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Family Medicine (Expert Forum)
Complex Issue: Mycoplasma/fungal/EBV/or other STD?
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.
Complex Issue: Mycoplasma/fungal/EBV/or other STD?
by buddha, Jun 11, 2002 12:00AM
History: I am 40, male. Previously I was very healthy with the hobbies of regular yoga and meditation, running 20 miles a week, trecking in the mountains, etc, and never had any health problems. Always have good eating habits. But on sept 15, 2001 I had sexual encounter with a 25 years old woman that I met through internet. The encounter includes deep kissing, and genital fondling without condom and also brief penetration with condom. I am married since last 6 years and this is the only encounter I had outside of marriage.
Symptoms: (
1. with in 3 days from the exposure developed intense penile itching due to yeast infection and it took 6 weeks of nystatin cream treatment to cure.
2. from 2nd or 3rd week crystal clear urine turned into yellow color, foamy and bubbles in the urine.
3. 3rd week allover the body developed tingling which lasted a month.
4. With in two or three weeks from the exposure developed lack of energy at the joints and muscles so quit all my physical activities.
5. developed profound fatigue, severe joint and muscle pains with in 5 weeks from the exposure.
6. Headaches. burning of eyes, redness of eyes.
7. Exactly 35 days from the exposure the right side parotid gland swollen for 3 days.
8.At the same time the hard bumps appered on the tounge including tip and sides of the tounge. some other lesions also appear. These all are non painful. tounge started feeling of burnng and started appering red/ pink color.
9. Mucas forming in the mouth and tounge.
10. throat clearing developed.
11. headache, eye pain dveloped I think sinusitis
12. Stomach upsets developed with in 5 weeks from the exposure. Too much gas formation, Bowel movement became abnormal, stool, apperance and color changed. Long and hard stools, with undigested food. and also rectal itching developed.
13. lost approximately 10 lbs from 160 to 150 but some weight is back now 154lbs.
14. Feeling of toxins or poisonness in the body.
(i did not develop fever or sore throat during this period. If I develop fever i did not notice)
Doctors visites: Infectious specialist, allergy specialist, ENT, dentist, Internists, Gastroenterologist.
Tests: ABNORMal:
1. Semen PCR test: Ureaplasma Urealyticum positive
2. Mycoplasma General blood PCR positive from one lab but negative from other lab. Blood PCR tests for specific Mycoplasmas(homnis, Pneumonai,genitalium, sallivarium, fermantans, penetrans are negative from both labs.
3. Candida in urine analysis
4. ALT and Bilurubin levels elevated first 3 months but they are normal now.
5. IGG subclass-3 slightly elevated above the normal level
6. Natural killer Cell function is slightly below the normal range.
7. candida blood PCR test was positive in the beginng ut became negative later.
8. in the beginng slightly elevated protein but later normal.
Normal Tests: HIV-1 and 2 and viral load(6 months after): negative, HSV-1 and 2 are negative both culture and antibodies, CMV antobody is negative, syphilis , C & G are negative. several urine culturea and throat cultures are normal.hepatitis a, b, C and E are normal. several WBC with differentialblood tests are normal. Blood PCR tests of EBV, HHV-6, chlamydia, uraplasma are normal. CD-4 is normal. HTLV 1 and 2 tests are nrmal.
Lupus, ANA, smooth muscle, protien, thyroid and all other regulatr auto immune and health tests are normal.
EBV AB test results:
EBV VCA IGM (this test is done 100 days from the exposure: .53, EBV VCA IGG: 1.30,, EBNA Igg: 5.4, Early antigen D.: .45. ( .90 is positive). So the interpretation ws past infection.
:
I was treated 5 months ago with Diflucan, Nystatin, and sporonaax for fungal infection . Some symptoms are reduced but still most of the symptoms are chronic and persistant.
Still fatigue, weakness, Joint and muscle pains, yellow urine,
bumps on the tounge, Redness and burning of tounge, Eye burnng and pain, Mucas in the mouth, throat clearing, gas formation in the stomach is present but the sevearity is some what reduced.
First time 5 days back the feeling of toxins in the body is reduced large extent so started doing yaoga nad runnng. But other symptoms are there.
