Anxious...should I test again

[ssanxious]

Dr HHH,  I am a male 36yrs (uncircumsized, straight, healthy, monogamous) living in US. 15 weeks back I had a low-risk exposure (Kissing 3-4 secs with Saliva exchange, HJ 6-8 secs – I did not ejaculate, my hand rubbed stripper’s vagina 3 secs) exposure in a strip club in US. I was anxious and went to my FP on day 3. As I was anxious, he ordered a HIV screening test, came back -ve. On day 5,  I developed two pimples 3 inches below my navel. On week 3, I developed lesions on my foreskin after sex with my wife (she does not have any STDs). I took Doxy for week and the lesions subsided.

On day 39 after the exposure I got a Roche Elecsys p24 Ag/Ab test done abroad, came back -ve.

At week 10 I started getting fever, body aches with Pharyngitis. I do have a tonsils problem and get Pharyngitis and/or Sinus infection, avg 3 times a year. I went to my FP on day 79 and he looked at my throat and ordered Amoxicillin. He also ordered for a HIV screening, Syphilis test and a CBC. All came back negative with normal CBC (WBC count 8.7).

Later, the Pharyngitis got worse and I had to take a dose of Augmentin after my Amox dose. I also developed Allergic Rhinitis and also started having mild eye infection (1st right eye and the then left). Since last 2 days I started having discomfort near my groin and passed a drop of blood late last night with urine.

Yesterday, I went for a Urine analysis and CBC and CMP. Urine analysis shows Blood at 25 high, WBC 20-50 and Leuko at 500 High. The WBC in CBC is 15.9. My FP gave Levaquin now.

My questions:
1. Should I be concerned about HIV and go for another test now?
2. Is there a possibility of late seroconversion (esp. on a low risk exposure) with 11 weeks test being false negative?
3. Should I test for any other STD or is this kidney related?
4. What does Blood and WBC in urine indicate?
5. What could be my real risk here and why is my immune system behaving so erratic? Is this stress related ?

[Edward W Hook, MD]

You promised no more questions.  You do not have HIV.  There is no need for further testng. EWH

[alienshadow]

You are negative for hiv and stds its time for you to ck back with your dr. You need to move on from here end of story.There is no need to retest

[ssanxious]

Doctor,

I spoke to FP and got X-Ray, Ultrasound, CT Scan for adbomen (Kidney, Bladder, Galbladder). Everything came back normal.

My Urine culture however, had EColi. Since I started taking Levaquin I feel better, all groin pain gone.

Once again, Tests results so far:
Day 3 ELISA Neg
Day 39 p24 Ag/Ab Neg
Day 79 ELISA Neg, Syphilis Neg
Day 105 Urine culture on GC, Chlamydia Neg

Doc, my question (pls one last), should I take that high WBC in CBC/Urine are due to UTI (E Coli) and move on?

OR should I restest for HIV/STD?

Please do answer...anxious!

[ssanxious]

Thanks Doc. Reassuring! You provide great service and advice.

Joggen - I never had any "'real" risks in the past before this episode. I hope (& I believe) your are right; Its a bitter sweet - Guilt is better than Infection!

As for me, I will move on now to address my current urine analysis issue with and other anxiety/guilt related issues.

[joggen]

Buddy,

You can't get HIV from a stripper without sexual penetration. period. And your test results prove you didn't get it from any real risks you may have had in the past.

You paid $15 for the doctor's opinion, which he already gave. I strongly suggest you believe it and move on.

A lot of people who come on here with no risk exposures have guilt issues; I suggest you might want to look into that if you can't shake this.

[Edward W Hook, MD]

None whatsoever.  It was not ARS. EWH

[ssanxious]

Doctor,

One last question on ARS? Is there are remotest possiblity that my symptoms that started on week 10 (now ongoing till wk 15) are ARS and that caused the high WBC?

I pledge no more questions beyond this. Thanks

[Edward W Hook, MD]

You are now moving from STD issues to kidney stones. That is beyond the scope of this forum.  After this answer there will be no further answers.

Yes, I think an ultrasound is an appropriate next step.  EWH

[ssanxious]

Doctor,

Just wanted to update you. My Urine culture for GC, Chlamydia came -ve.

You were right, Kidney stones is the likelyhood for blood in urine and high WBC in CBC. Since my doc already gave me Levaquin (for UTI), I will wait and get the Ultrasound for Kidneys by next week. Is that the right thing to do? Pls advise.

[ssanxious]

Thank you for the advise Doctor!  It is very reassuring. Part of me did rule out HIV/STD after initial anxiety caused by the embarassing incident, but I kept getting these symptoms since week 10 which were bothering. Now, I can contribute Pharyngitis,Sinus, Rhinitis to my stress. If I look back my Pharyngitis episodes are almost always during stressful times or due to acute sinus infection.

I suspect blood in urine (this is the first time) is probably a kidney stone and trauma caused by exercise. I did run on Sunday afternoon (not much 2 miles, but more of a sprint after a long time). Exertion plus already dehydrated body with high Antibiotic dosage for 20 days, Guifenisin, Sinus infection, Allergic Rhinitis, too much of green tea (diuretic) etc probably is causing the blood in urine. I strongly suspect trauma on Sunday casued blood in urine, because 5 weeks back my WBC in CBC was normal, now its high. Am I guessing right, I am not trained in medical field?

Now, the Kidney stone part you brought up is interesting. For the last 2 years I have complained to both my FPs (changed my physician last year) of right leg and abdomen pain and lower back pain on right side. My docs always brushed it away and prescribed more exercise, sitting position changes as I used to drive a lot.

While this is not the appropriate forum for urology, I would still like to keep you and the forum posted with the findings. Hope thats OK.  

Thanks again!

[Edward W Hook, MD]

Your question suggests that you are quite worried about this very low (actually no-) risk exposure which occurred over 10 weeks ago.  The overwhelming evidence is that you did not get HIV from the exposure you describe, that you need not worry and that you do not need further testing.  On to your specific questions:

1.  No, absolutely not. At this time 99% of tests that are going to be positive will have already become positive.  Since your initial exposure was no risk to start with, you do not need further testing.
2.  No, virtually none whatsoever.
3 & 4.  The WBC in your urine might suggest this however between the doxycycline and augmentin you've taken, the chances of you having an STD are very low, not to mention the no risk nature of your exposure.  Since red blood cells were also there in the urine, a kidney stone might be a possibility or, although unlikely, a urinary tract infection.  I would talk with your regular health care provider about whether further evaluation of your urine test is warranted, putting STDs very on the list of possibilities.
5.  Your biological risk is zero.  Stress could be contributing somewhat to your problems but you still have a (non STD) abnormality in your urine test.  If you repeat the urine test and the abnormality is no longer present, I would not worry further but if it is still there, as I said, you and your doctor may wish to address it.

Hope this helps.  This is not HIV or an STD.  EWH