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Suggest Treatment For Seroconversion Illness Symptoms
Question: Hello Doctor
My question is going to be a little long and I request your attention and response so that it can ease my mind.
1. I had unprotected sex with a girlfriend (Married to someone else now) in January 2015. A week later, I realized that I had contracted an infection in the form of Chancroid (diagnosis by three different doctors). I got treated with antibiotics and it was cured by the second week of February 2015.
2. I got tested for HIV I&II by ELISA in February 2015, four weeks after my exposure. HIV Status of the girl was unknown to me then and to her as well. I also got tested for Genital Herpes. Both test results came negative.
3. The girl discovered she is pregnant during that time and also decided to take an HIV I&II Test about 6 weeks after our encounter and the results were Negative.
4. I again got genital lesions that was diagnosed as Genital Herpes and I also got diagnosed with Genital Warts in March 2015.
5. I got tested for Herpes, Syphilis, Hepatitis B & C towards end March 2015 and all tests came negative. I also got a PCR HIV Test at 70 days post exposure for HIV I&II and the results came as Not Detectable for both. I also got an Ultrasound done in both my armpits, neck and scrotum which revealed Grade I Varicocele and Regional Lymphadenopathy in the neck even though both armpits were clear with no swollen lymph nodes (all of these tests were conducted in end March 2015)
6. The girlfriend got tested for HIV I&II again as part of the routine process during pregnancy in the month of April 2015 after 10 weeks from our last sexual encounter and turned out Negative.
7. Since then, I have had an apparent Herpes Outbreak almost once every month (not sure whether they are Herpes outbreaks or not) and I have taken Valacyclovir to treat these. I have also had my warts removed twice with a single dose injection of Interferon given locally in the month of XXXXXXX 2015 and again now last week in August 2015.
8. I have had unexplained mild pain on occasions under both my armpits over the last few months and moderate to severe pain behind my right knee at times. I was also experiencing an on and off pain in my right groin which subsided after a 10 day course of Nucoxia 60mg twice a day and the course got over in XXXXXXX 2015 but has returned again since last week.
9. I can also feel a one painless bump inside my mouth under the lower lip and one under my upper lip which are not painful and which are not causing me any discomfort yet and wish to know if they are connected to my other problems or are they isolated. I also experience random one or two day episodes of itching behind my ears and occasional pain in my groin area
10. I have not had any kind of sexual contact with anyone since January 2015. Most importantly, I am seriously dating someone presently and wish to get married soon.
11. MY QUESTION: Can I hope to lead a normal happy married life and plan a baby? Do I need more HIV Testing or am I clear?
Also, should I reveal my health condition to my fiancee and reveal everything to her?
Please respond.
P.S. I am taking Olive Leaf Extract capsules twice a day as I have read extensively about it's benefits in fighting such infections.
My question is going to be a little long and I request your attention and response so that it can ease my mind.
1. I had unprotected sex with a girlfriend (Married to someone else now) in January 2015. A week later, I realized that I had contracted an infection in the form of Chancroid (diagnosis by three different doctors). I got treated with antibiotics and it was cured by the second week of February 2015.
2. I got tested for HIV I&II by ELISA in February 2015, four weeks after my exposure. HIV Status of the girl was unknown to me then and to her as well. I also got tested for Genital Herpes. Both test results came negative.
3. The girl discovered she is pregnant during that time and also decided to take an HIV I&II Test about 6 weeks after our encounter and the results were Negative.
4. I again got genital lesions that was diagnosed as Genital Herpes and I also got diagnosed with Genital Warts in March 2015.
5. I got tested for Herpes, Syphilis, Hepatitis B & C towards end March 2015 and all tests came negative. I also got a PCR HIV Test at 70 days post exposure for HIV I&II and the results came as Not Detectable for both. I also got an Ultrasound done in both my armpits, neck and scrotum which revealed Grade I Varicocele and Regional Lymphadenopathy in the neck even though both armpits were clear with no swollen lymph nodes (all of these tests were conducted in end March 2015)
6. The girlfriend got tested for HIV I&II again as part of the routine process during pregnancy in the month of April 2015 after 10 weeks from our last sexual encounter and turned out Negative.
