Can you please sell me a time machine?

[damagedanddistressed]

Hi,

You mentioned that you have never come across someone who turned out to be positive. I am a good candidate to be the first.

May 9, 2009: I was a regular cocaine user (not intravenous) and this was just another evening of indulging in this atrocious habit. As the buzz set in, my good judgment left me and I ended up calling a transsexual escort. We engaged in unprotected oral and I received unprotected anal sex for less than a minute.

Three days later, I developed a sore throat and fever. I went to a doctor who did a strep test that was positive. I was given amoxillan for 10 days. Much to my dismay, my sore throat returned 2 days after I finished the anti-biotics accompanied by a headache and muscle pain. I had no fever or rash, but I did have one episode of profuse night sweats. I read the forums online and was reassured by your comments that ARS is almost always accompanied by fever, something I did not have (and believe me I took my temperature often!).

I called the escort who refused to answer my questions, she only said - if you are sick, go see a doctor.

My life basically continued as it had before, regular cocaine and alcohol use (I am 26, male, by the way). In the months since, I have developed what I assume to be an enlarged lymph node in my neck. I don't have to look for it, there's a hard lump on the right side slightly smaller than a golf ball. I haven't found any similar lumps elsewhere. I have had 3 sore throats since the first 2. I have had 2 other episodes of profuse night sweats. I have had two occurrences of odd mouth sores (1 cyst on gum which disappeared or popped and burning tongue with tiny white spots on tip).

I know the drugs are horrible for me, so I have stopped them a month ago. I was especially horrified when I found out that cocaine use could speed up the progression from HIV to AIDS. I know that unprotected sex was an idiotic thing to participate in. I don't need a lecture.

What else could this be?

[Edward W Hook, MD]

I must say that the exposure and circumstance that you describe does raise concerns about your risk.  At the same time, even if your partner was infected, most exposures do not lead to infection and when a person acquires HIV and is symptomatic from it, they typically have a viral illness (the so-called ARS) which is characterized by fever, muscle aches, a rash and other flu-like symptoms.  The ARS typically passes in a week or so and then the person feels fine. You tale of continuing symptoms is not typical of how early HIV effects people.  There are many other viral illness which can cause the sorts of symptoms you describe. While in some instances these infections go undiagnosed (there are hundreds of viruses and there are not available tests for most of them), in some instances symptoms such as yours might be caused by hepatitis (typically B, rarely C) or mononucleosis.  Rather than trying to guess what might be going on, you need to see a doctor who can test you for HIV and other possible causes which will be determined by your history and physical examination.  There is no down side to getting tested.  EWH

[Edward W Hook, MD]

As I said, the only way you will know, and therefore the only way you can begin to address whatever is going on is to see a doctor.  I'm glad you made this decision.  Please let us know the outcome of your visit to the doctor.   EWH

[damagedanddistressed]

Hi,

I wasn't referring to vaccinations as being the cause of my swollen lymph node, only that I have been vaccinated against Hepatitis A and B, so they probably aren't the cause of my symptoms.

I must admit that I have been spending a rather massive amount of time online reading up on HIV and the associated symptoms. While I have tried to limit my research to trusted sites such as thebody.com, it's true this habit has done nothing but fuel my anxiety. That being said, I have a hard time believing that the lump in my neck could be a manifestation of my anxiety.

Regardless of that, you are right - I have been delaying seeing a doctor and delaying diagnosis if something serious is indeed going on. I guess we'll see what my results are when my tests come back and then take things from there. I just wish I wasn't so convinced of the outcome.

[Edward W Hook, MD]

1.  Swollen lymph nodes are a non-specific finding.  Vaccinations however do not cause swollen nodes.  If you are really worried about a swollen node in your neck, I suggest you go see a doctor who can firstly examine you to verify that there is a swollen node and then do what he/she feels is appropriate to evaluate it.  

2.  Night sweats are also non-specific.  See comment 1.

3.  No

Bottom line.  You have both what you feel are symptoms and signs. All of this could be a serious illness, including HIV or it could be a manifestation of your anxiety.  To try to answer your concerns by cruising the internet is not in your best interest. In fact, it could be a mistake as information gleaned over the internet is often incorrect or taken out of context.  You need to be examined by a good internist who can take a complete history, examine you and order the tests that are indicated by his/her findings.  To do otherwise will just fuel your anxiety and, if something serious is going on, delay diagnosis.  Please let me know what happens when you see a doctor.  EWH

[damagedanddistressed]

Hi,

So I went for the full battery of tests today, but I have to wait between 2 and 3 weeks for results.

If you don't mind, I'd like to ask a few other questions.

1- You mentioned that my symptoms could be caused by hundreds of viral illnesses, hepatitis or mono. I was vaccinated against hep A+B before going to China in 2008, but I'm not sure if I had to have another shot the year later. Anyway, do any of these illnesses cause long term, hard, painless swollen lymph nodes? The lump in my neck is probably the most worrisome of all the symptoms I have have.

2- The night sweats I have had have been absolutely drenching. It is not possible for these to appear months after infection, they always take a long time to manifest themselves?

3- I have read (http://www.aidsmap.com/en/news/50BA4AFB-1F00-4E6D-9FB5-93ACC52BF424.asp and http://www.hivandhepatitis.com/recent/2008/072908_d.html) that seem to indicate cocaine use increases HIV progression. Theoretically could this have caused symptoms to appear earlier?

Thanks for your time.