"crazed HIV-positive phlebotomist with excellent aim and technique"


Dear Dr. Bob

I know the title is funny (you actually use that expression to make fun of guys who think they were stabbed with a needle).

Has there been any reported case of infection by an intentional attack of such type? I saw a question in the archives that states an attack by a homeless in the lower part of the hand palm of the victim.....

Too much coincidence!! as I also discovered a tiny wound in that area (and right in a vein!) while i was walking through Las Vegas Strip (you know i took a little vacation)..... Now im scared as hell!!!!

I try to think this is irrational, but when that little red tiny dot starts to hurt i get terrorized and i think of the many homeless who are walking through that place who could have done me this.

I didnt considered going to a clinic or E-R at that moment as I was a foreign tourist(mexican) and i thought my little problem was nothing.

Now 4 days after discovering that damn red dot im back in my country and too late to seek for any PEP. The dot has turned into a small scab which tells me this was really a wound!

Please Dr. Bob, tell me, is testing suggested? or am i too paranoid? its so precise,small, red and hurty it just makes me being sure of this being caused b a needle!

Thank you, and remember all the love for you here in Mexico!



Hello Mexican-Guy,

If someone is homeless and living on the Strip in Vegas, don't you think they'd have more important things to worry about than trying to infect paranoid tourists with HIV? For instance, food, shelter, you know trivial stuff like that?

Your fears are indeed completely irrational. Just as there aren't any "crazed HIV-positive phlebotomists with excellent aim and technique" attacking folks at the local Piggly Wiggly, there also aren't any HIV-positive homeless folks in Vegas jabbing tourists while they enjoy the dancing waters in front of Bellagio!

If you're worried, get tested at the three-month mark. There is no medical reason to do so, but it may well be the most efficient and effective way to put your irrational fears permanently to rest. Your chance of contracting HIV from the scenario you describe is the same as your winning the Megabucks jackpot on the dollar slot machines in every casino on the Strip the same night. I'll bet that didn't happen either.

For our readers benefit I'll repost the "crazed HIV-positive phlebotomist with excellent aim and technique" question below.

Dr. Bob

I can't do this anymore Jul 8, 2006

Please Dr. Frascino, help me. What are the approximate probabilities of contracting HIV when infected blood from a needle is directly injected into your blookstream? I'm still freaking out and can't do this anymore. I don't have the courage to get tested. The palms of my hands regularily get a rash, swollen, and then peel. I've seen this online and I believe it is Kawasaki like syndrom in HIV+ men. I have small and very numerous warts all over the backs of my hand, and appearing less numerously on other areas of my body such as feet. I've never had this problem before and I'm a 26 yr old athletic male. little bumps on my skin, and yellow spots on my shoulders. The follicules on my back have hard, yellow substance in them, similar to blackheads. I can rub/force them out using my hands or fingers (like pimples). i have developed outbreaks of folliculitus all over my upper body and trunk. it will appear rash like, with little white heads on them, and show up quit suddenly, leaving after a few days or less. sometimes i get big infected follicules on my arms and back. i pop them and the leave horrible scarring, i'm starting to look like a freak. Dr. could you tell me whether the onset of these symptoms is consistent with one who was infected around 8 years ago? I was stabbed in the vein by an infected person's blood, but failed to get PEP treatment b/c I was afraid and did not know about it. i don't remember seroconverting, but i did develop the edema/rash/peeling of my hands 6 months later. ever since then I've neglected to find out whether the assault got HIV into me. now all these problem have developed and continued within the last year or so. It's not just the peeling hands (and a few times on the bottoms of my feet). This couldn't be anything else could it? it all points to weakened immune system and blood work. For about 6 months now i've had little muscle twiches all over my body, arms, legs, calves, pecks. I'm too scared to find out b/c i have too much on my plate right now. just graduated from law school, in a real serious relationship, and too happy with life, and insecure with myself to cope with such an issue. I regret putting myself in the situation i did 8 years ago so much. She pricked me in the urethra, and i felt it, after didn't see any mark there, likely b/c my penis was no longer erect, and 3 months later i have an infection inside the urethra, it itched and was irritated. i went to a dr who took an std swab which came back negative, however, i did no follow her instructions to have blood tests done. That is when my fears began. Now 8 yrs later, i can't take it anymore, i'm going crazy with guilt and sorrow. sorry this is so long, but i need your support and you are a wonderful person, probably the only one i trust to talk with right now. Thanks, Depressed and in hiding (HELP!_

Response from Dr. Frascino


You got "stabbed in the vein by an infected person's blood . . . ." What??? How did that happen? Did you get attacked by a crazed HIV-positive phlebotomist with excellent aim and technique?

You "neglected to find out whether the assault got HIV into (you)????" Hmmm . . . you "neglected" this for eight years??? Eight years???? Buddy, that's a whole lotta neglect!

So now you "believe" you have Kawasaki-like syndrome, because of something you saw on line? Guess it's a good thing you didn't happen to check out the Ebola Web site.

You think "it all points to a weakened immune system???" Hmmm . . . you also report you just graduated from law school. Really? Well, Counselor, your "it all points to a weakened immune system" theory really wouldn't hold up in court. It's not even circumstantial evidence. In fact, there is no evidence at all suggesting that conclusion. (Better review "evidence"related stuff before taking your bar exam!)

This story just keeps getting more and more bizarre. I just read the part where you state that "she pricked me in the urethra . . . ." Dude, you really think someone deliberately pricked your prick with HIV eight years ago???? Oh gosh, just what we need, another delusional lawyer. I suppose Dubya will want to appoint you to the Supreme Court as well.

OK, Lawyer-Guy, here's my take on your pricked-prick predicament. I don't believe it happened. I don't believe someone deliberately injected HIV into your trouser snake. Your fears are irrational. If you placed yourself at risk for HIV by having unprotected sex, you need to get an HIV test. A single rapid HIV test will give you a definitive result within 20 minutes. The result will most likely be negative. However, you appear to have a much greater problem. That being anxiety, depression and irrational fear. I strongly recommend you seek the counsel of a psychiatrist to help you confront and cope with these very real medical conditions.

Counselor, you need counseling! "Going crazy with guilt and sorrow" is really not a good alternative.

Good luck.

Dr. Bob