7. Since then, I have had an apparent Herpes Outbreak almost once every month (not sure whether they are Herpes outbreaks or not) and I have taken Valacyclovir to treat these. I have also had my warts removed twice with a single dose injection of Interferon given locally in the month of XXXXXXX 2015 and again now last week in August 2015.
8. I have had unexplained mild pain on occasions under both my armpits over the last few months and moderate to severe pain behind my right knee at times. I was also experiencing an on and off pain in my right groin which subsided after a 10 day course of Nucoxia 60mg twice a day and the course got over in XXXXXXX 2015 but has returned again since last week.
9. I can also feel a one painless bump inside my mouth under the lower lip and one under my upper lip which are not painful and which are not causing me any discomfort yet and wish to know if they are connected to my other problems or are they isolated. I also experience random one or two day episodes of itching behind my ears and occasional pain in my groin area
10. I have not had any kind of sexual contact with anyone since January 2015. Most importantly, I am seriously dating someone presently and wish to get married soon.
11. MY QUESTION: Can I hope to lead a normal happy married life and plan a baby? Do I need more HIV Testing or am I clear?
Also, should I reveal my health condition to my fiancee and reveal everything to her?
Please respond.
P.S. I am taking Olive Leaf Extract capsules twice a day as I have read extensively about it's benefits in fighting such infections.
Brief Answer:
Poly microbial STD.Require reassessment of HIV status.
Detailed Answer:
Hello, Sir.
I understand your concern.
I have gone through your entire query with great insight.
You have been tested negative twice for HIV 1,2 at 4 weeks and 70 days.
You have also been tested for Hbs Ag, HSV 1,2 and VDRL all three tested negative.
You have taken an initial test for Hiv Screen after 4 weeks of exposure which is reasonable to overcome window period. Even on day 70 the test came negative.
But you seem to have symptoms similar to seroconversion illness. But having said that coexistent lesions like Herpes flares-March, XXXXXXX and subsequently thereafter(herpes virus is known to cause frequent flares irrespective of negative blood tests) prior to which are the genital Chancroid in XXXXXXX 2015 and oral ulcers in march 2015.
These infections are largely responsible for producing "Seroconversion like" illness -symptoms of tender armpit nodes, pain behind knees and right groin, itching in the groin etc. Seroconversion illness is usually caused by HIV, but also other coexisting infections.Hence, a recheck for HIV is important under the current context.
Hence, you need two important changes pertaining to your current therapy and disease course.--
1.To prove seroconversion-like illness is not due to HIV-?
Sometimes seroconversion does not take place even after 1 year in few individuals these people are more prone to get false negative results on ELISA.
I advise you to get a repeat ELISA FOR HIV 1,2 using 4th Gen test kit.
Additionally I advise you to get a CD4 count. I have ordered these tests only to make sure that you are completely 100% free of HIV 1,2.
2.Benzathine Penicillin G is not added to your current list of medications.?
This drug is mandated in cases of clinically proven chancroid lesions.This if untreated can lead to further complications later on.You already had an oral painless lesion -inside mouth and lips.after 4-5 months of initial chancroid.
The above need has to be stressed to your doctor.
please note the additional tests prescribed for HIV have to be carried once again only after initiation of treatment with XXXXXXX Pen G.Please check with your doctor if he shares my views and if can be prescribed to you.
Yes, you can certainly lead a normal life, fathering a child once all these infections have to be eliminated both clinically and biochemically.
Yes, you are supposed to reveal all the issues so far happened to your fiancee and explain that you are not 100% free of viral illness and may require further evaluation.This move will only gain confidence and support between you couple.
Olive leaf extract has no scientifically proven effects on these infection control.
Post your further queries if any.
Thank you.
Poly microbial STD.Require reassessment of HIV status.
Detailed Answer:
Hello, Sir.
I understand your concern.
I have gone through your entire query with great insight.
You have been tested negative twice for HIV 1,2 at 4 weeks and 70 days.
