[Question #6417] Follow up on previous ARS question

15 months ago
Hi doctors, thank you for your previous service just a few followup question to another unprotected vaginal sex with same girl in previous question.  After the negative results i had one more incident of unprotected vaginal sex, with same woman what worries me is the atypical symptoms i had developed approximately 7-8 days later.  i devoloped what I thought was a hemorrhoid which started as a painful nodule near the anus it became swollen and very hot tender to touch for the next couple of days. By day 10-11 i developed low grade fever and inflammation, headache lasting 36~48 hrs  i don't recall having sore throat or muscle/ joint aches I continued to apply hemorrhoid cream assuming thats what i had . Symptoms resolved mostly and within two weeks it came back with a vengeance very painful again with 24 hr fever   I went to hospital they diagnosed me with an perirectal abscess . They didn’t seem too concerned since i mentioned crohns but i never had this symptom in 15 years of managing the disease. The other thing concerning is my blood work came back low lymphocytes high monocytes & absolute values was high for monocytes only.  Platelets were normal The abscess was ultimately drained. I devolped a rash in the perianal area after completing antibiotics  that looked like a dozens white heads which cleared up within a 2 days never experienced this as well. I  read the Zurich atypical ARS study and it mentions anal abscess as primary atypical symptoms although infrequent is a possibility I assume

 Does this sound like atypical ARS ?Are my labs concerning?  Is it suggestive in anyway? 

What are the odds of being infected? Finally,I don't feel like spending another couple of hundred to be tested again as i got a result of all negative within the last three months but these new symptoms sound worrying. For someone who has an auto immune disease i guess i worry and focus more on symptoms then the average person so i wonder  should i be tested more frequently 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Welcome back to the Forum.  I'll try to help.  The problems you describe really do not concern me for the ARS in the least and are far, far more likely to represent a coincidental problem related to your Crohns (even acknowledging that it is not a familiar symptom for you) than to be in any way related to the sexual encounter you describe.  Similarly, changes in lymphocyte or monocyte counts is not something that suggests a likelihood of HIV.  I would not be worried about HIV at all if I were in your situation.

I'm not sure why you spent "a couple of hundred" dollars for testing.  If your symptoms were due to HIV, widely available 4th generation tests which are inexpensive and available at public health facilities would effectively rule out the likelihood of HIV.

I hope that this reflection is helpful.  Feel free to follow-up if I have missed some aspect of your question.  EWH


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15 months ago
I went for testing last week and awaiting my results i fear i cant open  as my symptoms have worsened with nights sweats every night for last 6 days  i may be flaring but  i cant be certain its caused by the crohns as i  do not feel good.  Made an appointment with my GI as well

Am i acting irrational Dr.  based on your experience
one hurdle was getting tested my other fear is opening the results.  

Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

You are not reacting logically.  Looking at your test results will not change whether or not they are positive.  I anticipate they will be negative.  In the unlikely circumstance they are positive, the result gives you the opportunity to seek the treatment which is highly effective.

As I already said, I am confident your test results will be negative.  Look at them so you can move forward. EWH

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