Question of symptoms after possible exposure

[lagoon77]

Hi Doctor, I am in need of a second opinion to my current situation.  1 month ago I had protected anal receptive sex and unprotected receptive oral sex w/o ejaculation for either. About 7-8 days later I developed a sore throat, difficulty swallowing, and on day 9 developed a full body rash/redness. (skin turned white when pressed down on). The rash lasted about 1 day, but the sore throat lasted nearly three weeks until I went to see a doctor, who performed a swab and came back "slight positive" for strep. He did not notice any enlarged lymph nodes in my neck.  I also developed a white coating on my tongue, that appeared like a plaque.  I was given antibiotics and the throat problems cleared about three days later, and the plaque retreated off my tongue.  I always try to practice safer sex, but this incident really scares me, do you think it could be ARS given only the "slight positive" on the strep test?  Should I obtain further testing?  Thanks for your help.

[lagoon77]

This was done doing the rapid oral test, does that make a difference?

[lagoon77]

Negative at 40 days, is that an accurate test?

[H. Hunter Handsfield, M.D.]

HIV is a rare cause of enlarged lymph nodes in the neck.  Strep infection is one of the most common causes.

[lagoon77]

Doctor, just one quick follow up question, is it normal to have sore glands in the neck during ARS, or is this a typical strep symptom as well?

Thanks!

[H. Hunter Handsfield, M.D.]

Sure, some of your symptoms sound like some of those seen with ARS.  But you could say the same about a hundred other conditions.  Bad sore throat is rarely if ever the main symptom. and on balance, no, your symptoms do not sound like you had ARS.  You give a classical story for strep throat with exanthem (scarlet fever).

I don't know what your "doing the right thing" comment means.  You don't describe anything you did wrong, as far as I can tell.

I know that intellect can be overwhelmed by emotion, but  you really need to mellow out.  The chance you have HIV really is microscopically low.  Get tested if you want further reassurance.

[lagoon77]

Thanks for the response,  honestly at the moment HIV wasn't in the front of my mind, however when thinking about it later these symptoms seem very similar to ARS and started right around that time period. Does this sound like ARS?

I'm extremely nervous from all of this, I really thought I was doing the right thing in this case.  

[H. Hunter Handsfield, M.D.]

Your risk of HIV was close to zero from the exposure you describe, and that fact is not altered by the strength of the strep test.  In any case, your symptoms are most suggestive of a non-HIV viral infection, or strep throat (perhaps with scarlet fever, explaining the skin rash). Many people with true strep infection have weakly positive rapid strep tests, and the rapid response to antibiotics also is against HIV as the cause of your symptoms.

Did you discuss your concerns with your own doctor?  What did s/he say?  You could have an HIV test and put your fears to rest.  Enough time has gone by so that a negative antibody test would be highly reliable; or you could wait until the 6 week mark for 100% security.

Good luck--  HHH, MD