mild symptoms after oral sex

hi - a little background on me:  i am a gay male, 33, with a recurring EBV infection - i have been feeling very healthy lately and have no other diseases or conditions that i know of.  i test regularly for HIV and am negative - last test was 2 months ago.  i am in a relationship with someone who is also negative.

a few nights ago, i had too much to drink on a work trip and met a guy - we kissed extensively and he performed oral sex on me.  of course i'm feeling remorse over what happened - i will be traveling for another 3 weeks so i will be brooding over this until i can speak face to face with my partner.  but in addition to the guilt, i have started experiencing mild symptoms, beginning at day 3 - sweating, mild stomach pain, a sore in my mouth (it was only there on day 3 - then it seemed to pop - it seemed like a swollen ball in the back of my mouth - and then it was just - gone) - and i'm also a bit itchy.  it's now day 4 since the incident and it seems like the symptoms are getting a bit worse, but i'm sure anxiety counts for at least some of this.

my question - what are the possible STI's I could have contracted that are compatible with my (early) symptoms?  Would they show this soon?  Based on what I've read, I think it's a bit early to show symptoms if this were HIV, plus i have read that receptive oral sex is low risk for HIV infection.  also - at what point can i have tests run - how soon will i show as positive for any/all of these potential STI's?

thanks for your help - and for letting me vent.  

[auntiejessi]

Receptive oral sex is no risk for HIV.  You could get gonorrhea, hsv1, syphilis and maybe chlamydia from receptive oral sex.  (Chlamydia orally is pretty rare.)

You can test for gonorrhea at about 3-5 days after, and you can try a syphilis, but it might not be accurate yet.

Herpes can take up to 4 months to show on a blood test, but you might already have that, so you wouldn't have to worry about it.

AJ

[dichotomy73]

thank you for your response - i will follow up with testing as soon as possible.  

[dichotomy73]

hi - me again.  an update and more questions.  something i forgot to mention - when i urinated the next morning after the incident, there was a tiny bit of dried blood from my penis - i noticed it in the toilet bowl.  since blood was involved (mine?  his?), it makes me more concerned about HIV.

yesterday, i went to a clinic and explained my situation.  since i only had the opportunity to be on land (i work on a ship) for a few hours, she tested for everything and gave me some meds just in case.  syphillis (syphilis) came back neg.  the other tests i am still waiting on.  she gave me a shot of rocephin (?) and a script for doxycyline.  i also took a rapid HIV test, which came back negative.  i asked for the early HIV test but they wouldn't perform it b/c i was not local to the area.

it's now day 9 since exposure - and my symptoms have gotten worse - sore throat, huge swollen glands, fatigue, possible low grade fever (not sure) and strange tingling sensations throughout my body - it's kind of like a mild "zap" of electric current - it's like a feeling of anxious current that just zaps in random places in my body.  i see a few tiny red spots on my chest - very few - maybe 6 or 8 and they are all spread out - not together at all - if i wasn't looking for a rash, i probably wouldn't notice them at all - and i didn't notice the "rash" until this morning - after i started taking the doxy and had the shot of rocephin.  i also have a slight feeling of "burn" in my lower chest - inside though, not on the skin.  my symptoms seem to get much worse in the late afternoon/night - the mornings aren't so bad. i have had no diarrhea, nor vomiting, no major headaches.  i have had insomnia the last few nights and have had to take a xanax to sleep.  i also have very little appetite.  day 7-8 were the worst day for symptoms so far.  

i will not be back home for another 3 weeks - i will continue my medication, but i cannot get the early HIV test until at least 3 weeks since i will be on the ship.  are my symptoms consistent with primary HIV infection?  i know receptive oral sex is low risk for hiv transmission, but with the presence of blood, what are your thoughts?  my symptoms are also consistent with a flare up of my EBV infection so it could be just that - but i'm worried that perhaps i have contracted HIV and i'm having a flare-up of EBV due to contracing HIV and i'm now in the primary HIV stage.  sorry to babble - but i'm freaking out and i'm stuck on this ship for another 3 weeks and don't know where to turn.  your advice is greatly appreciated - thank you!

