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Developed a sore on penis shaft and foreskin after unprotected sex. Any advice?

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Dermatologist
Practicing since : 2005
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hello doctor,

I just had sex 8 days before with a girl whom I had met in a bar. I inserted 2-3 times without condom and later put a condom realising it.Jjust 3 days after I had developed a sore on penis shaft and foreskin which become red after treatment with a cream.

Tested for HIV as negative atter 7 days with OD ratio as .03, cut-off being 1.

Also it has been 27 days since then and I had a swollen lymph node in my right neck. I dont have any fever or other symtoms during the last 28 days.

Please advice as I am very much worried and cant eat anything or can't even concentrate on anything. I feel like there is a lump in my thraot and cant swollow because of hypertension. I am having anti anxiety and blood pressure tablets.

Rgds,
XXXXXXX
Posted Sun, 4 Nov 2012 in HIV and AIDS
 
 
Answered by Dr. Sudarshan 4 hours later
Hi XXXXXXX

Thanks for writing in.

As you had protected intercourse there is very little possibility of HIV transmission.

Actual exchange of body fluids like semen, blood , CSF is essential for HIV transmission.Even after unprotected exposure and exchange of fluids HIV transmission rate is low.

The rate of HIV transmission with sexual intercourse is much lower than with other sexually transmitted diseases-approximately 0.3% per sexual contact with an HIV-infected person.

The risk of HIV infection increases if you or your partner has a sexually transmitted disease (STD). Do you or your partner had any of the sore or ulcer over the genital area?

Also HIV will not manifest so early.


Sero conversion illness is the one which occurs after 4 weeks of getting HIV infection.

It is characterized by
fever,
Decreased appetite
Fatigue
Headache
Malaise
Muscle stiffness or aching
Skin Rash
Sore throat
Swollen lymph glands
Ulcers of the mouth and esophagus

You dont have any except lymph node.


As you have tested negative for HIV it is unlikely that you have HIV.

You can test by western blot or DNA PCR to be sure of HIV negative status.

Dont worry .You should be fine with negative tests.

Hope this helps.

If you need any further clarification.Do let me know.

Regards.

DrSUdarshan
HIV specialist
Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 11 hours later
Then what is .03 in ELISA test
 
 
Answered by Dr. Sudarshan 1 hour later
Hi again XXXXXXX

.O3 in ELISA does not signify positive test.

Test is considered positive only when antibody
titre is more than 1.

If reading is more than 1 then positive result is given.

O.03 suggests negative test.

So there is nothing to be worried about.

Hope this helps.

If you need further clarification do let me know.

If you are satisfied with answer ,accept it and rate it at the end.

Regards.

Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 37 minutes later
I mean after 7 days the test should have read 0. Also does that mean antibodies have started developing. What is the usual value for other people after 7 days.

I am very worried as just after 4 days I had developed a rash on my penis which happened for me for the first time.
 
 
Answered by Dr. Sudarshan 1 hour later
Hi XXXXXXX

0.03 means a very small or negligible amount of antibodies.
Which can be present normally in few persons.Also these can be cross reacting antibodies produced as a result of some other infection.

Large no of patients have this kind of very low titre they are absolutely normal and healthy.It does not mean that antibody production has started and it will raise slowly.

Also please upload the photos of the penile rash close up and distant view.
It will help in predicting the condition.

“You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.” Alternatively, you may mail me at YYYY@YYYY with subject as “Attention to Dr. Sudarshan”.


Upload the photos and we can continue the discussion here.

Regards
DrSudarshan


Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 10 days later
Well none of the cream worked. I applied hydrozole for 2 days and the rashes are all gone now. Is it because these are HIV rashes and have gone on their own or hydrozole can fix them in two days.

Looking forward for your response.
 
 
Answered by Dr. Sudarshan 3 hours later
Hi,

Hydrozole cream contains hydrocortisone and clotrimazole.

Hydrocortisone is a mild steroid.

As it has subsided by application of hydrozole for 2 days,it indicates that it was a mild allergic reaction
taken care by by hydrocortisone.

HIV rashes are usually persistent and do not go away so quickly.

So there is nothing to be worried about .

Hope this helps.

Regards.
DrSudarshan.

Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 14 hours later
Well, I got some rashes on my arm and check. Shape of a dime, also a lymph gland on the right side of my neck is swollen and i have some irritation in swollowing and Breathing.

Breathing by my mouth all the time. The GP I visited says the throat is clear. But I can still feel the swollen lymph on the right side of my neck, I believe it's just one.

Any thoughts??

 
 
Answered by Dr. Sudarshan 7 hours later
Hi XXXXXXX ,

Swollen lymph nodes in neck can be from throat infection,scalp infection ,dental infection etc.Do you have any symptoms related to these ?Is the l
painful?Is it soft or hard.
Rashes can be due to eczema ,fungal infection etc.
Are they itchy/ painful/scaly?are they raised or flat?

Can you upload the photos of the affected area of skin rash?

Photos can be helpful in predicting the condition.