One doctor thinks I developed Chronic EBV viral infection and says that IGM is negative because the test was done after 3 months. But other doctor says EBV is not causing the problem but thinks mycoplasma, and also he says that once EBNA is positive EBV does not cause theproblem. I have prescription of cipro, doxy/mino, and zithro, diflucan, sporonaax, to use it. But I am not taking still. your help is needed in diagnosis of my problem.
Q1. what is your analysis of my infection and also your detailed diagnosis of my problem? Please note the girl whom I exposed has yeast and bacterial vaginitis during that time . She also told me later that she has all the symptoms since two years including occasional swelling of right parotod gland and bumps on the tounge. But she does not know the problem because her STD tests are normal.
Q2) do you suggest any more tests? Because I am nt taking anti biotics still because this medecene may inhibit the diagnosis of other bacteria if any thing is there? So do you want me to wait or i can take this medecene now?
Q3) Doxy or Mino cyclene which one is better?
Q4) Do you think my problem is chronic EBV or mycoplasma or candida or other or combination? plesse help.
Symptoms: (
1. with in 3 days from the exposure developed intense penile itching due to yeast infection and it took 6 weeks of nystatin cream treatment to cure.
2. from 2nd or 3rd week crystal clear urine turned into yellow color, foamy and bubbles in the urine.
3. 3rd week allover the body developed tingling which lasted a month.
4. With in two or three weeks from the exposure developed lack of energy at the joints and muscles so quit all my physical activities.
5. developed profound fatigue, severe joint and muscle pains with in 5 weeks from the exposure.
6. Headaches. burning of eyes, redness of eyes.
7. Exactly 35 days from the exposure the right side parotid gland swollen for 3 days.
8.At the same time the hard bumps appered on the tounge including tip and sides of the tounge. some other lesions also appear. These all are non painful. tounge started feeling of burnng and started appering red/ pink color.
9. Mucas forming in the mouth and tounge.
10. throat clearing developed.
11. headache, eye pain dveloped I think sinusitis
12. Stomach upsets developed with in 5 weeks from the exposure. Too much gas formation, Bowel movement became abnormal, stool, apperance and color changed. Long and hard stools, with undigested food. and also rectal itching developed.
13. lost approximately 10 lbs from 160 to 150 but some weight is back now 154lbs.
14. Feeling of toxins or poisonness in the body.
(i did not develop fever or sore throat during this period. If I develop fever i did not notice)
Doctors visites: Infectious specialist, allergy specialist, ENT, dentist, Internists, Gastroenterologist.
Tests: ABNORMal:
1. Semen PCR test: Ureaplasma Urealyticum positive
2. Mycoplasma General blood PCR positive from one lab but negative from other lab. Blood PCR tests for specific Mycoplasmas(homnis, Pneumonai,genitalium, sallivarium, fermantans, penetrans are negative from both labs.
3. Candida in urine analysis
4. ALT and Bilurubin levels elevated first 3 months but they are normal now.
5. IGG subclass-3 slightly elevated above the normal level
6. Natural killer Cell function is slightly below the normal range.
7. candida blood PCR test was positive in the beginng ut became negative later.
8. in the beginng slightly elevated protein but later normal.
Normal Tests: HIV-1 and 2 and viral load(6 months after): negative, HSV-1 and 2 are negative both culture and antibodies, CMV antobody is negative, syphilis , C & G are negative. several urine culturea and throat cultures are normal.hepatitis a, b, C and E are normal. several WBC with differentialblood tests are normal. Blood PCR tests of EBV, HHV-6, chlamydia, uraplasma are normal. CD-4 is normal. HTLV 1 and 2 tests are nrmal.
Lupus, ANA, smooth muscle, protien, thyroid and all other regulatr auto immune and health tests are normal.
EBV AB test results:
EBV VCA IGM (this test is done 100 days from the exposure: .53, EBV VCA IGG: 1.30,, EBNA Igg: 5.4, Early antigen D.: .45. ( .90 is positive). So the interpretation ws past infection.
:
I was treated 5 months ago with Diflucan, Nystatin, and sporonaax for fungal infection . Some symptoms are reduced but still most of the symptoms are chronic and persistant.