[dichotomy73]

i also have a yellow tongue - it's like a yellow film all over my tongue that won't brush off.

[auntiejessi]

This could be early HIV, but since the risks are so low, I wouldn't go there first.

I'd go with EBV since that is by far the more likely scenario.  I don't know what the coating on your tongue is, but it could be yeast.

Its also possible you have something else going on, but since you are on a ship, I don't know what to tell you.  Maybe its just the flu or something.

AJ

[dichotomy73]

thanks for your advice - it is helpful.  it's just that this bout of EBV flare up (which i'm hoping it is) is different that those i've had in the past.  also, i should clarify the encounter - i had insertive oral sex (i mentioned receptive oral sex in my previous post - i had my terminology mixed up i think - in other words, he gave me a blow job - pardon my candor, but just trying to avoid confusion).  that's why the blood the next day freaked me out, b/c it was blood on or from my penis, and i'm not sure if it was his blood or not.  i believe in order for him to pass HIV to me, there would have to be blood present, to pass into my urethra, correct?  i know the chance is somewhat remote, but since i did spot blood the next morning, of course i'm freaked, especially given my symptoms.

[auntiejessi]

Receptive and insertive are sort of interchangable as far as oral sex is concerned.  I know its different for anal sex, but with oral sex, you are receiving as it is your penis being inserted into his mouth.  It is confusing, but I got what you meant - you got the blow job.

The presence of blood makes this a bit trickier, especially since you don't know where it came from.  Have you had your urine or semen checked to make sure there isn't any blood in those?

The presence of blood doesn't guarantee an HIV transmission either.  Its not so much about getting it in your urethra, as much as it is getting into your blood stream.  

How do you normally treat an EBV flare?  Are you able to do that while on ship?

AJ

[dichotomy73]

hola - yeah, the blood is what really scares me - the risk for oral is low, but with blood i feel all bets are off.  i have not been checked - i really don't want to do this onboard - word travels very fast - the ship environment isn't very discreet.  i haven't noticed any additional blood - just the one tiny bit the morning after.  i don't even know if this guy was hiv +, but since i don't know for sure, i assume the worst.  

a "normal" flare up for me consists of fatigue, swollen glands, fever, sore throat, excessive sweating, etc.  the "new" symptoms related to my current condition are the tingling in my hands and feet and various burning/tingling sensations throughout my body (the "zaps" i referred to), slight burning in my chest and mild stomach cramps, as well as loss of mental "sharpness" - i feel a bit cloudy, i also have some insomnia and a high level of anxiety, which i haven't felt with an ebv flare up (this is partially due to my concerns of HIV i'm sure).  i also have the normal EBV symptoms except for the excessive sweating.  i haven't had any diarrhea or high fever, nor any new headaches.  i'm also not sure if i have the rash or not - i do feel that i have maybe 6 or 8 slight pink dots scattered on my chest - and my skin is somewhat blotchy - but i'm not sure i would call this a rash.  plus couldn't this be due to the doxy and/or rocephin?  my symptoms do seem worse in the afternoon for whatever reason.  the film on my tongue is pale yellow, almost white - it may be yeast - would the doxy or rocephin clear that up as well?

i may be able to get off the ship for a day or two next week, at which time i will try to get an early hiv test to test for viral load.  i should also know the rest of the other tests tomorrow and will let you know what i find out.

thank you for listening - i truly appreciate it.  do you have any other advice or questions regarding my situation?  

[dichotomy73]

sorry - i didn't answer your question - to treat an ebv flare - i just rest - it has to run its course and then i eventually feel better after a week or so.  if my current situation felt like what i have gone thru in the past i wouldn't be so worried.  do you think my symptoms (and timing of symptoms) are consistent with primary hiv or ars?  i had early onset of symptoms which progressively got worse, peaking around day 7-8.  now day 10 still not back to normal, but symptoms were never severe.  the worst part now is the tingling and the fatigue.  i don't think i have a fever at all, and my sore throat is almost gone - glands are still slightly swollen.  with primary hiv, how long do symptoms normally last?  and do they come on that early?  

