HIV Concerned

[idiot123]

I had unprotected vaginal sex two times over the course of 6 weeks.  It was with two different girls.  Both of whom I have known for a while.  The first time was prolonged intercourse, the second time was for a short period, maybe 10 seconds.  No ejaculation in either case.  I have no reason to suspect either girl is high risk.  Two days after the second time, I developed a fever/rash that lasted two days adn increased bowel movements, but not diarhea.  Subsequent to that I developed a cough that has lasted for 10 days.  That didn't concern me as much as I developed a white coating on my tongue around the 10th day (My dentist said it was thrush but by visual).  It won't scrape off and Nystatin doesn't seem to be helping.  My questions are

1.  What is the difference between coated tongue and thrush.  All the websites point to antibiotics or HIV as being the main drivers in health adults.  I am not on antibiotics so this has me freaked out.  My coating cannot be scraped off.  Are there ways to tell?  What can cause this in otherwise healthy adults?  The night before it showed up I had taken a medicine that has a possible side effect of dry mouth.  Could this be the cause?

2.   I took a PCR and await results today.  If I had symptoms, would the PCR show positive.  I am also worried about potential false positive after reading your boards.  What steps would I take if it were positive?

3.  Should I be overly concerned I have HIV.  I haven't been able to focus on anything else for a week?

[idiot123]

Thaks Doc.  The info on this forum has helped me maintain my sanity.

[H. Hunter Handsfield, M.D.]

From your description, you are not at significant risk for HIV, so whatever the cause of the appearance of your tongue, HIV isn't the cause.

1) That said, your description suggests coated tongue, not oral yeast infection (thrush).  Even if you had thrush, it wouldn't mean HIV; it occurs in healthy, immunologically normal people--I had it myself once.  Coated tongue is a nonspecific finding that occurs in many minor viral infections and other health conditions besides HIV.  Many cases are unexplained and do not indicate any health risk of any kind.

2) A PCR test was not called for.  Had you come to my clinic, I would have refused to do it.  But if you had acquired HIV, the PCR test probably would have been positive.  The proper test would be a standard antibody test a few weeks after the last potential exposure.

3) I very much doubt you have HIV.  But if you remain concerned, follow up with your personal health care provider.

Regards--  HHH, MD