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Family Medicine (Expert Forum)
Its not diabetes or hiv so what is it?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Its not diabetes or hiv so what is it?
by Rich UK, Oct 23, 2005 12:00AM
I've recently posted twice to the STD forum which helped eliminate many of my concerns regarding hiv after a low/no risk encounter back in early July.
I tested negative for all stds and hiv at 13 and a half weeks but have now been having symptoms of aching legs, persistent oral candidiasis (despite nyastatin suspension) and a tender neck gland for 5 weeks or so. I am not visiting my private doctor any more as he is convinced its hiv despite the negative test and the gum clinic's assertion that I should look for another cause.
I have high levels of ebv antibodies in my blood apparently - hence they have diagnosed glandular fever, but does glandular fever cause oral candidiasis? My sister has sjogren's syndrome and I have suffered from frequent sinus infections, penile rashes and dry eyes for some 2 to 3 years now. Should I push for a referral do you think or just wait out the glandular fever? Also, should I ask for fluconazole for the candidiasis or wait? I have also tested negative for diabetes by the way.
My anxiety levels are low, I'm working and just dealing with this thing but I'm hitting walls with who to see and what to do. Help appreciated.
I tested negative for all stds and hiv at 13 and a half weeks but have now been having symptoms of aching legs, persistent oral candidiasis (despite nyastatin suspension) and a tender neck gland for 5 weeks or so. I am not visiting my private doctor any more as he is convinced its hiv despite the negative test and the gum clinic's assertion that I should look for another cause.
I have high levels of ebv antibodies in my blood apparently - hence they have diagnosed glandular fever, but does glandular fever cause oral candidiasis? My sister has sjogren's syndrome and I have suffered from frequent sinus infections, penile rashes and dry eyes for some 2 to 3 years now. Should I push for a referral do you think or just wait out the glandular fever? Also, should I ask for fluconazole for the candidiasis or wait? I have also tested negative for diabetes by the way.
My anxiety levels are low, I'm working and just dealing with this thing but I'm hitting walls with who to see and what to do. Help appreciated.
Doctor's Answer
by Kevin Pho, MD, Oct 25, 2005 12:00AM
, Oct 25, 2005 12:00AM
EBV and other viruses (i.e. CMV) can lead to glandular swelling. If the glands continue to be swollen after several weeks, then further diagnostics (i.e. a possible lymph node biopsy) can be considered.
Regarding the candidiasis, the two more common diseases - HIV and diabetes - have been ruled out. Fluconazole can be used for treatment, as well as nystatin swish and swallow or clotrimazole troches.
Sjogren's syndrome can be considered. A referral to a rheumatologist can be considered. Blood tests looking for autoantibodies, anti-Ra and anti-La, can be suggestive of the diagnosis.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Regarding the candidiasis, the two more common diseases - HIV and diabetes - have been ruled out. Fluconazole can be used for treatment, as well as nystatin swish and swallow or clotrimazole troches.
Sjogren's syndrome can be considered. A referral to a rheumatologist can be considered. Blood tests looking for autoantibodies, anti-Ra and anti-La, can be suggestive of the diagnosis.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
To check for this, ask for thyroid antibody testing - not just the standard TSH test for thyroid dysfunction. I'd also want to see the actual thyroid hormone labs, Free T4 and Free T3.
Cindi
Those comments are of help to me. I will mention this to the doctor at our next scheduled appointment. They have just done some blood tests today to check liver function since my bilirubin levels were raised last time.