[auntiejessi]

No, your symptoms aren't consistent with ARS.  In all my years of working in this field, I have only seen one person get this, and it was bad enough to put him in the hospital.  In fact, the docs that I work with hadn't seen anyone else with it either.  It doesn't happen that often, even though some of the literature says differently.

The rash is VERY pronounced, and there is no mistaking it, and you'd have a fever.

You wouldn't have any tingling in your body, or any brain fog.

The antibiotics wouldn't cure yeast, and would probably make it worse.  Yeast needs an antifungal.  You can have your ship medics look at that, as that's common, and doesn't have to be sexually transmitted.

AJ

[dichotomy73]

ok - that's reassuring that what i have isn't consistent with ARS.  i have friends that have gone thru ARS and were also hospitalized.  but then i also have friends that had no symptoms that they recall.

how prevalent is the high fever and rash when seroconverting?

what are the symptoms of a yeast infection - i didn't know men could get yeast infections - ?

[dichotomy73]

i have done a little research - some sites describe similar symptoms with hiv primary infection, other sites say it could be chronic fatigue syndrome (aka chronic EBV) or fibromyalgia.  do you know much about those?

[dichotomy73]

i keep reading that "pins and needles" in the feet and hands is a symptom of early hiv - i'm freaking out again.  i need to quit self-diagnosing, but i can't!  

[auntiejessi]

No one I have ever known with that has HIV described tingles in the feet and hands.

I think if you look hard enough, you can find something that says this is all related to HIV.  You can also find things that say its EBV, or whatever.

Personally, I think you need to treat this (as much as you can on a ship) as an EBV occurence, which wouldn't be much different than treating fibromyalgia (which I don't know a whole lot about).  Just rest as much as you can, try to stop researching on the internet, as that will just make you insane, and when you come ashore, see if you can get some medical attention.

Keep me posted, ok?

AJ

[dichotomy73]

thank you - sound advice - which i will try to follow.  it's difficult though.  do you know of any other STD's that can cause pins and needles?  that and fatigue are the only persistent symptoms at this time - sore throat is gone, glands are still a bit swollen.  i am going to call to find out my results shortly and will advise.  thank you again!

[auntiejessi]

No, I can't think of any std that would cause that, except maybe herpes, and that's not all that common with herpes.  If you have oral hsv1, the chances of you getting genital hsv1 are very slim.  I don't know if you've ever had a cold sore, but if you have, you have hsv1.  You could also have hsv1 and not ever know it, as only 20-40% of folks who have hsv1 ever get a cold sore.

Just try and hang in there,
AJ

[dichotomy73]

i do get cold sores occasionally, often when i am sick. i take l-lysine, which seems to help prevent cold sores.

[dichotomy73]

fyi - my STD panel came back negative - syphilis, chlamydia, gonorrhea, etc.  all negative.  so i'm back where i started - either EBV or early HIV infection.  i don't think i will know anything until i test in a few weeks.  thank you for listening.

[jmv58]

The chances of getting HIV from receipt of a BJ are so remote that it is not even funny.  Man, get over the HIV part.  You don't have it.

[dichotomy73]

ok - thank you for the reassurance.  i will still get tested b/c of the blood issue and the new symptoms, but i do know the chances are remote (thankfully).  thanks again!

