I am a Doctor and I need help
Nov 13, 2000
I am a Doctor and I have a patient. He had intercourse with a girl from guyana. He was with her till this year of February. I diagnosed him with CMV, EBV and Toxoplasma. He has white tongue. He always complains about his intestines. He has lots of gas. He has fungal infections. He's losing weight. I though it was HIV I tested him for HIV 1 and HIV 2 almost after 7 months from last exposure. The test are negative. I did PCR DNA and PCR RNA test twice it's undetectable. I check his immune system, he's CD 4 on July was 717. But I noticed that he's WBC is decreasing? Please help.Should I do a bDNA? Or do you think is another strain? What do you think I should do I am at lost, I hope you can help me.
Response from Dr. Stryker
This sounds like a tough case, and possibly one with an immunodeficiency component. But it seems unlikely to be HIV, based on the thorough testing you have done. A negative bDNA would be fairly definitive at this point.
You don't give enough other history, including the manifestations of CMV, EBV, toxo, etc., to allow me to comment in more detail. If you mean that he has evidence of exposure (only) to these pathogens, then this is not particularly helpful, as many otherwise healthy folks have evidence of past exposure, but not active disease. Further, his normal CD4+ count makes active disease in these categories very unlikely...
White tongue is not a diagnosis, but a "sign", with many possible explanations. So are the other symptoms you describe. If you are a physician, than you probably realize that you are in over your head at this point; the patient needs more specialized diagnostic input if he is truly suffering. If he is largely asymptomatic, or if more specialized care is unavailable, than you should watch him closely and continue to followup on his symptoms.
In general, this is intended as a patient forum for questions, not for expert consultation from doc to doc. If you are truly in need of a medical consultation for your patient, I would advise you to continue your search through more traditional channels. Good Luck! RAS
Rick Stryker, M.D., M.P.H.
Get Email Notifications When This Forum Updates or Subscribe With RSS
- How Did Chris Brown Get Aids?
- How Can I Get Infected By Hiv By Getting A Tattoo?
- Would Swollen Lymph Nodes Not Show Up In Blood Work If It Is Hiv
- The Average Time Span Between The Initial Hiv Infection And The Onset Of Disease Symptoms In Untreated People
- Can You Die From HPV?
- Getting Pneumonia When You're Hiv Positive
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.