[Question #5795] [Question #5587] Follow up, is ARS common at 5 weeks?

22 months ago
Exactly 35 days have passed since encounter in og question ( #5587). 
Since that, I have gotten G/C neg test, no syphilis test yet, but not worried since I have not seen anything uncommon (with how anxious I was you can guess I was looking real hard.)
My new question is: Yesterday morning I had some diarrhea, at night I came up with a fever (I didn't have a thermometer, but was getting some chills even with a 62 outside temp). Ibuprofen took care of it, but could not sleep well since I had at least 6 trips to the restroom, and a couple or 3 more today. I should say, this weekend I ate reaaaally bad (junk food, street food, red meats, hot sauce, lot's of fat). Got a thermometer and was constantly checking all day long, ranging from 98.5 to 99.5, with average of 98.9 to 99.5 (saw one spike to 99.7 once), but I actually did not feel feverish or ill at all (not even from my stomach, just when going to the restroom). I should also say, I do not trust the thermometer as I could see .5-.7 variations from measure to measure, immediately after.I have no sore throat at all, and the only sore muscles are my legs, most likely due to me playing soccer last night after months of no physical activity. I had also been sleeping badly (had a 16 hour trip at night, no sleep Thursday to Friday, so I guess I was quite drained.)
Given fever (certainly yesterday with chills, and in case measures were right, low grade fever never reaching 100 today) and diarrhea as my only symptoms 35 days later, with no general malaise, could this be ARS, or just an stomach bug?

Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome back to the Forum.  On this occasion I will be answering your questions.  I did review your earlier interaction with Dr. Handsfield and agree with all that he said.  OTOH, I know how, when one has a bit of worry, there is a tendency to link coincidences to amplify worry.  This is what you are doing.  Several comments below but the punch line is below- when the ARS occurs, it typically occurs within 4 weeks of exposure (peak occurrence is around two weeks) so you are too late for your symptoms to be the ARS.  Further, while diarrhea does occasionally occur in persons with the ARS, the main symptoms of this syndrome are HIGH fever, sever sore throat, and sever muscle or joint pains, none of which you have.  I would add that, should you want the comfort of a negative test, if your symptoms had been due to HIV, your test would be positive at this time and further, that over 99% of recent HIV infections would be detected by now as well (the remaining small fraction of 1% would occur in the next few days, before day 42, if you were infected which I am confident is not the case).  

Having delivered my main response above, a few additional comments as FYIs:
1.  Body temperature does fluctuate over the course of the day, a degree or more.  Your thermometer may not be bad.
2.  I suspect your diarrhea reflects something acquired during your activities of daily living.  Hot sauce is famous for harboring the bacteria that cause traveler's diarrhea for instance.  

I hope this information is helpful to you.  Please don't worry.  EWH