[dichotomy73]

hi - quick update.  i was able to get 18 hours in NY between ships - i did speak with my boyfriend, who was undertanding, but of course upset.  i also tried to get a PCR test but at 15 days, the clinincian wasn't comfortable with the accuracy and said i should wait two more weeks to take the test.  speaking with my bf helped me mentally, but unfortunately, not physically.

since my last post, my symptoms are still persistent but some have changed.  the pins and needles got really severe between 7 - 14 days, has since subsided - now more of a feeling of "falling asleep" along with numbness that comes and goes.  i developed what appears to be thrush (around day 10 - lasting about a week - seems to be going away now) - thick white film on my tongue surface with huge wart-like bumps on the back of my tongue.  this lasted for about a week - my throat felt so swollen it hurt to swollow a bit, although the nodes in my neck had gone down some - interesting.  

day 16 a mild headache started, which hasn't gone away.  i still have mild stomach pain, ongoing since day 4 - day 17 & 18 - diarrhea.  the worst part now is the ongoing fatigue and also the pain in my feet - the bottoms of my feet hurt so badly - very sore, and the glands all throughout my body are very swollen and sore (groin, underarms, even feels like back of knees - ?), my neck nodes are still swollen but not as bad as they were.  they seemed to go down some when the others swelled.  

so - my questions.  given all of my symptoms, i am still really concerned about HIV.  given the timing of my symptoms, i'm wondering if perhaps the early symptoms were due to an EBV flare up, but around day 7 - 9, perhaps i started with primary HIV infection.  i don't want to sound paranoid, especially since everyone says my exposure was low-risk, however, there was blood involved.  i know that anxiety can cause some of the symptoms i mentioned, but the neuropathy i experienced for about a week was pretty severe - not just minor "pins and needles" - it felt like electric current - i couldn't even sleep.  and then the thrush - and now with all the new symptoms that started around day 14 - i'm a bit freaked.  i am stuck on a ship in foreign seas until march 25t, when i will test conclusively.  i know i have to wait to test - but it's difficult when every symptom i type seems to confirm primary HIV infection.  HELP!

[Zilian]

I've been searching the forums and a doctor said in a post (I don't remember where) that it's impossible to get HIV by receiving oral sex. He also said that in 30 years of experience, he's never experienced something like that.

I've received oral sex some years (3-5 years go) ago from a prostitute and got an yeast infection (maybe, my tests were unable to find anything twice). I have discharges. Well, I've read many things about HIV and every page I read says that it takes some months not days for you to start having symptoms. I guess you might be paranoid, like me. Of course, paranoid for some symptoms not all. I think it could be something else other than HIV. Think about. When I've received unprotected sex, every little symptom I had  I was like "Oh, damn, it's just gotta be HIV!". Easy, buddy!

Try to get tested! If the results are negative, then you should take the test 3 months later. I didn't mean to interrupt AJ, she's a true master. I just feel like writing. :)

[auntiejessi]

LOL interupt all you want.

Did the doc look at your mouth or listen to any of your other symptoms?

AJ

[dichotomy73]

zilian - thank you - i agree with you, at least in theory that the risk from a bj is remote; however, since there was definite blood exposure, that is what i am worried about, and the fact that the symptoms i'm having are not normal for an epstein barr flare up (at least for me).  and unfortunately, they are consistent with the CDC's and thebody.com's symptom list for primary hiv infection, which normally occurs about 1.5 - 2 weeks to up to 4 weeks after exposure.  

aj - when i was home, i called the NYC gay men's health crisis line when i was home and they recommended a clinic where i could get an early PCR test so i went to the clinic - i don't think the guy that saw me was a doctor so no he didn't really examine me at all - just listened to my story and i told him the symptoms i was having.  he didn't check my mouth.  i'm hoping the thrush may have been due to the fact that i took the doxy (only for 5 days - i stopped when i found out everything came back negative).  he said to come back in a few weeks.  he did say though, that if the guy was positive, and if his blood got into my bloodstream (via my urethra presumably) that it was possible to become infected - what concerns me is that i had no cuts on my penis - and the blood that came out the next day when i urinated was somewhat dried (one drop was dried in a bit of fuzz, the other was more liquid so probably was inside my urethra) - so i don't really think it came from my penis - but i can't be sure of course..  i know there are alot of "ifs" in that statement, which reassures me somewhat.  if it wasn't for the damn symptoms, i wouldn't be so concerned.

