[Question #7702] VERY High Fever Followed by Bleeding Gums and Multiple Mouth Ulcers

1 months ago
Hello again. I'm very worried since last week I had an extremely high fever and sore throat for about 5 days straight (reached more than 103). The fever came out of nowhere and was very unexpected with no obvious cause. Also, my gums were bleeding every time I brushed my teeth. Then, I developed a lot of mouth ulcers in my mouth. One in my tongue and 3 canker sores in my lips. I have NEVER had canker sores in my lips. They looked very bad. So, I am very worried. If my exposure was about 4 years ago, could this be a sign of advanced HIV? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
As for your previous questions, this one also indicates you are obsessed with a past sexual decision you regret and are prone to attributing any symptoms or other health issue to that event and to HIV. As has been discussed in all your other threads, the HIV tests you had prove you do not have HIV. Any and all illnesses you have now or any time in the future will NOT be HIV from that event. In any case, HIV does not cause especially high fever, and is not a likely cause of oral ulcers and sore throat. Even if you had more typical HIV symptoms, your tests have repeatedly proved you don't have it.

So what IS causing these symptoms? No STD is likely, especially if you have had no new and recent sexual exposures. If you have kissed someone with oral herpes in the last couple weeks, you may have initial oral herpes. A number of other viral infections -- not STDs -- can cause such symptoms. You need to see a doctor soon to sort out the cause -- don't take chances with a temperature as high as 103. But for God's sake, forget the sexual exposure several years ago. Of course it has nothing to do with your current symptoms.

Repeated questions on the same exposure, concerns, etc are not permitted. This must be your last about that exposure and your fears of HIV.

HHH, MD
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1 months ago
Thanks for the reply Dr. I went to the doctor today and he was sure that it was herpes. I had a blood test done to confirm whether or not its herpes. I'm afraid that if the test is negative, something worse may be the cause... I have a few quick questions:
1. Can herpes cause such high fever of 103?
2. If it's not herpes, are my symptoms suggestive of advanced HIV? I've never had a lot of mouth ulcers before accompanied by high fever.  
3. Would a healing pimple/bruise in my penis increase my risk of HIV? 
4. About 3 weeks after my exposure in 2018, I developed a petechiae rash in the palms of my hands and on top of my feet (tiny red dots signaling bleeding under skin). Ever since that exposure, I've had petechiae on and off in the palms of my hand to this day. I read online that HIV can cause a decrease of platelets, which can cause petechiae. I never had petechiae prior to that exposure and so that makes me worried. Would this symptom suggest HIV, given that I never had it before that exposure? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Interesting. But a blood test alone is the wrong way to go. If it's herpes, it's a brand new infection, and it takes a few weeks for the antibody (blood) tests to become positive. You should have had a swab test from the throat and/or oral ulcers to check directly for the virus by DNA testing (actually PCR, for polymerase chain reaction). Re-contact your doctor's office to arrange it. If s/he declines, find a doctor who understands herpes better; or as a last resort, make arrangements directly with a lab such as Quest or Labcorp. One way or another, get an oral PCR test.

Also, you don't mention treatment. Whenever new herpes is likely, treatment with valacyclovir or acyclovir should be started immediately: successful treatment depends on starting early, and the drugs have virtually no side effects, so no harm in starting treatment while waiting for test results. You definitely should be on one of these drugs ASAP.

What exposure(s) have you had? Personal contacts with herpes? Kissing? Or oral sex on someone who might be infected? Herpes is still unlikely if no potential exposures. As I said above, there are other viral infections that can cause fever and oral sores (e.g. hand foot and mouth virus, coxsackie virus, and others).

Now to your questions:

1. Yes, initial herpes can cause all this, including fever as high as 103F.
2. Please stop asking about HIV! How many times do you havre to be told you do not have it??? There must be a thousand medical conditions that cause the same or similar symptoms as HIV. Get over that obsession or get counseling as to why you cannot.
3. I'm going to assume this is still referring to your exposure a few years ago, and therefore will not answer. You do not have HIV, so the risk of infection at the time of that event is irrelevant.
4. Once again, you're asking about things that don't matter. Petechiae alone is not evidence of HIV, and since you know you don't have HIV, this is also irrelevant.

Let me know if you have anything additional to ask or clarify about your current symptoms, and I would love to have the answers to my questions above about exposures etc; and eventually to learn the results of an HSV PCR test. I'll even leave the thread open beyond the normal two follow-up questions, but only for this purpose. If you ask anything more about HIV and your exposure 4 years ago, the thread will be immediately closed without further reply.
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1 months ago
Thanks for the reply. The doctor did put me in that medication since he is sure I have herpes. The blood result arrives in a week. I did kiss someone with an active herpes infection in her lips so I suspect that caused it. However, it is surprising how bad it affected me. I will let you know the result of the test once it comes back. 

Just to clarify, recurrent petechiae (for more than 3 years) after a sexual exposure won't raise suspicion of an STI? Especially if this symptom was never seen before? Thanks. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Thanks for the clarification and glad to hear you're on proper treatment.

You still need the PCR test. It is dumb to rely only on the blood test. Not only will the initial test be negative, but a third of people with HSV1 (almost certainly the cause) never develop positive blood test. Without the proper test, you run a good chance of never knowing the diagnosis with certainty. Tell your doctor I said so -- you could print this out as a framework for discussion with him.

Petechiae is not a symptom of any STD. And probably you have never had true petechiae anyway; that would be very unusual as a sole symptom without other serious health problems.

That concludes this thread. Please note the forum rule against repeated anxiety driven questions by the same users. This being your seventh about your exposure 4 years ago and concerns about HIV, it must be your last on those topics; future ones will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers; because experience shows that continued answers tends to simply prolong such anxieties, when the real answer normally should be professional counseling; and because such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

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