Mistake of a lifetime

[ccgo]

hello dr
I’m a 38-year-old married hetero male. I had an experience at a bachelor party with a white 22 year old female escort. It consisted of unprotected oral that she performed on me and some deep kissing. We then had protected vaginal sex but during intercourse the condom somehow came off. This lasted at least a few minutes until I pulled out and saw no condom.
3 days post: Itching at the opening of the urethra and inside the urethra
8 days port: swollen lymph node in the right side of the groin the size of a large bean
11 days post: small lymph node in the neck size of a green pea
13 days post: went to clinic. Doctor confirmed the lymph node in the groin but was unworried about the small node in the neck. I had light discharge from the penis to go along with the itching and slight irritation after urinating. Urine and swab test both came back neg for ghonorrea/Chlmydia. I was given Azithromax, levaquin and a shot of rocephin.
15 Days post: viral pink eye in both eyes and an itchy rash on the skin between the eyes. lasted about 8 days.
16 days post: Lymph node swelling in groin goes away and the urethral itching and discharge goes away.
25 Days post: A second lymph node the size of a pea develops in the neck
33 Days post: Scratchy throat  lasts for a week. Feels like im getting sick but never comes to fruition. Highest temp around 98.9. A week prior my wife had the same scratchy throat.
39 Days post: Found a lymph node the size of a pea on the upper fore arm and on the upper left side of my stomach. Im a chubby guy and I could not tell if it was a fat cell that I irritated by continuously looking for swollen nodes.
I am very afraid a I might be experiencing or have experienced ARS.  So far I have had no fever and have seen no rash.. I also have a lingering light scratchy throat and Im afraid that I may be the one person to have offset the odds here. Can you give me your opinion on what is happening to me? Thank you.

[Edward W Hook, MD]

As I said, I anticipate your test will be negative.  Try not to worry.  EWH

[ccgo]

Hi Dr,
          I went for my test yesterday and I also booked an appointment with a couselor. I can see by your tone you really believe my tests will be negative. My apologies for all my comments. Sometimes you just dont realize when fear takes over your rationale. Thanks again Dr and I'm hoping for the best

[Edward W Hook, MD]

I hope the appointment is with a counselor.  If it for testing, when the test is negative if this is still on your mind I urge you to work through this with a trained, trusted counselor.  EWH

[ccgo]

Thx Dr, I think my guilt is causing me to worry unnessacerily and may have even knocked me into a mild depression. Im looking at this from a point of view based on your advice to help me see the facts and stop being hypchondrious.
Although I have swolen nodes in the stomach arm,neck and now behind the ear they all swelled at different times over the course of 6 weeks without fever or rash so that is not characteristic of ARS/HIV infection. So im putting that out of my mind.

At six weeks past exposure although I had mild nightsweat a few times which I assume is due to high anxiety I have had no fever or rash and six weeks is a bit late to start ars so im putting that out of my mind.

My symptoms are spread out over the past six weeks and not all at once which is not indicitive of ars so I'm putting that out of mind.

Last but not least my partner although she was a CSW she was not african american or any other high risk group so my one time hetero exsposure was low risk. So Im putting that out of my mind. Thx doc. I have an appointment monday and we'll se what happens.

[Edward W Hook, MD]

This still does not sound at all like HIV. It sounds like one of the non-specific viral infections most people get from time to time which you acquired coincidentally  EWH

[ccgo]

Hi Dr,
          thanks for your comment. Im trying my best to stay positive. Another node enflamed today behind my ear and it is visable.  I feel like I am going to be the first poster on here to test positive. Still no fever. or rash. Mild night sweats I think.Is it possible to be going through Ars at 6 weeks and why does it seem that the lymph nodes are swelling at different times? 3 in two days. I am going to see a health care provider tonite if needed at an emergency room because i am that scared of this being HIV. Do lymph nodes swell at different times for HIV? I also have a lot of chest phlegm. Thank you dr.

[Edward W Hook, MD]

Welcome to the Forum.  From the sound of things you may have acquired urethritis (penile infection) due to gonorrhea, chlamydia or non-gonococcal urethritis (NGU) from your exposure and have had a good response to therapy.  Getting urethritis however does not, by any means however mean that you have also acquired HIV.  In fact the chance that your partner had HIV are less than 1 in 1000 unless she used IV drugs and the risk of HIV from a single act of sexual intercourse is less than 1 in 1000.  thus your mathematical risk for HIV is less than 1 in a million.   Furthermore, the chance that your current sypmtoms are ARS are likewise tiny- ARS is not associated with conjunctivitis and the absence of fever and risk make your symptoms incompatible with the ARS.

Finally, about lymph nodes, detection of swollen glands is a medical "art form".  Clinicians train hard to detect subtle abnormalities and to try to detect them in yourself is fraught with error, because you are likely to mis-interpret other irregularities as being lymph nodes, because you might miss them and finally, if they are present, interpretation of why they are present is difficult.  This is because "glands" are lymph nodes which can swell due to any of a large number of infections both viral and bacterial, as well as due to allergic reactions, due to autoimmune disorders and other problems.  For this reason we encourage clients who are concerned about swollen glands to check with their own health care providers rather than try to diagnose themselves and, if swollen lymph nodes are present, not to worry about them in relationship to HIV because they are such a non-specific problem.  When a person has swollen lymph nodes, the chance that they are due to HIV can be measured as a fraction of 1%.

My guess is that you may have gotten urethritis from your extramarital encounter.  I have no concern however that you got HIV.  I suspect that your symptoms reflect the sort of "every day" viral infection that most people get on a regular basis.  You are now nearly 6 weeks past your encounter.  At this time a standard HIV antibody test will detect over 95% of persons with HIV.  Get tested and then, when the test is negative, believe the results.  

I hope these comments are helpful. EWH