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Worried Sick (donation for answer)
Jun 20, 2009

Hi Doctor Francisco,

I had protected receptive anal sex about 3 months ago with a person that claims to be HIV negative (which I believe for the most part). Unfortunately the condom broke. About 5-6 days latter I developed a flu-like illness that included a fever of 102, headache, severe sore throat, lethargy, night sweats, malaise and one swollen lymph node in my neck. My doctor ruled out mono with a blood test and ran an HIV test (negative). She also took a total WBC count which was highly elevated (19000/ml), she told me that this was due to a bacterial infection but strep came back negative. She gave me antibiotics on the 3rd day as she thought the infection was initially caused by the flu. I came back with a lymph node the size of a quarter in my neck and she gave me some meds. The illness seemed to clear up the next day. I'm getting ready to take an ELISA test at the 3 month mark as recommended but I'm really worried for obvious reasons. I have a couple of questions:

1) Do you think that I could have begun to experience ARS symptoms within a week of exposure? I know symptoms are notoriously unreliable for predicting HIV infection so I wont ask if they could have been caused by ARS.

2) Could the symptoms of ARS have cleared up so quickly - 4 days? I ask because I wonder if the symptoms cleared up coincidentally and not because of the antibiotics.

Response from Dr. Frascino

Hi,

1. It would be unlikely. Usually symptoms associated with acute retroviral syndrome (ARS) take several weeks to become manifest.

2. Again this would be unlikely. ARS symptoms generally hang around for a week or two; however, there is great variability from person to person. Your illness seemed to respond to antibiotics, which would fit with the assumption that this was a bacterial infection (high WBC).

Good luck.

Dr. Bob



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