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Is it PN and should I stop considering HIV as a cause of these symptoms?
Dec 12, 2010

Hi doctor Bob. This is the fourth time I am writing to you; please answer my question as your words will go a long way in relieving me of this stress. I had sex with a prostitute in March of 2010. That was immediately followed by a fungal infection at the tip of my penis. Then after 6 weeks I started experiencing symptoms like sore throat, dry mouth, itching all over and lack of appetite. I went to a doctor and got myself tested for syphilis, Herpes and then HIV 1&2 Elisa after completing 3 months. All the tests were negative. The doctor also gave me an ointment to be used for the fungal infection which almost cured it in a month or so but it sometimes still returns, though the intensity is not even 2% of what it was initially and on applying the ointment disappears again. Anyways, after a month or two I started to have burning sensation in both my feet. I heard PN due to HIV normally starts from the tip of the toes. In my case it started on both feet simultaneously and covered all areas of the sole at different times but has not affected the toes yet. I then took another ELISA test after 6 months of possible exposure and it was negative too. The PN symptoms meanwhile still continued do I went to my doctor again and his opinion was that it could be due to vitamin b12 deficiency. Along with 6 month ELISA test I also took a CBC test and a blood sugar test. Blood sugar was normal and CBC was normal too except that the lymphocytes count was on higher side (38%). Then post 8 months I took an antibody test for Hepatitis C and Rh factor which were both normal (Rh factor-4.7). Its been three months and the burning sensation on my feet still continues except for some time in between when it seemed that the symptoms have vanished and now I think I am starting to have the same symptoms in my left palm as well. Total WBC count was 7200. My questions to you are:

1) Was the Hepatitis C test I took conclusive? Could it be possible that I have acute infection but it didnt transform into chronic infection and in 8 months the antibodies had cleared, so that would mean that I should take an ELISA test after an year as well. 2) Do you see a need for HIV retest? 3) Is this PN? I have been taking vitamin B12 tablets since last 2 months and it doesnt seem it cure this. The initial burning is now transformed into a bit of pain and slight burning as well. Can one have PN symptoms so early and if this is PN does it mean that I have to live with this for the rest of my life? 4) Does that fungal infection on the tip of my penis for sure indicates that my condom had ruptured. The condom I used was one without a reservoir and I am not sure if it was latex or a lamb skin one. It did look intact after sex but I did not check closely for any pinhole damages. Please do answer my questions doctor Bob I have been going through your forum since last 6 months but still confused. What do you suggest I should do next?

I have read lot of your earlier posts and I know my post 6 month test should be conclusive but these symptoms still worries me. I have never had any such health issues before that Cancun trip in March. Last 9 months have been the worst of my life. Why do I have such PN related symptoms which are not even common?

Response from Dr. Frascino

Hello,

1. Yes. No.

2. No.

3. No.

4. No.

As for what to do next, continue to follow up with your general internist for any persistent ailments. But rest assured the cause of your symptoms is not HIV. Your negative HIV-antibody tests, STD screen and hepatitis tests are definitive and conclusive. If the pain in your feet continues, consider seeing a neurologist, as they are the pain specialists. If no physiological cause for your symptoms can be determined, you should be evaluated for psychosomatic illness. Anxiety can cause symptoms such as yours.

Good luck.

Dr. Bob



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