White spots on tongue @ 6 weeks after possible exposure

[gophish11]

Six weeks ago, I performed unprotected oral on another man, without ejaculation, but I know there was precum present.  I had gums that would occasionally bleed at the time, but I don't recall bleeding during the contact.  I asked him about his status - he said he was HIV negative and that he doesn't "do this kind of stuff" often enough to be concerned, but didn't mention having gotten a test.  I also performed unprotected cunnilingus on Jan. 1.  Last week, I caught the flu or a nasty cold, fever and sweats for a day, lymph nodes in neck, groin, and under one arm were swollen, and are still slightly swollen now.  A rapid HIV antibody test came out negative yesterday, about six and a half weeks after exposure, providing me some peace of mind.  I do have a symptom, however that continues to worry me:

Over the past week I've developed a white patch on the middle of my tongue, that's gotten somewhat bigger and more visibly noticable, with a smaller spot behind it.  The larger patch is about 1/8 inch diameter and irregularly shaped.  I have what I assume is a "geographic tongue", and often a white fuzzy looking coating, that brushes off fairly easily.  The new patches of concern do not brush off and feel a little hard, and raised slightly from the rest of the tongue.  They appear similar to the gunk that builds up on my tongue that I can brush off, but these ones remain and are slightly tender to touch.  They look like larger white tastebuds, but appear similar to pictures of mild thrush cases.

My questions:
1).  I know you can't diagnose thrush without seeing the patient, but are my symptoms consistent with a thrush infection?

2).  If this were an HIV-related thrush infection, would I have tested positive yesterday, or is it possible to have such a case BEFORE antibodies were detectable, as part of acute infection?

3).  How conclusive do you think yesterday's test was in terms of being an accurate negative result?

[gophish11]

Thank you doctor, your advice has helped myself and countless others dealing with HIV preoccupation.  To clarify, the contact was between HIS penis and MY anus, I'm sure slightly elevating the risk, but minimal nonetheless?

[maynemt]

A related discussion, Thank you, but still not sure was started.

[Edward W Hook, MD]

Still minimal risk.  sorry for the confusion.  EWH

[Edward W Hook, MD]

You mention oral sex with two partners and unprotected rubbing of your penis and a partner's anus as your risk factors.  There is very., very little risk to your oral sex and no risk from placing your penis near his rectum without penetration.  Thus, even before we address your tongue, it is most unlikely that you have HIV.

Then we add to that a negative HIV antibody test over 6 weeks after exposure and this makes your risk of infection about as close to zero as it can get.  You do not have HIV. Now let's deal with your questions:

1.  No, your symptoms do not suggest thrush but some other process.  Among other things, thrush is more likely to occur on the roof of the mouth than the tongue.
2.  If you had thrush (and you do not) it still would not be related to HIV.  HIV persons tend to have had their infections for years before their immunity gets so low that they have increased risk for getting thrush.
3.  I urge you to believe your test result. You do not have HIV and do not need further testing.

Hope this helps.  EWH

  

[gophish11]

I forgot to mention there was also unprotected rubbing between my anus and his penis, but no penetration, and only for a very short time -

Thanks in advance for your time.