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Dr. D. Love
Dr. D. Love, Doctor
Category: HIV and AIDS
Satisfied Customers: 17539
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a Male. 3 years ago, unprotected oral sex was performed

Customer Question

I am a Male. 3 years ago, unprotected oral sex was performed on me by a stripper. I had high fever, cough and cold 5 weeks from then. I am having multiple symptoms since then 19 May 2014 09:42 I am experiencing symptoms and need some guidance on what these
symptoms could be pointing to - 1. Chronic Diarrhea - been going on for more than 2 years now. 2. Cottage cheese like whiteness and red spots on the tongue 3. Neck pain/stiffness 4. Shortness of breath 5. White and brown spots on the body 6. Redness near the
neck I have had multiple HIV tests in the past 3 years. I got tested for HIV and herpes at 7 months post exposure which also came back negative. HIV test (HIV Screen 4th Generation wRfx) which was non-reactive and this test was done 2 years from the date of
exposure and then again at 2 1/2 years from exposure. I got HIV RNA by PCR done at 3 years from exposure which came non detectable. My PCP has done EKG, chest xray etc and has no idea whats going on. I am concerned about HIV, as the symptoms are pointing to
it but the tests have all been negative. Need guidance on what's going on. What other tests are needed?
Submitted: 12 months ago.
Category: HIV and AIDS
Expert:  Dr. D. Love replied 12 months ago.

Hello from JustAnswer.

This is not from HIV. You have had far more testing than is necessary to prove that it is not from HIV.

There are many possible causes of these symptoms, but to determine what other tests are necessary, it would require knowledge of what tests have been done. Could you list the tests that have been done for each of these symptoms?

Customer: replied 12 months ago.
Colonoscopy for diarhea, EKG & chest x ray for shortness of breath, other STD testing, blood tests that I don't remember the names of.Are the HIV testing results conclusive? Every symptom that I am experiencing is listed as seen in HIV patients.
Expert:  Dr. D. Love replied 12 months ago.

Regarding the possibility of HIV from the encounter 3 years ago, the HIV tests were conclusive 2 1/2 years ago. If you have had other encounters since then, then additional testing would be appropriate, but not because of the encounter 3 years ago.

None of these symptoms are specific for HIV, and HIV is never diagnosed based on non-specific symptoms.

When the colonoscopy was done, what did the Gastroenterologist say was the cause of the diarrhea?

What evaluation was done for symptoms 2,3, 5, and 6?

Can you attach pictures of the tongue and skin symptoms?

Customer: replied 12 months ago.
Gastroenterologist could not find a cause for the diarrhea. I am slightly anemic so he thought it might have something to do with it and referred me a specialist for that. He did his blood test and confirmed its a non issue. Nothing after that.No evaluation for other items. For 2, PCP said that it's normal - even though I have never had it before this.I have attached some pics for the tongue - whiteness after brushing. Typically its much whiter. Skin - tried to take close ups to show small white and brown spots.
Expert:  Dr. D. Love replied 12 months ago.

What evaluation has been done for the neck pain and the skin symptoms?

None of these pictures appear to be of the redness near the neck. Could you attach a picture of the redness?

Customer: replied 12 months ago.
No evaluation for those items. Attached the pic for small red spots. Whats your diagnosis based on the details?HIV is completely ruled out? No further testing required for it? I can be 100% confident on that?
Expert:  Dr. D. Love replied 12 months ago.

There is no further testing needed for HIV for the encounter three years ago. It is recommended that everyone should be tested regularly, but that is more to detect HIV from any new encounters. If you know that you have had no further encounters, then it is reasonable to opt out of regular HIV testing.

When you say that there has been no evaluation, does that mean that you have not complained of these symptoms to your doctor?

Customer: replied 12 months ago.
that's correct. What is your opinion based on the pictures?
Expert:  Dr. D. Love replied 12 months ago.

Chronic diarrhea can have many different causes. One of the most common is irritable bowel syndrome, or IBS, but there is no test for IBS, so the diagnosis is usually based on excluding other possible causes of chronic diarrhea. A Gastroenterologist would usually know the additional testing that would be appropriate, but the primary testing after a colonoscopy would be a series of blood and stool tests. It is also possible to have chronic diarrhea from a variety of food sensitivities, such as gluten sensitivity or lactose intolerance. The blood and stool tests can look for many of these food sensitivities, but it also may be necessary to try an elimination diet to see if the symptoms improve.

For the shortness of breath, the other primary test that would be the next step would be a spirometry, which measures movement of air in and out of the lungs.

For the neck pain, the first step would be a physical examination, but that would require you to complain of the neck pain to your doctor. Depending on the findings on exam, it may be necessary to get x-rays of the neck or advanced imaging, such as an MRI.

None of the pictures look worrisome. These are minor variation of skin and benign lesions of skin, none of which look worrisome. If there is a more prominent white coating of the tongue at times, it may be necessary to examine it under a microscope. Your primary care physician can do a more detailed skin exam than can be done via pictures, but if there is any question, the next step would be consultation with a Dermatologist.

Lastly, many of these symptoms can be related to anxiety, but that also would require that other possible causes are excluded, because there is no test that can prove that non-specific symptoms are due to anxiety.

Is there any other information that would be helpful?

Customer: replied 12 months ago.
Thanks, ***** ***** any case where someone could have HIV and it doesnt show up on the test(s) for long periods of time. I know you have said no need to worry about HIV but lack of explanation to other things keeps bothering me.
Expert:  Dr. D. Love replied 12 months ago.

Not really, which is why I said that the tests are conclusive.

It is theoretically possible that a new virus can develop and cause a similar infection, in the same way that HIV was a new infection in the 80s, but this theoretic possibility would not be considered until you have a more specific symptom, such as an opportunistic infection.

Expert:  Dr. D. Love replied 12 months ago.

Is there any further information that would be helpful?

Expert:  Dr. D. Love replied 12 months ago.

I have not heard back about any questions, so will close out the thread, but if you think of any follow-up questions, please let me know.

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