaks - resubmitted from fatigue and anemia forum Apr 28, 2006

Dear Doctor,

I'm hoping you can offer some advice. I'm a married man with 2 young children. About 3 weeks ago, my buddy and I went to an Asian cocktail lounge where you enter these private rooms, sit on couches, and attractive young women sit next to you and pour you drinks, etc. I got a bit tipsy and ended up making out with one of these girls, and did some deep french kissing with lots of saliva exchange. About 1 week ago, I developed chapped crusting on the corners of my lips and noticed these very thin, slightly raised white streaks on my inside cheeks which aren't painful, but won't scrape away when I try to clean them away. My tongue appears to be normal. My regular doctor thought that I might have oral thrush and gave me mycelex about a week ago but it seemed to do nothing, so another doctor gave me one dose of fluconazole 2 days ago, with no success yet. I did some research on various websites that said that oral thrush is easily scraped away, but another condition called leukoplakia is not easily scraped away, which is like my condition. I was so freaked when I read that leukoplakia is often an early symptom of HIV, though my condition doesn't seem to be the "fuzzy or hairy" kind, at least not yet. I'm not a tobacco user, nor did I seem to fit into any of the other possible categoris for leukoplakia or oral thrush, thus the possible HIV angle really scared me. I had an Oraquick Antibody test done 2 days ago which came back negative, but since it's only been about 3 weeks since the suspected exposure, I also ordered a p24 Antigen test, which I was told usually has a 16-day window...I'm supposed to get the results back sometime next week. I'm so afraid that I might have contracted HIV from french kissing this girl...again, there was quite of lot of saliva exchange, and while I don't think there was any blood in her mouth, I can't remember for sure. Some websites say there is zero chance of getting HIV in this manner, while other sites say there is a slim but real chance of getting it. I could sure use your advice because I've been stressing myself to death lately....thanks!!

Scared Dad

Response from Dr. Frascino

Hello Scared Dad,

Glad you found the correct forum for your question. Your HIV risk is negligible to nonexistent. I do not believe you have HIV, thrush or oral hairy leukoplakia. Your three-week negative OraQuick is encouraging, but not conclusive. I would assume your p24 antigen was negative as well, right? Yeah, I thought so.

My advice:

1. Discuss your indiscretion with your wife. You need to confront your guilt over this episode.

2. If you remain worried that you've placed yourself at risk for HIV, get a single HIV test at the three-month mark. It will be negative as well. Personally I don't feel it's necessary; however, it may well be the most efficient and effective way to put your unwarranted fears to rest.

Good luck.

Dr. Bob



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