You have also been tested for Hbs Ag, HSV 1,2 and VDRL all three tested negative.
You have taken an initial test for Hiv Screen after 4 weeks of exposure which is reasonable to overcome window period. Even on day 70 the test came negative.
But you seem to have symptoms similar to seroconversion illness. But having said that coexistent lesions like Herpes flares-March, XXXXXXX and subsequently thereafter(herpes virus is known to cause frequent flares irrespective of negative blood tests) prior to which are the genital Chancroid in XXXXXXX 2015 and oral ulcers in march 2015.
These infections are largely responsible for producing "Seroconversion like" illness -symptoms of tender armpit nodes, pain behind knees and right groin, itching in the groin etc. Seroconversion illness is usually caused by HIV, but also other coexisting infections.Hence, a recheck for HIV is important under the current context.
Hence, you need two important changes pertaining to your current therapy and disease course.--
1.To prove seroconversion-like illness is not due to HIV-?
Sometimes seroconversion does not take place even after 1 year in few individuals these people are more prone to get false negative results on ELISA.
I advise you to get a repeat ELISA FOR HIV 1,2 using 4th Gen test kit.
Additionally I advise you to get a CD4 count. I have ordered these tests only to make sure that you are completely 100% free of HIV 1,2.
2.Benzathine Penicillin G is not added to your current list of medications.?
This drug is mandated in cases of clinically proven chancroid lesions.This if untreated can lead to further complications later on.You already had an oral painless lesion -inside mouth and lips.after 4-5 months of initial chancroid.
The above need has to be stressed to your doctor.
please note the additional tests prescribed for HIV have to be carried once again only after initiation of treatment with XXXXXXX Pen G.Please check with your doctor if he shares my views and if can be prescribed to you.
Yes, you can certainly lead a normal life, fathering a child once all these infections have to be eliminated both clinically and biochemically.
Yes, you are supposed to reveal all the issues so far happened to your fiancee and explain that you are not 100% free of viral illness and may require further evaluation.This move will only gain confidence and support between you couple.
Olive leaf extract has no scientifically proven effects on these infection control.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
Helloe Dr. Heijebu
Thank you for your detailed response. However, a couple of things are incorrect in your response.
1. I do not have or had any oral lesions. They are a couple of painless bumps/glands inside the mouth, one inside the lower lip and one under the upper lip which is like a pimple that is usually not there when I wake up in the mornings but usually can be felt after I eat or drink something and both of them appeared around June/July 2015 and not in March as mentioned in your response.
Also, considering that the Chancroid was already cured, would you still recommend Benzathine Penicillin G to be administered intra muscularly and if yes, can you please mention the dosage and if it has any serious side effects.
2. I do not have tender armpit nodes but its more like a dull pain that comes and goes on its own periodically. What I do seem to have since last week is pain in the right groin and some atypical pain in the testicles (mild and only once or twice).
I did an ultrasound of my armpits, neck and groin in March 2015 at the same time when I had given blood samples for the other tests for PCR HIV, HSV, RPR and Hepatitis B & C and my armpits were found to be clear.
The ultrasound did reveal a Grade I Vericocele in my testicles and regional lymphadenopathy in the neck on 23 March 2015.
3. I have had three different doctors responding to same query on this website who have all said that PCR HIV is a Gold Standard test for HIV and I do not need further testing whereas your response has made me supremely anxious considering my plans for my future.
4. The pain behind my right knee has been attributed to postherpetic neuralgia (not sure what that means). The pain is not constant and is again random. It had gone off completely before last week when it came back after about a couple of months.
I have also consulted Dermatologists in XXXXXXX XXXXXXX as well as XXXXXXX in three different hospitals who have asked me not to worry about HIV post the PCR HIV Test.
With all due respects to you, I request you to only view this particular part of the question more as an expression of my mental anxiety and not as a question mark on your medical expertise.
Please advice.
Thank you for your detailed response. However, a couple of things are incorrect in your response.
