Oral thrush after 8 days

[worried321]

I want thank you for all of the fine work you have posted here.  
1. 1/09/07 - A little too much to drink and hired what would I think would be an expensive escort: $600
2. Performed brief oral on her (5+ minutes).  She uses Glide but washed it befor.My tongue was a little raw in that I burned it on coffee earlier in the evening and since she had just washed off it was like licking dry skin…no noticeable vaginal secretions
3. She briefly performed oral on me (no more than 2 minutes),
4. Followed by condom protected vaginal sex (also very brief)
5.  2 days later upset stomach, no vomiting, but 2 small episodes of diarrhea. Fine after 2 days. Initial thought was gastroenteritis as I had eaten a fair amount of sushi and oysters during my trip. No cause for concern yet.
6. 8 days later noticed the front of my tongue was slightly white (really coated in back),  Went to the Dr. and she prescribed Nystatin.
Questions:
1. Can thrush come on in 8 days after an event like this? And be the only symptom of ARS?
2. If I had the thrush before, would this increase my risk of exposure?
3. Would a coffee burned tongue increase my risk of exposure?
4. what is my risk of being infected with HIV?
I plan on going in for a test at 4 weeks.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.

You had accurate responses before I saw your question.  It is probable that nobody ever got HIV by performing cunnlingus.  HIV symptoms cannot come on so quickly.  I'm not sure you had thrush (visual diagnosis, even by an experienced doctor, may or may not be accurate--but you could have caught a yeast infection if your partner had it.  It doesn't necessarily indicate immune deficiency, and certainly doesn't mean you caught HIV at this time or any other.  So the answers to your questions are :  1) Yes, thrush can come on quickly, but it doesn't necessarily suggest immune deficiency or HIV.  2, 3) The risk of cunnilingus is so low that nothing really can increase it signficantly.  4) You have zero risk of HIV from this event.  Sexually active people outside committed, monogamous relationships should have an HIV test from time to time, like once a year.  If you haven't been tested recently, this would be a good time, since it's on your mind.  But that advice is totally unrelated to your escort exposure.

HHH, MD

[strata]

Read the archives. Dr HHH has answered the same question several times recently.

1) You did not contract HIV from the encounter you describe. The risks for HIV transmission by cunnilingus and insertive oral sex (i.e., getting a bj) are mainly theoretical (no documented cases that I've read or heard of), on the order of 1/20,000.

2) Your escort likely did not have HIV.

3) Neither the symptoms you experienced (thrush) nor the incubation period (8 days) suggest HIV ARS. Many healthy HIV- people get thrush.

3) Testing is not warranted on the basis of this exposure. All sexually active people should be tested for HIV periodically, so, if you haven't been tested recently, get tested 4-6 weeks after the exposure (just a simple rapid oral or ELISA antibody test). If you haven't had any riskier exposures, it will undoubtedly be negative.

[sparkeler]

Oral thrush usually happens when people have actual AIDS, not hiv.  I.e., thier immune system is very, very weak.  Even if by some small teeny chance you had hiv, (which I dont think you do)it wouldn't explain your white tongue.

[Teak]

You don't have to have AIDS or HIV to get thrush.

[sparkeler]

I didn't mean that you have to have hiv to have oral thrush.  I meant that if he has oral thrush, it isn't due to Aids/hiv.  Usually people with hiv will develop thrush long after their diagnosis.  You can't rely on your fury tongue to tell you whether or not you have hiv.

[worried321]

My question still is if I had the thrush before the event would that increase my risk and would my coffee burned tongue increase my risk?

[Teak]

It would not increase your risk.

[worried321]

thanks you all of your words of encouragement and hope.

I am still very worried though.  I plan on testing at 28 days which is on Tuesday...

I am also considering a PCR DNA test but from everything I read here it there are too many false positives and I don't want to deal with that right now...yet it is touted as being very accurate at 28 days

Please...what are your thoughts.

[H. Hunter Handsfield, M.D.]

Your thinking is irrational and your behavior unreasoned.  Do not get a PCR test.  There is a very much higher chance of a false-positive result than the chance it will pick up an early HIV infection not detected by antibody testing--and think what you will go through (needlessly) if that happens.  PCR testing would be a waste of time, money, and energy, and and no responsible provider will order it anyway.

This is the last comment in this thread.  If you want to continue the discussion, take it to the HIV Support forum.

[zhiv]

People sometimes take white tongue as oral thrash. My doctor told me that stress can cause white tongue because it causes  changes in the metabolism.

[worried321]

thank you for all your advice...I really do appreciate it.