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if it walks like a duck...
Apr 5, 2008

I had unprotected sex with a man during the summer. A couple weeks later I had sore throat, night sweats, and rash. They ran the mono and strep tests and they were negative. I never recovered and at 5 months post exposure I developed generalized lymphadenopathy as diagnosed by my physcian and confirmed on a CT scan. They've tested me for everything under the sun, especially because at the same time I developed a skin condition called keratosis pialris - which is sometimes caused by immune system problems. I've had HIV tests all the way to seven months using a combination of Elisas (early on) rapid finger sticks, rapid oral tests and an HIV 1/O/2 test from Labcorp. They are all negative, yet the lymphnodes are huge in my forearms, underarms, elbows, knees, thighs, groin, neck and collarbone/chest. They ache. I've also been having a problem with ring worms, etc... things I've never had before, and sores in my mouth.

Given testing out to 7 months, you'd think I was negative, but nothing else matches these symptoms --

My doctor says "if it walks like a duck"

and then he admits to not having a lot of experience in HIV. Whatever you respond, I plan to print it and take it to him. What is in order next? A DNA PCR? Biopsy of a node?

One way or another, you'll be saving my life.

Response from Dr. Frascino

Hello,

". . . if it walks like a duck" is not a diagnosis. If your physician has tested you for "everything under the sun" and still cannot diagnose the cause of your generalized lymphadenopathy, he should refer you to a specialist. Multiple negative HIV tests out to seven months are definitive and conclusive. HIV is not your problem, even if you were quacking and waddling more than Daffy Duck. I cannot diagnose the cause of your symptoms over the Internet, but there is no doubt additional evaluation is indeed warranted. There are many potential causes for lymphadenopathy. Based on your laboratory tests to date, your physician should be able to determine whether what you have is infectious or immunologic. This information should help in determining if you should be referred to an infectious disease specialist or an immunologist for the next step in your evaluation.

Good luck.

Dr. Bob



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