1. I do not have or had any oral lesions. They are a couple of painless bumps/glands inside the mouth, one inside the lower lip and one under the upper lip which is like a pimple that is usually not there when I wake up in the mornings but usually can be felt after I eat or drink something and both of them appeared around June/July 2015 and not in March as mentioned in your response.
Also, considering that the Chancroid was already cured, would you still recommend Benzathine Penicillin G to be administered intra muscularly and if yes, can you please mention the dosage and if it has any serious side effects.
2. I do not have tender armpit nodes but its more like a dull pain that comes and goes on its own periodically. What I do seem to have since last week is pain in the right groin and some atypical pain in the testicles (mild and only once or twice).
I did an ultrasound of my armpits, neck and groin in March 2015 at the same time when I had given blood samples for the other tests for PCR HIV, HSV, RPR and Hepatitis B & C and my armpits were found to be clear.
The ultrasound did reveal a Grade I Vericocele in my testicles and regional lymphadenopathy in the neck on 23 March 2015.
3. I have had three different doctors responding to same query on this website who have all said that PCR HIV is a Gold Standard test for HIV and I do not need further testing whereas your response has made me supremely anxious considering my plans for my future.
4. The pain behind my right knee has been attributed to postherpetic neuralgia (not sure what that means). The pain is not constant and is again random. It had gone off completely before last week when it came back after about a couple of months.
I have also consulted Dermatologists in XXXXXXX XXXXXXX as well as XXXXXXX in three different hospitals who have asked me not to worry about HIV post the PCR HIV Test.
With all due respects to you, I request you to only view this particular part of the question more as an expression of my mental anxiety and not as a question mark on your medical expertise.
Please advice.
Brief Answer:
Relevant answers suggested.Kindly go through them carefully.
Detailed Answer:
Hello, Sir.
I apologise for the delayed response.
The word bump itself implies lesion in medical terms.Hence, I referred them to Lesions.This is a non-specific term to indicate disease manifestation.You need not worry about it.I reconsider them to have appeared in June/July.
Benzathine Penicillin is the appropriate drug of choice for Chancroid.Any other antibiotic will not clear the infection.The recommended schedule is 3 doses of 2.4 million units IM each at 1-week intervals.Please check with your doctor if he shares my view and if can administer it to you.Following this, you need to have VDRL titers repeated.
The side effects are often very minimal except you should strictly avoid this drug in case you have penicillin allergy.
2.Pertaining to the nodes, I reconsider them to be neck nodes and apologise for the same.Regional cervical(neck) lymphadenopathy is an important parameter which needs resolution.This can secondary to both HIV as well as Herpes outbreaks. Hence, this needs real time distinction.But the most common reason will be bouts of herpes.
The atypical testicular pain could be possibly related to Varicocele.Its not a major concern at this moment.
3.Pertaining to the pain at the back of the knee, post-herpetic neuralgia is extremely unlikely.PHN presents with extreme pain with tender skin lesions.Also this site, back of knee is unusual for its presentation. I advise you to get an Orthopedic consultation for the same after having an MRI scan.
4.Now coming to the big question, PCR HIV RNA.
I do agree that HIV PCR RNA is the gold standard for HIV detection.
But in your case, I wanted you to be doubly sure that your are 100% free of the virus since you are willing to marry in near future.The need to eliminate anxiety completely (after 3-month result), is to opt for another test taken again at 6 months.This is a rule of thumb. Retesting is important in your case.Good viral load for test detection usually develop after 3 months.
You had your PCR test 70 days post exposure.This is 1st inadequacy.Precise results are from day 90 onwards with a 2nd test on day 180.
The test can be negative if the Viral RNA levels are less than 900/ml for HIV 2 and less than 20/ml for HIV 1.This is called limit of detection LOD.If the viral levels are below LOD the test reports as Not Detectable.This does not always imply Non-existence of the virus. This is 2nd inadequacy.
You also seem to have a seroconversion-like illness on clinical grounds as mentioned in my earlier response.This is a kind of clinic-biochemical disparity(lab test negative but symptoms present).This is 3rd inadequacy.
Considering these 3 inadequacies, I advised you to for a repeat testing for HIV.
This is only to rule out the disease with great confidence beyond all doubts.
