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PLEASE, Fourth Time! Thanks a Lot!
Apr 22, 2007

Dear Doctor: I had an extremely regretful protected sex with a prostitute almost five months ago in China, including together in the small bath tube and touching her vagina with figures. Then the second day, I found two lymph nodes on the back of neck became enlarged, and then nightmarishly experienced many other symptoms afterwards, including: (1) Generalized swollen lymph nodes in the neck (four), jaw (four), cheek, armpit (two), and groin (seven) until now, no sign of waneC bilateral, symmetrical, and with size (latest - 2.9¡Á1.3 cm, 2.8 ¡Á0.8 cm); (2) Fever once around the sixth week for two days; (3) Myalgia on back; (4) Rash C slight purplish blemish on face, and some parts of trunk turned red in hot water; (5) Recurring tonsillitis and headache; (6) Whitish coated tongue, although it seemed exist before such behavior .

Conducted Tests: (1) HIV antibody tests Ctwo months and three months C all negative; and viral load test (NASBA C another RNA test used in China, apart from PCR and bDNA) on the 28th day C negative (<LDL C 50c/ml) (2) HIV antibody test for the prostitute C the ninth week C negative (she claimed to repeat the test on the fourth month and also negative, although doubtful, since I was not there this time); (3) Toxoplasma IgM, measles IgM, HCMV IgM, Anti-herpes simplex virus IgM and EB IgM at the second week C all negative (4) Syphilis RPR and TPPA test in the third month C negative; (5) Lymph node biopsy C Reactive hyperplasia, but I cannot find any specific reason.

The doctors said that HIV can be mostly excluded and may be just normal lymphadenitis. Do you agree with their conclusion, and what the odds that I am infected, and do you have any other advice for the reason of my swollen lymph nodes and further test. Thanks for a lot for your help.

Response from Dr. Frascino

Hello,

"Extremely regretful" sex? Wow, was it that bad? Of course "touching her vigina with figures" doesn't exactly sound all that hot.

OK, regarding your "nightmarish" experience, the sex was "protected." If the latex condom was used properly and did not fail, your HIV risk would be nonexistent, no matter how "regretful" the sex may have been.

Next, regarding symptoms, whatever happened on the second day would not be HIV related. It takes weeks, not days, for HIV ARS (acute retroviral syndrome) symptoms to occur.

Next, your repeated (and excessive) HIV testing is definitive and conclusive. HIV is not your problem. No way. No how. I disagree HIV is "mostly excluded" and rather would state it's definitively excluded.

I cannot diagnose the cause of your swollen lymph nodes over the Internet. However, what I can do, with great certainty, is advise you what's not causing the problem: it's not HIV!

Dr. Bob



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Maybe add this to the QTND's category?

  
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