Oral Thrush? Atrophy?

Dear Doctor,

I am very nervous.  I thought I was okay when I got my negative 17 week HIV ELISA result after unprotected vaginal 2 times with same person but now a few months later I noticed that my tongue is its normal color (light pink with a little bit of white tastebuds down the middle,I think they're called filiform) but after I brush my teeth I sometimes take my finger nail to see if it will scrape off.  Now I noticed a few little bald spots where those tastebuds are. I don't know if it is a cause of my scraping it but then I read something called atrophy. My tongue does not hurt. I am so scared now that my test picked up a false-negative.  I've seen pictures of thrush and I don't think it is that. I had some red spots on my palate at this time too. I also have a very tiny canker sore on my lip.

1.)What are the chances that my result was a false-negative?
2.)Does this sound like it is HIV-related?
3.) If it is not HIV-related then what could it be from?
4.) Could this be a cause of taking antibiotics?
Thanks Doc.

[H. Hunter Handsfield, M.D.]

Initial response, after reading only the first 2 lines of your question:  Your negative test at 17 weeks proves unequivocally you do not have HIV and that something else is causing your symptoms.

Now having read the rest:

1) No chance, especially given the low risk situation you describe.

24) None of your symptoms sounds like anything caused by HIV, regardless of what you might have read.  Most likely your tongue is entirely normal; and in any case, innumerable things (diet, minor viral infections, oral hygiene, maybe stress) can cause coated tongue and the other things you describe.  And yes, taking antibiotics is a possible cause as well.

3) I don't get into guessing at diagnoses other than HIV or other STDs, and your symptoms don't suggest those problems.

Follow up with your personal health care provider, and/or the provider who prescribed the antibiotic.  But don't worry about HIV.  A negative test result is an infinitely more reliable indicator of HIV than any symtpoms of any kind.  You don't have it.

Good luck--  HHH, MD

[protected fun]

I should probably add that I am not experiencing any tingling of my tongue or difficulty talking, knowing that this may be a symptom. Just where my natural tastebuds are supposed to be in the center of my tongue are a few small pink spots.  Thanks doc.

[H. Hunter Handsfield, M.D.]

The additional information makes no difference in my opinion or advice.

[protected fun]

Thank you for your reply.  I have another question which I hope you will answer.

I read that Atrophy takes off some tastebuds from your tongue and I know it can do serious damage to your tongue, eventually making speech and eating impossible.  If I do have it I would like to get help right away.

Does what I have even sound like atrophy or do other symptoms usually occur also?    Please explain.

Also, in people with HIV who get Atrophy, is it usually when they are closer to developing AIDS, or soon after they become infected?  

Thank you.  Your answers will be appreciated!

[protected fun]

I might add that I am female.  I hope that does not change your opinion in my "low risk" situation you said I had...I know females are higher risk.

[protected fun]

sorry for all of these add-on comments.

my tongue has the filiform papillae in it down the middle, but some areas on that are missing, leaving a pinkish spot. Could that be geographic tongue?  I don't have lots of white build up called thrush.  I know geographic tongue can be associated with HIV, otherwise RARE in others without HIV which makes me scared.  Does it sound like Geographic tongue?

[monkeyflower]

You do not have HIV, so obviously whatever's going on with your tongue has nothing to do with HIV at all. My guess would be you've spent way, way too much time online researching oral symptoms and HIV, and way, way too much time in front of a mirror, staring at and poking around your tongue.

See your dentist or doctor if you're worried about your tongue's appearance. In the meantime, get off the internet and out of your house. Visit friends, take in a yoga class, do whatever you'd normally do. You don't have HIV.

[H. Hunter Handsfield, M.D.]

The worst possible way for anyone to explore unexplained symtpoms--whether possibly caused by HIV or anything else--is to go on the web and uncritically just read symptoms.  A hundred things cause coated or "geographic" and all of them are more common than HIV infection.  If you're going to look at websites, keep in mind that most of them don't give context; you cannot just read symptoms and draw conclusions.  There are no exceptions to this rule.

As usual, monkeyflower has good advice.  I won't have any further comments on this thead.

[protected fun]

Might I add one more thing.  I have a weird growth under my toenail and is making my toe turn very red and painful.

also, I heard that here in San Francisco that the HIV rate is much higher??  Does that mean my risk goes up?!?!

[monkeyflower]

The HIV rate in SF or anywhere else is completely irrelevant, since YOU DON'T HAVE HIV.

See your doctor about the toenail thing. And since it's clear you can't move past this on your own, that would be the perfect time to talk to him/her about medication for your anxiety, and a referral to a therapist.

[tomtee98]

Believe me. The doctor you are consulting to online at this forum knows what he is talking about. I've been through the same situation before; checking the symptoms online, matching them with mine, deciding on my possible infection, etc etc.. but it is all useless. If the doc told you its not HIV, be sure about it. Best is to get tested to calm yourself down. That is the only way you could be stress free otherwise even if HIV turns into a human being and tells you that you don't have HIV, you wont trust him too. No kidding... I am no doc, nor a medical student but i've spent days and nights on internet for HIV and turned out to be -ve in the end by having a test (Thanks God). If i'd have believed this doc, i'd have got rid of anxiety a long time back.

I salute this doc on his great efforts in this regard.

Stay healthy.