I hope there is absolutely no harm in taking another test.
I do agree with all your doctors from all states, but my intention is to be doubly sure leaving no stone untouched.Within logical limits, there is no wrong in using the technology if available.
Post your further queries if any.
Thank you.
Relevant answers suggested.Kindly go through them carefully.
Detailed Answer:
Hello, Sir.
I apologise for the delayed response.
The word bump itself implies lesion in medical terms.Hence, I referred them to Lesions.This is a non-specific term to indicate disease manifestation.You need not worry about it.I reconsider them to have appeared in June/July.
Benzathine Penicillin is the appropriate drug of choice for Chancroid.Any other antibiotic will not clear the infection.The recommended schedule is 3 doses of 2.4 million units IM each at 1-week intervals.Please check with your doctor if he shares my view and if can administer it to you.Following this, you need to have VDRL titers repeated.
The side effects are often very minimal except you should strictly avoid this drug in case you have penicillin allergy.
2.Pertaining to the nodes, I reconsider them to be neck nodes and apologise for the same.Regional cervical(neck) lymphadenopathy is an important parameter which needs resolution.This can secondary to both HIV as well as Herpes outbreaks. Hence, this needs real time distinction.But the most common reason will be bouts of herpes.
The atypical testicular pain could be possibly related to Varicocele.Its not a major concern at this moment.
3.Pertaining to the pain at the back of the knee, post-herpetic neuralgia is extremely unlikely.PHN presents with extreme pain with tender skin lesions.Also this site, back of knee is unusual for its presentation. I advise you to get an Orthopedic consultation for the same after having an MRI scan.
4.Now coming to the big question, PCR HIV RNA.
I do agree that HIV PCR RNA is the gold standard for HIV detection.
But in your case, I wanted you to be doubly sure that your are 100% free of the virus since you are willing to marry in near future.The need to eliminate anxiety completely (after 3-month result), is to opt for another test taken again at 6 months.This is a rule of thumb. Retesting is important in your case.Good viral load for test detection usually develop after 3 months.
You had your PCR test 70 days post exposure.This is 1st inadequacy.Precise results are from day 90 onwards with a 2nd test on day 180.
The test can be negative if the Viral RNA levels are less than 900/ml for HIV 2 and less than 20/ml for HIV 1.This is called limit of detection LOD.If the viral levels are below LOD the test reports as Not Detectable.This does not always imply Non-existence of the virus. This is 2nd inadequacy.
You also seem to have a seroconversion-like illness on clinical grounds as mentioned in my earlier response.This is a kind of clinic-biochemical disparity(lab test negative but symptoms present).This is 3rd inadequacy.
Considering these 3 inadequacies, I advised you to for a repeat testing for HIV.
This is only to rule out the disease with great confidence beyond all doubts.
I hope there is absolutely no harm in taking another test.
I do agree with all your doctors from all states, but my intention is to be doubly sure leaving no stone untouched.Within logical limits, there is no wrong in using the technology if available.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Dear Dr. Heijebu
Thank you for your detailed response once again and I really appreciate the time you have taken out to answer all my queries.
As advised by you, I shall follow the same and even though I have discussed with my doctor in XXXXXXX about your prescribed medication, he has asked me to get a CT Scan of my pelvic region and groin. He did seem in agreement about the Penicillin course but has asked me to get the CT Scan done first.
I would on my part however, would like to start with the Penicillin IM injections at the earliest possible.
1. Can you please share a prescription for the same so that I can purchase the drug and start the regimen. I am most willing to remit your fees by means of account transfer in any bank of your choice in advance. You could send me the prescription on my e-mail address so I can take a print and get the first dose. Also, how do I ascertain if I have Penicillin allergy or not?
I am assuming that you would recommend a skin test for the Penicillin G before getting the same administered.
2. Also wanted to share with you that the pain in my armpits is also being felt in the surrounding muscle area which is a little baffling to me. The only reason I have been inclined to connect this pain with my infection is because the armpit pain first appeared after around a month of the Chancroid infection.
