[Question #1327] Persisting Issues Ref: Q1090 & Q1207

46 months ago
Dear Doctors,
First of all, your service has been of significant help to me so thank you. If you quickly referenced my questions posed 3 months ago, you'll recall I had a traumatic HIV scare. I won't belabor all of the symptoms I experienced. The good news is that I was conclusively negative through testing. I tested positive for HSV1, EBV (IGM was negative, IGG positive, Early Antigen Positive, Nuclear Antigen Positive) and I had an endoscopy performed which showed I had no infection, but I did show "inflammation". My stools seem to slowly be improving, which is also good, however I still have a dull pain just under my sternum at times. I also still have dry mouth, bitter post nasal drip, white tongue and inflamed taste buds.

Here is the news that has me greatly concerned. A week ago I received a text from my live-in girlfriend telling me that for the first time in her life, she had an abnormal pap smear. They tested her for HPV and it was negative. My girlfriend told me that the doctors believed some "inflammation" may have caused the pap smear to come back positive. I asked her if she had been experiencing any weird symptoms lately and her answers scared me. She showed me her tongue, it was coated white just like mine. Her stomach has been making very loud noises, and she told me her stool is pale and discolored, like mine. She also told me she is having discomfort in her upper abdomen.I abstained from vaginal sex with her for three months, until all of my aforementioned testing was complete. She did perform unprotected oral sex on me once about a month ago, and she swallowed the semen. I am convinced this oral act spread something from me to her.

1). Is it clear that something infectious is in both of us causing said inflammations?
2). Is it possible that our symptoms are HPV related?
3). Is it possible that her negative HPV test was a false negative? She is vaccinated with Gardasil.
4). Given this new set of information, what could this be?

Thank you,
Dan
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome back, but sorry to see you continue to be so worried about all this. As we discussed last time, your symptoms were entirely nonspecific, i.e. not pointing to any particular infection -- and most consistent with the physical manifestations of anxiety, not an infection of any kind. Your conviction that you transmitted some infection to your partner through a single oral sex event, and that this is causing symptoms in her, has no basis in reality. Llike your own symptoms discussed in your other threads, your partner's are everyday body sensations experienced by everybody from time to time. To your questions.

1) Inflammation on pap smear is a very common finding, usually not indicating any important health problem. My guess is her gyn will recommend a repeat pap smear, and women with such pap smears should also be tested for common STDs (gonorrhea, chlamydia, trichomonas) and for a vaginal yeast infection. Most likely the STD tests will be negative, but if positive, it probably would not be from you -- although in that case, you also should be tested (or retested). But probably this issue will fade away without a clear answer and without any health implications for either of you. She should discuss it with her doctor.

2) HPV doesn't cause any such symptoms. It is always entirely without symptoms except for cases causing genital warts.

3) HPV doesn't usually cause inflammatory changes on pap smear. Her negative HPV test is reliable.

4) "What could this be" assumes some sort of infection or health problem is present. You present no evidence of this. 

You are clearly obsessed with a sexual decision you regret. Your anxities about it are the only health problem in evidence both in your other threads and here. And I have to suspect your partner's "symptoms" are largely the result of you "infecting" her with your own anxieties, making her unnecessarily worried about varying normal body sensations. Coated tongue? All the time in healthy people. Varied color and appearance of stool? Intestinal noises? Same thing.

As noted above, your partner should discuss her pap smear result in more detail with her doctor, and probably should follow through with STD testing if not done already. Probably nothing is there, but even if something should be found, it will not explain your symptoms or hers. Continue to follow up with your own doctor if you remain concerned.

Regards--  HHH, MD

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46 months ago
Dear Dr. Handsfield,

Thank you for your response. I agree with you that anxiety likely caused many if not all of the symptoms I experienced. However, it just seems all too coincidental that my Gatro believed I had some "post viral inflammation in the duodenum that will take some time to get over", and just a few weeks later my girlfriend has this irregular pap. 

1). Her Dr. recommended another pap 1 year from now. In your opinion is that too liberal? She did not recommend STD testing, but I will ask her to do so based on your comments.
2). Understood. Neither of us are showing genital warts.
3). Understood. I am relieved to hear that is a conclusive HPV test.
4). Point taken.

My mouth symptoms are the most difficult to deal with, which led me to do my own HPV testing. I have read that there is no FDA approved male HPV test.

1). I did an at home self collection both salivary and penile for many HPV strains. All came out negative. If there is no FDA approved test do you know if these results are accurate?
2). I forgot to mention that I did test positive for Ureaplasma in my urine. I don't have any discharge or any symptoms on my penis at all. Do I need to seek further medical help for  this bacteria? 
3). Could Ureaplasma ingestion have caused any of the symptoms I did experience?
4). Could Ureaplasma potentially cause a pap smear to return abnormal cells?

Thanks,
Dan


  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
You are obsessed with a sexual exposure. Everything may be "coincidental" following that. However, in the time since that event, you also have had innumerable interactions with people:  shaking hands, exchanging money at case registers, day to day contact with co-workers, and on and on. You also had unknown environmental exposures. Your symptoms also are "coincidental" with all the events of daily life. And trust me on this:  There are no sexually transmitted infections that could possibly cause any of the problem you have described. All the science is against any association with the sexual exposure except one aspect of it:  your anxieties and regret over it. That your gastroenterologist thought you had "post viral inflammation of the duodenum" says nothing about what caused it!!! Anyway, if you analyze the frequency of such symptoms as yours and your gf's in healthy people, including her pap smear, the statistical fact is that "coincidence" is much more likely than any sort of causal event.

1) It was a waste of money and energy to test yourself for HPV. The results make it more likely than not that you don't have HPV at the sites tested, but that's all that can be said. As a sexually active person, you can be sure you have had one or more genital HPV infections (and possibly oral ones), might have one now, and might have more in the future. If so, they would not explain your current symptoms or any similar symptoms in the future.

2,3) Ureaplasma is a normal bacteria in the genital tract, present at any point in time in about 50% of healthy persons. It does not cause symptoms like yours. Some strains probably cause some cases of nongonococcal urethritis (NGU), but you obviously don't have NGU based on your symptoms.

4) Interesting question. To my knowledge the relationship between Ureaplasma and inflammatory pap smear changes has not been studied. But since this organism is not a clear cause of disease, I doubt they are releated.

I have done my best to give you expert, reasoned, science based reassurance. You're arguing every step of the way, obviously working hard to convince me (and confirm to yourself) that you have some horrible disorder that is somehow related to your past sexual contact. You do not. You might consider counseling to understand why you are reacting this way and help move beyond it. I suggest it from compassion, not criticism. In any case, I will have no further advice. Good luck.

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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Please also note that repetative anxiety driven questions are not permitted. Further questions about this exposure and/or your symptoms will be deleted without reply and without refund of the posting fee -- a policy intended to protect users from themselves (paying for questions with obvious and unchanging answers), and to prevent questions with little educational value for other users, one of the forum's main goals.

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