i know some of my symtpoms are some of the more unusual primary HIV symptoms - (e.g. the neuropathy and the thrush) - i'm thinking that if this is primary hiv infection, it could be happening in my case, b/c of the weakened immune system due to the chronic EBV.  i'm so confused !!

how long does thrush take to clear during primary hiv infection?  i think thrush can be brought on by taking antibiotics (i was on doxy for 5 days) - if it was due to the meds, upon stopping, how long would it take to clear up?  

also - since the std panel came back negative, i stopped the doxy - is this advisable?  especially since i got the thrush, i thought it best (since it wasn't really treating anything anyway since my results were negative) - was it ok to stop, or should i resume?  i stopped 6 days ago.

thank you for your advice - regardless of the outcome, i am trying to prepare for the worst but hope for the best.  

[auntiejessi]

No, if your tests were negative, there's no reason to continue with the doxy.  If the thrush is from the doxy, it should start clearing up soon, though it can take awhile, since the mouth is moist and dark, which yeast loves.

Hang in there, ok?  I know this is scary, though.  When are you off the boat next?

An HIV test at 30 days is 90% accurate, so it might be worthwhile getting a test the next time you are off the boat.

Jess

[dichotomy73]

i do think the thrush is clearing up - i have tried to modify my diet to help a bit.  i am off the ship on 3.25, that will be exactly 4 weeks - i will do a PCR and an antibody probably the next day.

i have read that syphilis can cause peripheral neuropathy - and you mentioned that the results may not be accurate at 1 week out.  when is a syphilis test accurate?  would a shot of rocephin and/or a week of doxy clear up the syphilis if i did have it?

[auntiejessi]

Rocephin would.  Doxy might, but you'd need 2 weeks of it, and that's not a recommended treatment unless someone has a penicillan allergy.

Early syphilis wouldn't cause peripheral neuropathy.  EBV can, though, as I am sure you know.

A syphilis test would be accurate by the end of the first month, so you would have perfect timing when you get off the boat.

AJ

[dichotomy73]

ok - so i will get retested for everything at 4 weeks post-exposure - just in case of false negatives with the STD's.  i have read that EBV can cause "pins and needles" - but i have never experienced anything like what i had over the last few weeks related to the neuropathy.  also - the pain in the bottom of my feet is new to me.  i'm still hopeful.  thank you for your help!

[auntiejessi]

You're welcome, and keep me posted, ok?

AJ

[dichotomy73]

hi AJ - i noticed for about the last week, my underarm and groin lymph nodes are swollen and really sore, the last two days i have experienced a burning sensation in my groin lymph nodes - have you heard of this?

[auntiejessi]

Yes, this can indicate an infection or inflammation in the body.

I'd still go with EBV recurrence.

Hang in there, ok hon?

If you get too sick, can you leave the boat?

AJ

[dichotomy73]

hi there - i am going to be leaving the ship on friday - i should be home a day or two later (lots of connections!!) - i plan to do a pcr and an antibody test probably early next week (hopefully monday).  i will let you know how it goes next week.

fyi - i still have the swollen lymph nodes (neck, arms, groin), the groin nodes are still "burning".  still a bit fatigued, and mild headaches persist.  the pain in the soles of my feet is still there but getting better.  overall, my symptoms are getting much better - i think a few more days and i'll be back to normal.  this is good, but it still scares me a bit, b/c of the timing of the symptoms appearance and then disappearance - still seems very consistent with primary hiv infection.  i know that i won't be sure of anything until i test.  i am still hopeful.  thank you for all your support.  you have been an angel.  really - thank you!!

[auntiejessi]

LOL because you are panicked, it seems like classic early HIV.  To me, it sounds like classic EBV.

Let me know.