Still fatigue, weakness, Joint and muscle pains, yellow urine,
bumps on the tounge, Redness and burning of tounge, Eye burnng and pain, Mucas in the mouth, throat clearing, gas formation in the stomach is present but the sevearity is some what reduced.
First time 5 days back the feeling of toxins in the body is reduced large extent so started doing yaoga nad runnng. But other symptoms are there.
One doctor thinks I developed Chronic EBV viral infection and says that IGM is negative because the test was done after 3 months. But other doctor says EBV is not causing the problem but thinks mycoplasma, and also he says that once EBNA is positive EBV does not cause theproblem. I have prescription of cipro, doxy/mino, and zithro, diflucan, sporonaax, to use it. But I am not taking still. your help is needed in diagnosis of my problem.
Q1. what is your analysis of my infection and also your detailed diagnosis of my problem? Please note the girl whom I exposed has yeast and bacterial vaginitis during that time . She also told me later that she has all the symptoms since two years including occasional swelling of right parotod gland and bumps on the tounge. But she does not know the problem because her STD tests are normal.
Q2) do you suggest any more tests? Because I am nt taking anti biotics still because this medecene may inhibit the diagnosis of other bacteria if any thing is there? So do you want me to wait or i can take this medecene now?
Q3) Doxy or Mino cyclene which one is better?
Q4) Do you think my problem is chronic EBV or mycoplasma or candida or other or combination? plesse help.
Doctor's Answer
by Forum-M.D.-DT, Jun 12, 2002 12:00AM
Thanks for visiting the Family Practice Forum.
Well, my gut feeling here is that you have a systemic fungal infection that has not been fully treated. Also, if you have been on antibiotics, this can make fungal infections worse.
Q1 Many women have chronic vaginal infections whether they be candida vaginitis or gardnerella vaginitis. I suspect you got this infection during your encounter with this woman.
Q2 If you have a rash, discharge or growth in your mouth (i.e. the bumps on your tongue you mention), you need to have a "culture" of these areas. The doctor will take a "swab" of the areas and send it to the lab. If you have not had a Complete Blood Count (CBC), I would recommend you have this to make sure you have an adequate number of White Blood Cells present for fighting infection.
Q3 I doubt Doxycycline or Minocycline will help your situation.
Q4 I think your problem is a chronic fungal (likely Candida) infection which has become systemic and has not yet been fully treated.
Remember, fungal infections take several weeks or up to a month to treat. For example, athlete's foot is a fungal infection (tinea pedis). It rarely "fully" clears without the use of creams for a minimum of 2 weeks.
I would likely put you on Diflucan for 3 weeks if you came to my office with this history.
Let me know if you have further questions.
Well, my gut feeling here is that you have a systemic fungal infection that has not been fully treated. Also, if you have been on antibiotics, this can make fungal infections worse.
Q1 Many women have chronic vaginal infections whether they be candida vaginitis or gardnerella vaginitis. I suspect you got this infection during your encounter with this woman.
Q2 If you have a rash, discharge or growth in your mouth (i.e. the bumps on your tongue you mention), you need to have a "culture" of these areas. The doctor will take a "swab" of the areas and send it to the lab. If you have not had a Complete Blood Count (CBC), I would recommend you have this to make sure you have an adequate number of White Blood Cells present for fighting infection.
Q3 I doubt Doxycycline or Minocycline will help your situation.
Q4 I think your problem is a chronic fungal (likely Candida) infection which has become systemic and has not yet been fully treated.
Remember, fungal infections take several weeks or up to a month to treat. For example, athlete's foot is a fungal infection (tinea pedis). It rarely "fully" clears without the use of creams for a minimum of 2 weeks.
I would likely put you on Diflucan for 3 weeks if you came to my office with this history.
Let me know if you have further questions.
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I have now 200 mg very day for one month diflucan, and 2 months minocyclene/one month Doxy/15 days cipro prescriptions but not using anyone because none is conclusive.
I will use this one month diflucan and may be remainning two sporonnax Z packs. But still i am confused about Ureaplasma presence in the urene. Because semen PCR test showed ureaplasma presence in the semen.
