I need your follow-up help.

[mangu1]

Hello Dr,
here was my first post
http://www.medhelp.org/posts/HIV---Prevention/What-is-my-risk-of-HIV/show/1906962#post_8888204

Here is my succession of symptoms since the encounter.

day 18 rash on trunk, pin prick red dots,1-1.5 mm in diameter.

day 22 large pimple like thing in pubic region above penis. looked at closely, it had small blister-like bumps, with a couple of extremely small white-ish sticky-outy things. lasted 5 days, then retreated. turned purple with dry skin surrounding it.

day 24 felt sharp pain in left side, could feel small, hard, bean shaped thing in exact spot. pain came and went for couple of days.

day 26 a mouth sore, and THE REALLY SCARY PART…my lymph nodes on the left side of my neck and behind my ear started getting very painful. Pain at the base of my neck (both sides) where it meets the collar bone and in the left side of my neck. I also have the feeling of pressure which has gradually moved its way up from my temple, to about 1.5 inches above my temple. The pressure feeling is above and below my eyes,behind my nose and in the back of my head as well. It is not painful, just ‘heavy' feeling.

day 32 went to ENT doctor who I had previously gone to for sinus infection. He said my sinuses were inflamed, and gave me amoxicillin. I took it the 1st day, 3x 625 mg. Next morning I felt almost fine, but the morning after the 2nd day of medication, the symptoms returned. My neck is inexplicably stiff around where it meets the collar bone, and the lymph nodes in my neck and behind my ear are back in dull pain mode. I know these are lymph nodes because I’ve had this sensation before with mono…that and I trained to be an RN for 2 years before I decided it wasn’t for me.

1)Does it sound like an STD?
2)Syphilis is known to cause lymphadenopathy. Could this explain the antibiotic reaction?  
3)I have no fever, no night sweats, and no diarrhea. How much should these lack of symptoms affect my outlook with regard to HIV?

[Edward W Hook, MD]

At 5+ week after your no risk exposure, a standard 3rd generation ELISA test for HIV antibodies will detect nearly 95% of HIV infections.  At 8 weeks it will detect all of them.

If you have symptoms which trouble you, you should seek a medical opinion, not waste time and delay seeking help because of an inappropriate concern that you might have gotten HIV or other STD from a no risk event.  

That will be it for this thread.  It is time for you to move forward.  EWH

[mangu1]

Hello Dr., you were right in that I found some anonymous HIV rapid testing available. From what I could tell, they were using an ELISA 3rd generation rapid test.

I tested negative at 5+ weeks since exposure (which you may indeed deem as a non-esposure). I was hoping you might be able to speak to me in percentages about the accuracy of a 5 week test of this sort. The reason for this is because there is something going on with my health, and I'd love to figure out exactly what it is. The problem is is that if I go to a hospital and test positive through various blood tests, I'll have a real problem on my hands. Thanks for your hard work on this site.

[Edward W Hook, MD]

I'm sorry that you continue to worry about this.  I agree with what Dr. Handsfield told you last week- the exposure you describe did not put you at meaningful risk for HIV or, for that matter, other STDs.  I suspect that your concerns related to the exposure you had are making you look harder for signs or symptoms of infection and leading to a tendency to wonder if abnormalities you detect might somehow relate to the exposure you described.  I suspect that these sorts of concerns will continue to worry you until you prove to yourself that you did not acquire an infection by testing.  As far as the availability of testing is concerned, the fact is that there is nowhere on earth that you cannot get confidential testing for STDs, including HIV.  You just need to inquire as to where that might be accomplished.

As for your specific questions:
1)Does it sound like an STD?
No, the symptoms you are describing are non-specific.

2)Syphilis is known to cause lymphadenopathy. Could this explain the antibiotic reaction?  
Lymphadenopathy is a non-specific finding that could be due to any number of causes.  Most sinus infections actually start as virus infections and this could well cause the lymph node swelling you describe.  The likelihood that this is due to syphilis is close to zero.

3)I have no fever, no night sweats, and no diarrhea. How much should these lack of symptoms affect my outlook with regard to HIV?
As Dr. Handsfield has already told you, there is little, if any risk for HIV.

I hope these comments help you.  You really need to find out how to get tested.  EWH

[mangu1]

Sorry Dr, one more thing. Where I live getting a private HIV+ diagnosis is impossible. They'll kick me out. I'm all good with that, except my wife is a native, and who knows...this could be front page news, seriously.