3. You have also advised me to take a VDRL test which I know is for Syphilis. Are you suspecting a Syphilis infection in my case?
4. One thing I forgot to mention earlier is that for the past couple of months, I have felt something in my pelvic region on the right side as if there is something inside and the feeling starts usually sometime after I wake up. I do not feel anything when I am lying down.
I had consulted a general physician here who said it could be the initial stages of Inguinal Hernia and had advised an Ultrasound of the area which did not reveal anything. I did not mention anything of my other infections to this doctor. What is your opinion on this?
5. Now to the big and biggest concern of HIV. First of all, accept my sincere apologies if any of my questions or points in this regard have seemed offensive to you in any way.
It is just that I had started to come out of the fear of HIV before you again told me of the symptoms and the need to get tested again. It had taken a lot of courage and endless nights of anxiety, stress and depression for me to get tested the first couple of times.
I had almost decided to contemplate suicide in case of any misfortune after getting tested.
As you may imagine, I have an old set of parents to take care of and a younger brother who's yet to get married.
I had also reached out to Dr. Kutikuppala XXXXXXX XXXXXXX who's known to be the foremost specialist in HIV/AIDS in XXXXXXX
Without making this too emotional, I would like to conclude by saying that I shall follow your advice and get the Penicillin G as soon as I can get a prescription from you.
Look forward to hearing from you soon.
Warm Regards
XXXX
Thank you for your detailed response once again and I really appreciate the time you have taken out to answer all my queries.
As advised by you, I shall follow the same and even though I have discussed with my doctor in XXXXXXX about your prescribed medication, he has asked me to get a CT Scan of my pelvic region and groin. He did seem in agreement about the Penicillin course but has asked me to get the CT Scan done first.
I would on my part however, would like to start with the Penicillin IM injections at the earliest possible.
1. Can you please share a prescription for the same so that I can purchase the drug and start the regimen. I am most willing to remit your fees by means of account transfer in any bank of your choice in advance. You could send me the prescription on my e-mail address so I can take a print and get the first dose. Also, how do I ascertain if I have Penicillin allergy or not?
I am assuming that you would recommend a skin test for the Penicillin G before getting the same administered.
2. Also wanted to share with you that the pain in my armpits is also being felt in the surrounding muscle area which is a little baffling to me. The only reason I have been inclined to connect this pain with my infection is because the armpit pain first appeared after around a month of the Chancroid infection.
3. You have also advised me to take a VDRL test which I know is for Syphilis. Are you suspecting a Syphilis infection in my case?
4. One thing I forgot to mention earlier is that for the past couple of months, I have felt something in my pelvic region on the right side as if there is something inside and the feeling starts usually sometime after I wake up. I do not feel anything when I am lying down.
I had consulted a general physician here who said it could be the initial stages of Inguinal Hernia and had advised an Ultrasound of the area which did not reveal anything. I did not mention anything of my other infections to this doctor. What is your opinion on this?
5. Now to the big and biggest concern of HIV. First of all, accept my sincere apologies if any of my questions or points in this regard have seemed offensive to you in any way.
It is just that I had started to come out of the fear of HIV before you again told me of the symptoms and the need to get tested again. It had taken a lot of courage and endless nights of anxiety, stress and depression for me to get tested the first couple of times.
I had almost decided to contemplate suicide in case of any misfortune after getting tested.
As you may imagine, I have an old set of parents to take care of and a younger brother who's yet to get married.
I had also reached out to Dr. Kutikuppala XXXXXXX XXXXXXX who's known to be the foremost specialist in HIV/AIDS in XXXXXXX
Without making this too emotional, I would like to conclude by saying that I shall follow your advice and get the Penicillin G as soon as I can get a prescription from you.
Look forward to hearing from you soon.
Warm Regards
XXXX
Brief Answer:
Need for CT scan and VDRL test stressed.
Detailed Answer:
Hello, Sir.
I understand your concern.
I apologize for my delayed response.
Starting the course of penicillin with prior skin testing is all mandate.
