[Question #6544] Sharp object?

14 months ago
Dear Doctor,

15 days ago was walking at the bohemian neighborhood of Lapa (in Rio de Janeiro, Brazil) when I felt a sting on my left arm just as a guy was passing by me. As I looked at my arm I saw a small wound, something like an insect bite or a pimple, however, I didn't see any blood coming out of it. As I looked at the guy who just passed by me I realized that he was holding an object, but I was unable to see if that was a sharp object such as a needle or syringe; I also didn't notice if he did any movement in order to poke me with the object since I was distracted with my own toughts. At that moment I didn't care and continued my way, but, a few moments later I started to feel a little bit worried. What if I was attacked with a needle? (I know that there were attacks like these in northeastern Brazil back in 2018, as reported by local media...). Today, 15 days after this event I just found a single swollen lymph node in the back of my head (right side, maybe an occipital lymph node?) and I am feeling a mild sore throat and a light running nose. I haven't experienced fever, headaches, diarrhea, cutaneous rash, muscle aches and I didn't notice any other swollen lymph node throughut my body. What should I do? Should I get tested for any infectious disease? I'm worried... Thank you for your comments and for this important public health service.
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Welcome to our forum. Thanks for your question.  I'll do my best to help.  There is no way to know what cur you two weeks ago or whether or not it might have been transmitting HIV.  I will say however that it is statistically quite unlikely that it was intentional or that you have acquired HIV.  My suspicion is that your current swollen lymph node and sore throat are coincidence and unrelated. If your swollen lymph node were due to HIV, it would be expected that you would have a fever, a well as severe muscle and joint aches.  In the absence of these sorts of symptoms, it is unlikely that your current symptoms are due to HIV.  To be sure however, and to put your fears to rest, it may be worthwhile for you to go on an test for HIV using a combination HIV antigen/antibody test.  IF your symptoms are due to HIV, such a test would be positive. 

I hope that this perspective is helpful.  EWH 

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14 months ago
Hi Dr. Hook, thank you for your comments. In this case, and considering the window period for a 4th generation test, what would be the proper time to get tested? Should I wait more days? Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

I'm glad my comments were helpful.  The answer to your question depends on your level of concern.  If you are worried that your present symptoms are due to HIV, then a 4th generation test for HIV at this time will address this concern accurately BUT it will not be totally conclusive because your current symptoms may be entirely coincidental.  Test results for HIV are not totally conclusive until 6 weeks following an exposure. 

In other words if your present symptoms which, to be honest do not raise a concern for HIV to me given the absence of fever, muscle aches, etc. were due to HIV a test at his time would be positive.  On the other hand, if you just want to be completely sure you were not infected at the time of the incident you describe, I would wait to test until 6 weeks have passed.  Obviously, you could also test twice, once now and once again at 6 weeks if you are particularly nervous.  EWH

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