AJ

[dichotomy73]

hi AJ - me again.

ok - so updates...i got home 3.22.  i went to get an HIV antibody test on 3.25 - this was exactly 4 weeks post-exposure.  negative.  i know this was still in the window so i went to my PCP the same day and got alot of blood work done, including hepatitis, lyme disease, etc, plus an HIV-1 RNA QN PCR test.  everything came back negative (HIV was <400 copies and <2.6 log copies).  doctor didn't test me for EBV titers, even though i asked him to - it was an urgent care center - they were swamped - i think he just forgot to be honest.  anyway, my questions

1.  is a negative antibody and PCR test at 4 weeks conclusive for HIV, or do i need to retest at 6 & 13 weeks?  
2. do i need to retest for syphilis at 3 months, even though i had the shot of rocephin?

overall, i am still not back to normal but am feeling better - still have fatigue and swollen, burning nodes, and random headaches, but i'm much better than i have been the last few weeks.  personally, given the negative HIV, i think this was a strong EBV flare up (just like you said), or perhaps another case of mono - the doctor i saw for the results said he thought it was likely mono (even though i have had this before - he said it is possible to get it more than once).  

anyway, please let me know regarding additional testing or if i am in a position to move past this and forget about it (taking a valuable lesson with me, of course).

also - thank you so much for getting me thru crisis mode - you are truly an angel.  i had a rough few weeks at sea - your emails helped me get thru - for that i am extremely grateful.  thank you!!

[auntiejessi]

Hey you!!

I would say the chances of you being infected with HIV at this point are very slim.  90% would develop antibodies by the end of a month, but since you had no viral load, I would say that its a really good chance that you don't have HIV.  At this point, I'd think you would have had a viral load, given your other health stuff, and how lousy you were feeling.

And no, you don't need to be tested for syphilis if you've had a shot of rocephin.

I'm glad you are starting to feel better, and thanks for letting me know!!

Hang in there, and you know where I am if you need anything or just want to say hi.  :)

AJ

[Uppa]

Your tests are negative, negative, negative, so give yourself a break.  If you're feeling better, than try to get more sleep now that all the rustle is calming down.

Fibro could be it...  if that's the case, I just saw treatment for it on TV the other day so at least they're figuring it out.  I had a girlfriend with fibro for years.  The one thing that helped her was marijuana.  Not that I'm condoning the use of illegal drugs at all...  but it sure does help me sleep at night *wink*

Also - If you're not totally sick of seeing doctors yet, try seeing an herbalist.  It may be a bit more $ than seeing a doctor and having insurance cover most of the cost, but it's a new perspective at least.  And medicine that has been practiced for about, mmm, 3,000 years longer than western medicine.

Good luck.  Good to hear you're negative with all that other stuff.

[dichotomy73]

hi AJ - it's been a while - hope all is well with you.  :)

i've basically moved on and put this behind me with regard to the HIV - i had another test at 8 weeks which was negative so i feel very confident in my HIV status, given this result in conjunction with the PCR at 4 weeks

however, my doctor confirmed that i had an acute CMV infection, which caused my mono-like illness.  i've done a bit of research about CMV - learned it is a lot like EBV - both cause mono-like symptoms, etc.  it's now been about 10 weeks since i felt normal - i'm about 85% back to normal i'd say - still have fatigue, but i've just started getting back to the gym for light workouts, etc.  and the lymph nodes in my groin and pain in the soles of my feet are *almost* back to normal.

anyway, i was wondering if you had any advice about CMV - herbs or supplements to try, exercise or not, diet considerations, etc.  it's been about 10 weeks since i started getting sick, i want to get back to "normal" which for me means going to the gym, etc, but if it will prolong the illness, i'd rather not.  are there any hard-fast rules here?

also - thanks to uppa for the advice - i have done some reading on CFS/fibro - i think i may be a candidate for CFS, not so much fibro, as the pain has pretty much subsided.  will try to see a naturopathic doctor - i think they might be able to help with my EBV/CMV (and possible CFS) combination.

[Dallasfan]

Just for your information., CMV is a very common infection. Greater than 90 % of the US population have had CMV at some point. Good luck with your recovery. Take care.

[auntiejessi]

I don't know much about alternative treatments for CMV, but I am glad you are feeling better!  :)  And I am also thrilled that you are moving on from the HIV stuff.  :)

Keep me posted, ok?

Aj