You can ascertain the penicillin allergy by skin testing.This is done with the help of PRE-PEN test supply kit.The skin on the inner aspect of the forearm is used and results are interpreted after 15 min.This can done by a doctor as well as a nurse.
Yes, surrounding armpit pain is related to the infection.This is a usually inflammatory response in regional lymph nodes and surrounding soft tissues.Do not focus much on it.
Pertaining to groin/pelvic discomfort as you have mentioned- a mass sensation could be a hernia.Ultrasound cannot detect all forms of hernias. CT scan of the pelvis is the best test that can throw light on the symptoms.Hence, your doctor rightly advised you so.
You have earlier undergone RPR(Rapid Plasma Reagin)test-This test is used for screening of syphilis only.But it is not a specific test.The term "reagin" means that this test does not look for antibodies against the actual bacterium, but rather for antibodies against substances released by cells when they are damaged by the syphilis-causing bacterium.Hence, I asked for VDRL.
VDRL test can be used to track the progress of the disease over time and its response to penicillin therapy.Syphilis should always be the prime suspect by a physician in any case of unprotected and unsafe sexual practices.This is a routine practice. With the clinical picture of yours so far, the possibility of syphilis cannot be ruled out completely. Hope I clarified your doubt on this.
Sir Coming to your concern over HIV status-I has already explained to you in detail.The point is only to make sure that you are 100 % free of the virus.But as mentioned earlier there are few limitations with regards to your test time and test as well.A repeat test at a said time is only more conclusive.The tests which you underwent so far on HIV will give you 95% clearance.I want you to get a 100% clearance.I do not want to leave any stone untouched in your case.That's it.
I understand your personal issues.Do not lose your heart.Be bold and brave.Things will soon fall in their place.There is no need to over stress at this point.You have already done a great deal of medical investigations that have revealed results in your favors.My email is YYYY@YYYY me with your email address with regards to penicillin prescription.Do not ever think of suicide.Be courageous.
Post your further queries if any.
Thank you.
Need for CT scan and VDRL test stressed.
Detailed Answer:
Hello, Sir.
I understand your concern.
I apologize for my delayed response.
Starting the course of penicillin with prior skin testing is all mandate.
You can ascertain the penicillin allergy by skin testing.This is done with the help of PRE-PEN test supply kit.The skin on the inner aspect of the forearm is used and results are interpreted after 15 min.This can done by a doctor as well as a nurse.
Yes, surrounding armpit pain is related to the infection.This is a usually inflammatory response in regional lymph nodes and surrounding soft tissues.Do not focus much on it.
Pertaining to groin/pelvic discomfort as you have mentioned- a mass sensation could be a hernia.Ultrasound cannot detect all forms of hernias. CT scan of the pelvis is the best test that can throw light on the symptoms.Hence, your doctor rightly advised you so.
You have earlier undergone RPR(Rapid Plasma Reagin)test-This test is used for screening of syphilis only.But it is not a specific test.The term "reagin" means that this test does not look for antibodies against the actual bacterium, but rather for antibodies against substances released by cells when they are damaged by the syphilis-causing bacterium.Hence, I asked for VDRL.
VDRL test can be used to track the progress of the disease over time and its response to penicillin therapy.Syphilis should always be the prime suspect by a physician in any case of unprotected and unsafe sexual practices.This is a routine practice. With the clinical picture of yours so far, the possibility of syphilis cannot be ruled out completely. Hope I clarified your doubt on this.
Sir Coming to your concern over HIV status-I has already explained to you in detail.The point is only to make sure that you are 100 % free of the virus.But as mentioned earlier there are few limitations with regards to your test time and test as well.A repeat test at a said time is only more conclusive.The tests which you underwent so far on HIV will give you 95% clearance.I want you to get a 100% clearance.I do not want to leave any stone untouched in your case.That's it.
I understand your personal issues.Do not lose your heart.Be bold and brave.Things will soon fall in their place.There is no need to over stress at this point.You have already done a great deal of medical investigations that have revealed results in your favors.My email is YYYY@YYYY me with your email address with regards to penicillin prescription.Do not ever think of suicide.Be courageous.
Post your further queries if any.
Thank you.
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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