Lymph Nodes, Rash, Headache and Cramping

Dr H,

I posted in another section in this forum before I discovered (actually, directed to) this forum.  I have read many of the posts and share a similar story to many.

Very briefly, 3 weeks ago I had sex with a prostitute in Asia & the condom broke. After reading the posts I now know my risks from a single exposure are very (very) low.

I am in Asia and have no family, friends or contacts with me. I have rung a local AIDS/HIV helpline and all they could tell me was "get tested in 3 mths".  I have gone to a doctor and managed to get him to have me tested for HIV antibodies and antigen.  The results come back in 3 days.

I suffer from strong panic attacks.  

I have swollen lymph nodes on my neck (am checking constantly), had a rash on my upper abdomen (small flat red spots with many developing raised pus spots (like a sweat pimple)), a constant headache, abdominal cramping and strong scrotal pain. I have a buring sensation in my armpits and had a sore throat.  I have suffered a lower back injury and until I am able to return home (in another month or two) am taking significant amounts of painkillers to stay mobile.

Please, BEFORE anyone lambasts me for bringing up "the same symptoms yet again", my question has to do with the lymph nodes ...  Many websites simply state "swollen lymph nodes".  When the lymph nodes are inflamed due to HIV infection, are all normally involved and how swollen would they be?  Could my abdominal and scotal pain be due to lymph nodes?

This forum is the only "light" that I have seen for the last 3 weeks and wish that I had found it earlier.  The posts and responses are helping to calm my nerves (I haven't slept for more than 3 straight hours for 3 weeks unless sedative induced).  I know that there is little that can be offered except for reassurance, but in my isolation that is exactly what I need ...

Thanks to you all.

[H. Hunter Handsfield, M.D.]

Your risk indeed was vanishingly low.  Your negative test (about 3 weeks after exposure, if I correctly understand the timing) is fairly reliable, but not perfect.  But you don't need to wait 3 months for reliable testing.  Have another test 4-6 weeks after exposure.

Your symptoms do not suggest HIV.  Don't go looking for lymph node swelling on your own; non-professional self-assessment for enlarged lymph nodes is totally unreliable.  Your abdominal pain almost certainly is not due to lymph node inflammation.

Consider yourself reassured.  I won't have any other responses.  This isn't a counseling/emotional support website.

HHH, MD

[contrite]

If the doc responds, he would tell you that, lymphadenopathy tends to be generalized in acute hiv. If you (indeed) have  cervical lymphnode swelling which is isolated, it tends to point against acute hiv.

[skerdstraght68]

I have every one of your symptoms.  Even the white head red bumps.  My doc said those were heat/sweat related.  I thought I had swollen lymph under the jaw and my doc said i didnt.  She said stress makes the throat swell which pushes out the glands under jaw.  It also makes you feel like you have a sore throat (hard to swallow).  most if not all of your symptoms are stress related like the rest of us.

[skerdstraght68]

sticking out your tounge all day checking for stuff will also make your throat swell

[china1111967]

Thank you all.  Brings me peace of mind until I meet with the Dr again on Friday and fear not Dr H, i won't be further self-diagnosing in the meantime.

Kind regards

[china1111967]

SS68,  you say "I have the same symptoms".  Are you through the 'possible' period or are you in a similar position to myself at this time?

Regards

[skerdstraght68]

I have 2 tests, 4 and 6 week 3rd gen neg.  Doc HHH. and my doc seem both said I don't have HIV. But who knows.  The doc is right, stop looking at your body and the net for symptoms. You WILL find things that match what you have GUARANTEED.   It will drive you nuts.  I notice the more I stress, the more all my symptoms get the better of me.  The doc gave you good advice.  Your risk was minimal and your 3 week even though early is a fairly reliable.  If you figure that the average time to seroconvert is 21 days and you tested -, then you should have some sense of relief.  I would advice you to seek psyciatric help as I have done to help you cope with your mental state as it seems to be the bigger issue compared to your odds of HIV.  The good news is the neg test brings it all down to one act of sex which pushes the odds dramatically in your favor.  Stay away from that stuff in the future.  It's obvious your mind isn't strong enough to deal with it.  Good luck.

[china1111967]

Agree ... am staying well clear of that stuff in the future and am already seeking out support.  There are few options available where I am but I am sure I can find someone.

By the way, I don't have a negative test (yet). The results take 5 days to come back where I am but the testing centre agreed to do an urgent job and get them done in 3 to 4. I get the results back in 2 days.

Kind regards

[china1111967]

Dr H,

I should add ...  I have ears that require constant 'popping', sporadic joint and muscle pain (just brief) and a painful gum near a bad/dead tooth.

I truly hope that my symptoms are all anxiety related, but I cannot help but panic further when i get a new symptom that matches what the websites say are common early symptoms of infection.

Thanks

[H. Hunter Handsfield, M.D.]

When a person suspects his or her own symptoms are due to anxiety, almost alway s/he is right.

There simply are no symptoms that point exclusively to HIV.  Every symptom of HIV occurs much more commonly with other things.  The best thing you can do for your mental health is to immediately stop reading websites for HIV symptoms.  

HHH, MD

[china1111967]

Thank you.  

I did wish to know about how generalised lymph node enlargement is when this occurs during HIV infection.  This is a question that I haven't been able find answred on the net on in this forum.

I should clarify that I do not have the results of the tests yet ...

[china1111967]

Dear Dr HHH,

I am pleased to advise that the 3 week P24 Antigen and Antibody Tests came back negative.  I am scheduled to have a follow-up test at 6 weeks (just for final peace of mind).

My question pertains to the accuracy impact by having both the Antigen and Antibody Tests at this time.  Searching through the threads, I see that the Antibody Test is approximately 90% accurate at week 3 and that the Antigen test is (as far as I can tell), slightly more so (95%?)

Is my logic correct that if you are not antibody positive yet at 3 weeks, it is highly likely that you would be antigen positive? (especially if showing symptoms). That is, if I was (and I now don't believe that I am) one of the 'not yet' antibody 10%, of this 10% is it reasoanble to say that I can be 95% sure that I am not positive because of the antigen test?

If that is the case, would the current risk be:
exposure risk x 10% x 5% = current risk

I have been unable to find a thread that explains exposure risk impact as a result of combined antigen/antibody testing at this stage.

Many thanks

[H. Hunter Handsfield, M.D.]

The chance you have HIV is less than the chance you will be struck by lightning.  I'm through responding to anxiety-driven questions about test interpretation.  Just go on with life.

HHH, MD

[skerdstraght68]

Read this.  It's from Lisa Capaldini, M.D., One of the leading HIV experts in the San Francisco area and probably the world.  I've talked to a few people and they all said they hold her in very high reguard when it comes to HIV/Aids research.  If you google her name you will see her work is extensive and specific to HIV.  Her background like the Docs is based on the "science" not the "guidelines."  She probably tests more "High Risk" patients than the doc does so you know her guidlines and stats are extremely accurate.

http://www.aegis.com/askdoc/ASKD040617.html

Breath easy, you just tested neg on "the big one"  the rest of the tests would be long shots at best.

[skerdstraght68]

A good graphic on p24/antibody timeline that makes sense of everything:

http://www.retroconference.org/2001/posters/415.pdf (figure 1)

http://depts.washington.edu/hivaids/initial/case1/discussion.html (figure 7)

[ode2med]

You are obviously informed. I'm always impressed by your responses. I tried to find the "thread" to your exposure but couldn't find it. How did you almost become exposed?

[Ronyyyy]

A related discussion, 2 days severe headache was started.

[Khail19]

A related discussion, unprotected oral sex what are the risk was started.