How much of a risk could this be?

[Awesomeo123]

Dear Dr,

I was out on the weekend in a pretty dreadful drunken state, somehow I lost one of my shoes near the start of the night in a nightclub (idiotic I know!) so stayed out for the rest of the night with one shoe on, the other foot with just my sock on.   Due to drunkness, I can't remember a lot of the night but woke up the next day with my big toe swollen, blue with blood dried to the rest of my toes.  Obviously my foot had been trampled on a lot, and has only now stopped hurting but I have started fearing, as the club wasn't in the best area and there would have been a lot of party drug users in the club, could I have maybe stepped on a needle or syringe at some point in the night or when I left the club?  There was no puncture wounds on the heel or ball of my foot, just my big toe being crushed and a few scrapes to the front of my toes.  Even though due to this fact, I can't get the idea out of my head!

So my questions are -

1.If I did step on a needle, what are the chances that I could have become infected with HIV or anything else?

2.If I did step on one, would the puncture wound bruise, hurt and be visable for a few days?

3.Would you recommend HIV testing?

4.Would you recommend continuing unprotected sex with my partner?

I thank you in anticipation of your response.

Kindest regards

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

We got a fair number of questions about injuries in the environment and the potential of infection if the sharp object happened to be contaminated with HIV. The answer is always pretty much the same: in the three decades of the recognized worldwide HIV/AIDS epidemic, there has never been a single HIV infection reported to have been acquired in this manner. Even if somehow there had been a used drug injection needle involved in your toe injury (which seems extremely unlikely anyway), the chance there was sufficient live virus still present is very low.

Those comments directly or indirectly answer all your questions, but to be explicit:

1) No measurable risk; this has never happened and you won't be the first case.

2) It is hard for me to imagine that a needle stick is responsible for most of the signs of injury you describe.

3,4) I definitely do not recommend testing and you should continue your normal sexual practices with your partner without worry.

I hope these comments help ease your worries.  Best wishes– HHH, MD

[Awesomeo123]

Dr Handsfield,

Thank you for the mega quick reply and for totally putting my mind at ease!

You do an amazing job here for all the people like me who totally over-think situations like these.

Best wishes,