Upload the photos and answer the above questions to help you better.


Anticipating your response.

Regards.
DrSudarshan
Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 44 minutes later
Hi Doc.

Swollen lymph nodes in neck can be from throat infection,scalp infection ,dental infection etc.Do you have any symptoms related to these
I do have throat infection.
?Is the l painful?Is it soft or hard.
Not painful but kind of hard about .5 to 1 cm in diameter. they are just on one side.
Rashes can be due to eczema ,fungal infection etc.Are they itchy/ painful/scaly?are they raised or flat?
They are not ithy and painful but somewhat flat and raised, a combination.

I have added the photos. Same kind of rashes are there on my chest, arms and back.
 
 
Answered by Dr. Sudarshan 42 minutes later
Hi again XXXXXXX

Ive gone through the photos and details.

The rash you are describing can be tinea versicolor or pityriasis rosea.

Chances of pityriasis rosea are more.It is benign self limiting condition.It occurs usually after sore throat or HIV.

Lymph node swelling can occur due to sore throat you had.It is also not related to HIV.Will subside in few weeks on its own.In HIV there are multiple painless lymph nodes which do not regress for months together.

As of now you dont have symptoms suggestive of any STD or HIV.Also your HIV test is also negative.So there is nothing to be worried about.

Hope Ive made things clear.

Wishing you good health.

Regards.
DrSudarshan

Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 2 days later
Well Doc I have my Blood test done with WBC on high level. With no other infection present, all i can think about is HIV.

WBC - 0000
Neutrophils - 8100
Lymphocytes - 2800
Monocytes - 1430

Also the lymph nodes are becoming more and more larger with my throat being clear.

Also I can feel that lymph nodes are growing in the armpit and groin too with more and more rashes appearing up.

Please let me know your thoughts. I am freaking worried, have to jump my car into the river if diagnosed.

Haven't slept since last 10 days
Rgds,
XXXXXXX
 
 
Answered by Dr. Sudarshan 5 hours later
Hi XXXXXXX
Thanks for writing in.

Lymph nodes and rashes do not suggest you have HIV.

As you have tested negative for HIV it is unlikely that you have HIV.

You need to undergo a short course of antibiotics like Ciproflaxacin (500) twice daily for 7 days.It should clear your lympnodes and rash.

Please visit nearest physician or dermatologist for the evaluation of the rash.


Dont worry .You should be fine with drugs.Its un

Hope this helps.


Regards.

Dr Sudarshan
HIV specialist
Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 41 hours later
Please let me know why the neutrophils and monocytes are high:

I had a blood test done today and both of them are still high:

Neutrophils : 0000
Monocytes: 650

What can be the reason. The doctor I had visited had put me on amoxcillin for 7 days.

ALso the lymph nodes on the back of my neck are swelling up. I had a urge to urinate as soon as I drink something.

Rgds,
XXXXXXX
 
 
Answered by Dr. Sudarshan 10 hours later
Hi Again XXXXXXX

The monocytes and neutrophils can be high in Infections,leukemias,lymphomas etc.

As the count has decreased from previous levels this time.It indicates a resolving infection in your case.In other causes counts would remain high with no lowering of monocytes.As they are reducing it indcates that your body is responding to antibiotics.However another 7 day course of antibiotics will be needed.My advise to you would be to visit your physician again and get another 7 day antibiotic course.
After that blood counts would be normal.
Urge to urinate may be related to your anxiety or it can be mild good health.
Regards.

Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 5 hours later
Hi Doctor,

Then why all my lymph nodes are expanding. I cannot co-relate. Have read that high monocytes are also associated with HIV infection.

Please help. I think I can die any moment.
 
 
Answered by Dr. Sudarshan 8 hours later
Hi again,

High monocytes can be seen in HIV ,TB, infectious mononucleosis,
sarcoidosis.As you have tested negative on two occasions.HIV is least likely.
Also sometimes lymph node continue to enlarge even after infection is subsiding .It is called reactive lymphadenopathy .
You can get a HIV RNA PCR test get done .The test will confirm your negative status.
Get another 7day antibiotic course done and get this test done.

Hope this helps.
Regards.
Dr Sudarshan.

Above answer was peer-reviewed by
 
Follow-up: Developed a sore on penis shaft and foreskin after unprotected sex. Any advice? 2 hours later
I just tested negative 8 days after exposure with ELISA reading being 03.

Is high monocytes really in HIV infection. I am too scared to go for another test.

If tested positive I have to die being an Indian.
 
 
Answered by Dr. Sudarshan 5 hours later
Hi Again,

HIV is the least possibility in your case.Most probable cause of increased monocytes in your case can be other bacterial or viral infection.

You can get a HIV RNA PCR test get done .The test will confirm your negative status.
There is nothing to be worried about the test.Once negative reports are confirmed you can relax.You should keep your calm and hold your nerves.Its better to get tested than to live in misery.So stop worrying and get tested.

Wishing you good health.
Regards.
DrSudarshan
Above answer was peer-reviewed by
 
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