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constellation of symptoms
Jul 2, 2007

Dr. Bob,

Thank you so much first of all for all the good you do on this site. I had been terrified of getting tested for years, but in the last 2 years have had some concerning symptoms. I began having mouth ulcers constantly and what i think is geographic tongue. Then I began having intermittent diarrhea. It would be really bad for about a week or so, then be fine for a few months and then come back. Finally, this last month the diarrhea got so bad and I was convinced it was due to HIV -Im a gay man and while always having practiced safe sex, the mouth ulcers and diarrhea were red flags. I had a negative ELISA and my physician also did a PCR which was no virus detected and my T-cells were 700, all reassuring. As a physician (albeit im a pathologist :)) I know that psychosomatic manifestations can be severe. While I am reassured by the testing results, the symptoms I have still persist. Do you think this constellation could all be explained by anxiety about HIV or should I have further work up? All of my other lab work -CBC, BMP, etc were normal. I appreciate any thoughts you have...

-Sincerely, Dr. Matt

Response from Dr. Frascino

Hey Dr. Matt,

One thing that's for certain: HIV is no longer in the differential diagnosis. As I'm sure you are probably aware, the vast majority of cases of mouth ulcers, geographic tongue and intermittent diarrhea have absolutely nothing to do with HIV. If your symptoms are persistent (or persistently intermittent) and annoying, have them evaluated. There are a variety of potential causes for these very common ailments and appropriate treatment, even if only symptomatic, can be very effective.

Stay safe and you'll stay well.

Dr. Bob



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