[Question #3970] Follow up #3698 - need to know your opinion on full story

32 months ago

Hi Dr,

In the last months I have been ill and need your opinion (same incident last conversation, with details) as I am having high stress. I will take a hiv test, but have delayed. I went to Quest Diagnostics in LA on May 10th to have blood drawn (not stds). I was the second last patient that day and there were two staff complaining they were overworked. I helped an elderly lady check in. They were taking blood and manning reception. The front lights were turned off. I asked phlebotomist to show me the needle was clean and he did but disposed of it touching inside the sharps container. He got another needle that he used. The woman from reception, and who was taking other last patients blood entered. She had roughly nine samples on a tray on the counter. I was facing this/her to the side with my eyes towards her. She began sorting things, scanning samples etc. What she was doing involved test tubes/lifting things up and I believe she wore gloves. I felt something go into my eye from her direction though I was unsure what. I was concerned this maybe blood from her gloves coming toward me or from a test tube. I rubbed my eye quite a bit which I know wasn’t smart. Once home (20 mins) I rinsed. I went back the next day with my concerns and they said tubes are sealed and gloves changed. 15 days later I developed shaking chills, a fever and a bad headache (started with headache). Two more weeks I had an extremely painful sore throat at the back and obvious lymph node in my neck. Last week I lost my appetite for days and was nauseated with sometimes a violent cough. I am concerned that blood could have gone in my eye or maybe the needle was contaminated.. Is it procedure to do end of day tasks with a patient there? I had negative testing last year and have been in a monogamous relationship, using protection, since.

Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
On this occasion I, rather than Dr. Handsfield, happened to pick up your question.  In preparing to respond I have reviewed your four earlier posts and note that you tend to be fearful about acquiring HIV from circumstances in which, while there is perhaps a theoretical risk of infection, no such infections have been proven to occur.  The situation you describe is such a situation.  It suggests to me that you are a bit of a "germaphobe" whose sense of risk for acquistion of infections during your activities of daily living is high.  In general most persons are resistant to infections in every day situations, most people do not have infection that they might transmit to others, and when exposures do occur, most exposures do not lead to infection.  The situation you describe is, for all practical purposes, a no risk event and the symptoms you describe since then, while anxiety provoking for you, are not suggestive of recently acquired HIV.  When persons acquire HIV the symptoms occur at about the same time, not separated in time as your flu-like symptoms, followed by your sore throat were.  If you take an HIV test at this time, as you indicate you plan to, the results will prove both that your symptoms were not due to recently acquired HIV and that you did not acquire HIV from the event you describe.

I agree with Dr. Hands field's earlier statement to you that "It is a mistake to attempt to imagine scenarios in which HIV may be transmitted by means other than sex or overt blood exposure. Biologically, some of the things you suggest might make sense. But the main fact is that even the busiest HIV/AIDS clinics and research centers have virtually no patients without the traditional risk factors like unprotected sex, needle sharing, or being born to an infected mother."

I also note that Dr. Handsfield warned you about repetitive, anxiety-driven questions which is what both he and I would classify this questions as.  Since I happened to pick up the question rather than Dr. Handsfield, I provided you with my assessment which is very much in parallel with Dr. Handsfield's (no surprise, we virtually never disagree in our assessments). 

I hope this response is some help to you.  You are worrying about something that you need not be concerned about. I hope my comments will help you to accept this.  Follow-ups to this post will be very limited.  EWH


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32 months ago
Thank you for your sympathetic and encouraging response Dr. Hook. I really appreciate it and I certainly agree I have work to do in managing my fears and should seek counseling to do so.  I would have responded instantly but traveled to Canada today, my anxiety managed to finally decrease when I saw it this morning.  Can I just ask you these last things:

1.) Are you also saying you do not believe blood got in my eye and there would be no worry about blood getting out of a test tube or from her gloves? You do not think any protocol was broken in scanning patients samples from that day/doing end of day routine while I was in the room. I understand you think I am fine but you also think possibly I was not exposed at all to any blood and that something else likely went in my eye?

2.) Do my appetite/nausea issues that have continued seem concerning to you. I initially went for the blood tests mentioned because of stomach issues but no abnormalities came up in my results.  I usually eat a lot and have a very fast metabolism, stress has never affected my appetite. I should mention I had a bartholin cyst arise today with swelling on one side following my 5 hour flight. I have had this before but I read that e coli and streptococcus pneumonia (more likely in those with hiv) can cause this. I assume these would cause severe symptoms though . My issues revolve around my stomach, I do not feel feverish or fatigue, my energy levels are good. The only other thing is a lot of mucus in my throat at the moment but I do have asthma/dairy allergy and have been in the heat. I don't have a cough anymore.

3.) Lastly, as stated my last hiv test was right before I started my current relationship last July. I had a sexual encounter on may 21st, 2017 and took the hiv test on july 14th, 2017. This was at 54 days conclusive? I have only been with one std free partner since then so aside from the incident I am stressing about now I do not feel I have any reason to worry. I am going to keep calm due to your reassurances. I think my anxiety has been such that it is a good idea for me to take the test when I return from my trip however. Thank you again.
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
1.  I doubt you were exposed.  Even if exposed, I would not be worried.
2. These symptoms are in no way suggestive of HIV.
3. Your results from July 14 2017 were conclusive for your exposure on May 21
EWH
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32 months ago
Thank you Dr Hook. Last questions. If I was exposed and I rubbed my eye a lot, which I did, would I have increased my risk as I would think rubbing would get the fluid into my eye more? This was a main concern I was having.

Lastly, I am on a trip and am not going to see a health provider for this. I have had quite a lot of goeey thick discharge yellow tinged today along with the bartholin cyst. I am 100 per cent sure I don't have chlamydia, gonorrehea etc. Can a cyst or yeast infection cause this or what do you think?

Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Sigh, you are still over thinking this. Rubbing you eye would not change my assessment and there are no data to suggest it would change your virtually non-existant risk. 

You should see a health care provider about your Bartholin cyst.  You need microbiological testing and direct examination to determine the best therapeutic approach.

This is my 3rd response your questions.  Thus, as per forum guidelines, this thread will be closed shortly. EWH
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