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ARS Symptoms after Azithromycin
Hi Doc,
I had a drunken/black out encounter with a woman in Vegas. Very embarrassed and ashamed about this incident. Not sure who she was or the circumstances as to how we got together. I am assuming that we had unprotected sex. Two days after I began having some symptoms of tingling at the penis meatus and some general bloat in the lower abdomen. I developed over the next two weeks a small cut/inflamed area in the meatus region that was not too painful, but it was annoying to say the least... I had a full 7 panel test at 14 days and all came back negative. As I felt the test was a bit too early for a reliable positive, I went to see my GP. He inspected the small area on my meatus and diagnosed me with NGU. He gave me a treatment of Azithromycin at 2 grams as he said that it would clear everything up even if it was chlam or Gonn. Now here is where my concern comes into play. Two days after taking the antibiotic i woke up with swollen glands in the neck and it has progressed to the pits and grion. The glans in the pits and groin are a little tough to tell, but the neck is definately swollen. No diarreah and no fever as of yet. It has been 30 days since the possible exposure and the swollen glands came on two days ago. The questions are: Is it normal to have swollen glands after this type of treatment? Should I be concerned with ARS/HIV and should I retest now and would it give a reliable result?
FYI - My urethra does feel and look better...
I had a drunken/black out encounter with a woman in Vegas. Very embarrassed and ashamed about this incident. Not sure who she was or the circumstances as to how we got together. I am assuming that we had unprotected sex. Two days after I began having some symptoms of tingling at the penis meatus and some general bloat in the lower abdomen. I developed over the next two weeks a small cut/inflamed area in the meatus region that was not too painful, but it was annoying to say the least... I had a full 7 panel test at 14 days and all came back negative. As I felt the test was a bit too early for a reliable positive, I went to see my GP. He inspected the small area on my meatus and diagnosed me with NGU. He gave me a treatment of Azithromycin at 2 grams as he said that it would clear everything up even if it was chlam or Gonn. Now here is where my concern comes into play. Two days after taking the antibiotic i woke up with swollen glands in the neck and it has progressed to the pits and grion. The glans in the pits and groin are a little tough to tell, but the neck is definately swollen. No diarreah and no fever as of yet. It has been 30 days since the possible exposure and the swollen glands came on two days ago. The questions are: Is it normal to have swollen glands after this type of treatment? Should I be concerned with ARS/HIV and should I retest now and would it give a reliable result?
FYI - My urethra does feel and look better...
MEDICAL PROFESSIONAL
Sounds like you have a wise and knowledgeable GP. He is the one for those additional questions, not an online provider who hasn't examined you. I don't give personalized medical advice.
Just a follow up. I went to see my GP and he indicated that I did not have swollen nodes (although I felt for sure I did). He said that my anxiety is contributing to my symptoms. However, he prescribed a monospot and a CBC. All came back normal. He said an additional HIV test is not necessary. Do you concur and would a normal CBC help rule out any infection such as HIV within this timeframe from possible exposure? Thanks very much for all you do...
MEDICAL PROFESSIONAL
I don't remember your thread and didn't go back to look at it. But "I feel like if I had a cut or scratch" sounds extremely vague and very different than the story told by Questforanswer. You cannot translate my reply in this thread to your own situation. Rely on my reply to your own question, not this one. (No further discussion of it; thread jump.)
Dr. thats the same thing I was worried about, and you told me there was no risk. I was basically worried about aquiring HIV and HErpes at the same time. I feel like if I had a cut or scratch on the base of my penis that I didn't know about, this person could pass something on to me. I think I had a big risk.
MEDICAL PROFESSIONAL
As I have pointed out many times on this forum, the chance of catching HIV during any single vaginal sex encounter is very low, and the frequency of HIV in women in the US (even in Las Vegas) is low. So from astatistical standpoint, the chance you have HIV is very low.
However, your risk might have been higher than the average encounter, since you apparently acquired NGU or another STD. In fact, despite your GP's diagnosis, I'm concerned about herpes, which is more likely than garden-variety NGU to cause a lesion that looked like a 'cut'; and herpes causes some cases of NGU. And catching herpes at the same time as an HIV exposure increases the risk of HIV infection.
That said, your apparent lymphadenopathy came on a bit late for ARS, and ARS almost always is accompanied by fever. I have never heard of azithromycin causing acute lymph node inflammation (lymphadenopathy), but any drug can rarely cause atypical allergic reactions, so I can't say azithromycin isn't the cause - and the timing is right.
In response to your direct question, you should have an HIV test. I don't expect it to be positive, but better safe than sorry. Most important, you need to return to your GP and let him or her evaluate the lymphadenopathy (which you might not even have, since self diagnosis of enlarged lymph nodes by lay persons is very unreliable), to reconsider the herpes possibility, and perhaps consider other things, like mononucleosis or other viral infection. Let your doc make the decisions about the exact timing of testing for HIV or other things.
Good luck-- HHH, MD
However, your risk might have been higher than the average encounter, since you apparently acquired NGU or another STD. In fact, despite your GP's diagnosis, I'm concerned about herpes, which is more likely than garden-variety NGU to cause a lesion that looked like a 'cut'; and herpes causes some cases of NGU. And catching herpes at the same time as an HIV exposure increases the risk of HIV infection.
That said, your apparent lymphadenopathy came on a bit late for ARS, and ARS almost always is accompanied by fever. I have never heard of azithromycin causing acute lymph node inflammation (lymphadenopathy), but any drug can rarely cause atypical allergic reactions, so I can't say azithromycin isn't the cause - and the timing is right.
In response to your direct question, you should have an HIV test. I don't expect it to be positive, but better safe than sorry. Most important, you need to return to your GP and let him or her evaluate the lymphadenopathy (which you might not even have, since self diagnosis of enlarged lymph nodes by lay persons is very unreliable), to reconsider the herpes possibility, and perhaps consider other things, like mononucleosis or other viral infection. Let your doc make the decisions about the exact timing of testing for HIV or other things.
Good luck-- HHH, MD
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