[Question #10012] Follow Up on Exposure
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26 months ago
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Hi doctors. Sorry for coming back so soon, but I have still a few concerns that I want to address with you. Do you truly believe is just a coincidence?
- testicles pain (like heaviness and pressure)
- Penis and anal pain
- groin, perineal pain that also spreads to my upper thighs
- Diagnosed with a "bladder neck obstruction" an according to my urologist is mostly sure caused by an infection..what infection??
- difficult starting and maintaining urine stream as well as frequent urination
- Bowel movements cause pain and urge to urinate before and during
- I do feel like dripping out of my penis, sometimes I dont get to see anything, sometimes I get to see some transparent discharge (like pre cum) but randomly during the day. Other days I feel the same but as it is urine rather than discharge
- Very small ejaculation and almost without any force
1) Mostly what I want to know is if you truly believe all these is just coincidental. Never had anything like this before and a few days post encounter all this starting and not getting any better 14 months later, just worse.
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26 months ago
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Sorry I wanted to be super clear on my symptoms and ran out of space:..
2) What does complicated or long lasting not treated Gonorrhea's looks like in men?
3) What does complicated or long lasting not treated Chlamydia looks like in men?
4)I had a bunch of HIV tests also during this time almost monthly for a year, all negative. 12 months post encounter I had one positive P24 Antigen, Retested with 4th gen test, negative, also western blot and PCR test, all negative. Could this P24 positive at 12 months mean anything?
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Edward W. Hook M.D.
26 months ago
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You are hung up totally inappropriately on the possibility that your symptoms are due to an STI from a single exposure which occurred long ago. Get over it. I have explained in detail why your risk was very low and then went on to explain how you had proven that your symptoms were not due to an STI. I also explained to you that your symptoms are far more typical of prostatitis than an STI. I will not repeat the explanation
You ran out of space because you failed to follow Forum rules and exceed the word limit with your repetitive questions. My answers will be brief
1. Yes
2 and 3. Complicated gonorrhea or chlamydia does not in any way resemble your symptoms. Persons with these infections have positive tests. You have multiple negative tests. Local complications of gonorrhea or chlamydia include testicular pain accompanied by a urethral discharge
Please re-read my original reply. EWH
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26 months ago
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Thanks doctor.
Those specific complications that you mention are the same that I have now, testicular pain and a feeling of something dribbling out of my penis, if I milk it I get to see transparent liquid, isnt this discharge? I understand Chlamydial discharge could look like this.
There are also no signs of prostatitis in tests, no enlarge prostate and normal DRE exam. So what could I do with this case?
Isn't it possible that chlamydia went asymptomatic for long period then passes on thru other parts of my urinary system and causing more severe damage like the bladder neck obstruction my doctor found that is mainly caused by infections?
Could you also comment on question #4?:
4)I had a bunch of HIV tests also during this time almost monthly for a year, all negative. 12 months post encounter I had one positive P24 Antigen, Retested with 4th gen test, negative, also western blot and PCR test, all negative. Could this P24 positive at 12 months mean anything? All these lasts test were done 12 months post exposure
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Edward W. Hook M.D.
26 months ago
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Your tests for chlamydia are negative. As small amount of penile moisture is normal. if abnormal, his possible discharge could be a result of prostatitis or constant self-examination.
Bladder neck obstruction is not a known complication of chlamydial infection (which there is no evidence that you ever had)
Your single positive p24 antigen was almost certainly falsely positive, as proven by your subsequent tests which included a RCR test which certainly would have been positive if you were HIV infected.
I have already told you what I suggest that you do- accept that you do not have an STI, seek professional counseling and mental health assistance to deal with your unwarranted concerns that you have an STI.
EWH
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26 months ago
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Sorry doctor but now Im nervous what do you mean by "almost certainly false positive"?
I was assured by the infectious disease specialist that I visited that it was undoubtedly a false positive result because there's no way P24 would just appear for the first time 1 year after exposure. I had multiple tests all year almost monthly starting 1 month post exposure with Ag/Ac HIV tests and all came back negative (this tests should pick up P24 antigen right?)
I had PCR HIV test at 6 months also negative
I had P24 Antigen as a standalone test at 6 months - also negative
The same P24 standalone test at 12 months came back positive, but P24 was negative on Western Blot from a sample taken just 1 week later after the P24 positive result. PCR was negative as well and also another Ag/Ac HIV test (this would have picked up the P24 antigen too right?)
Do you believe there's still a probability of it not being false positive? How good are Western Blot tests? Could it be possible that 1 year after exposure someone has just started to develop P24 Antigen and have no viral load detected and no antibodies?
How reliable is a PCR HIV test 1 year post exposure?
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Edward W. Hook M.D.
26 months ago
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In your earlier questions, you were looking for indications that your problems were due to an STI. I indicated that there was no reason for concern but you expressed concern over my choice of words. I indicated to you at that time "I'm sorry you are feeling so insecure and mincing words". That remains the case. In science and medicine there are no absolutes. New information and findings occur on a daily basis. As scientists, we try to provide accurate, science-based information and advice. You have trouble accepting this. ALL of the evidence and subsequent testing you have had through your persistent excessive testing has provided proof that you do not have HIV (or other STI) and that your solitary positive HIV p24 antigen test was falsely positive. You need to believe this and move forward.
This will be the last response as part of this thread. Further, should you return with further unwarranted, anxiety-driven questions about test accuracy or arguing that your perceived symptoms are due to an STI from your casual encounter long ago, the question may be deleted without a response and without return of your posting fee. Our assessment is not going to change. EWH---
In the same manner, you need to accept that your symptoms are not due to an STI and move on withour further testing or concerns. I fear that you will have trouble doing that which is the reason that I suggested counseling.