Blood analysis was done several times. all the times every thing is with in normal. but one time white blood cells were slightly below normal but after with in a week they were normal again.
Q1) what do you suggest regarding this ureaplasma since still I have occasional mucal discharge in the urine also continued yellow color of the urine?
Q2)What causing my sinusitis problems such as mucas development, clearing throat, etc.?This i developed only after exposure.
Q3) two bumps on the tounge got bursted three months ago when I used sporonaax but at the same place getting lesions now and then. But another bump is on the tip of the tounge. I feel this bump with my teeth. Most of the times it is inside of the tounge. So it is hard to culture since only seldom it getts bigger. Culture is not possible because it is hard. But I think they can do biopsy but every one refused to do biopsy saying that it is not visible or only inflammation etc.? Please tell me what causes these hard bumps? candida/ EBV/Mycoplasma/ or something else?
Q4) I am confused about EBV do you think it is causing the problem.? is that infectuious specialist right? EBV antibody tets results: EBV VCA IGM: negative, EBV VCA IGG: positive, EBNA: positive, EA (D): negative. EBV blood PCR test is negative.
Q5) do you think i have also acquired bacterial vaginisis? if what is the treatment for this?
Q6) if you do not suspect mycoplasma infection can you still suggest to take either doxy or mino for urteplasma infection? Mino or doxy which is better?
Q7) I am also developing few small boils (acne type) with out any fus on the face and head which disappear after a week from apperaance? This also started after exposure. what causes?
I am not taking any medecene need your help.
Plase answer so i may get tretment and improve.
Thank you very much of your time and consideration.
Do you suspect any other infection apart from candia? either mycoplasma/ EBV? or even any other infection I did not ask you? please let me now. I am suffering since 8 months. really what infection caused one time 3 days swelling of right parortid gland? The girl says she getting now and then this swelling of parotid gland since two yearas.
Q2)What microorgnisim causes my sinusitis problems such as mucas development, clearing throat, etc.? This I developed only after exposure.
Q3) two bumps on the tounge got bursted three months ago when I used sporonaax but at the same place getting lesions now and then. But another bump is on the tip of the tounge. I feel this bump with my teeth. Most of the times it is inside of the tounge. cultures came normal.Please tell me what causes these hard bumps? candida/ EBV/Mycoplasma/ or something else?
Q4) EBV antibody tets results: EBV VCA IGM: negative, EBV VCA IGG: positive,EBNA: positive, EA (D): negative. EBV blood PCR test is negative. The result says past infection but infectious specialist still thinks my problem is chronic EBV. I am confused about EBV do you think it is causing the problem.? is that infectuious specialist right?
Q5) do you think i have also acquired bacterial vaginisis? if so what is the treatment for this?
Q6)I am also developing few small boils (acne type) with out any fus on the face and head which disappear after a week from
apperaance? This also started after exposure.what causes? (nose culture is normal)
Q7)what infection causes 3 days swelling of my right parotid gland from 5 weeks from the exposure? The girl says she gets now and then the swelling of her right parotid gland since two yearas.
Q8) Do you suspect any other infection apart from candia? either mycoplasma/ EBV? or even any other infection?
Q9) I have one month diflucan prescription which I will be taking soon. I want to know if diflucan can be stil effective working against candida if i take antibiotics also such as doxy/mino and cipro since antibiotics complicate fungal infections?
My blood analysis is normal. White blood cell count is with in normal range. but month ago it went slightly below normal range but came back to normal. natural killer cell function is slightly below the normal range. but CD-4 is with in normal range. eventhough I improved (upto 60 percent) still I have all the symptoms such as fatigue; muscle tiredness when i use the muscles; eys pain and burning and redness; tounge burning and redness and bumps and lesion on the tounge; mucas in yhe muth and clearing thraoat; etc.
Thank you very much in advance. eagerely waiting for your reply.
please answer my questions
All the best to you!
i have had the same shocking symptoms as yourself. I believe the underlying problem is of a fungal nature, more specifically systemic candidiasis, which the doctor made reference to.
What I want to know is, have your symptoms subsided, and if so how did you go about treating yourself.
You should get in touch with me, because I think we can help each other in this situation.
christian l.