Brief Answer:
Does not seem like HIV

Detailed Answer:
Hi

Thanks for posting your query on XXXXXXX

It seems like a chronic infection. There are many germs that can cause long term infection. It can also be disseminated candida. I think it is time that we get detailed blood tests done. It will help figure out the presence of infection or allergy etc. I think you should also get tested for typhoid with widal test.

If you can send me a photo of the rash, I will be better able to help you. Armpit swelling can either be from infection of chest or arms.

It has been 3 months since the sexual exposure and the HIV tests have been consistently negative. Thus HIV infection seems unlikely.

Though low immunity due to ongoing stress and travelling etc may be responsible. Another cause can be drinking impure water while travelling or later. Since the digestion is getting affected, impure water seems to be a cause.

Apart from the tests, lifestyle changes should help increase the immunity.

My following advise should help you until you are able to find a reason:

- Take hygienic, nutritious diet and pure drinking water

- Eat more of fruits and vegetables - atleast 5 times a day

- Do regular exercise at least 20 min a day. Exercise can include walk, yoga, gym, cycling, swimming etc.

-Take adequate hydration for diarhea. OPtions include gatorade, pedialyte etc.


Waiting for your reply.

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Parasitic infections can be tested with stool analysis for ova and parasties. Even if the test is negative you can always take tablet albendazole (anti-parasitic) single dose. It is usually curative.

Since you are not feeling well, while travelling or visiting, you should take precautions regarding diet and lifestyle. Avoid food from outside. Take nicely washed home-made food that is more hygienic. Always wash your hands with soap and water before preparing and eating food.

Regarding rash, pearly pimples can be caused by molluscum contagiosum - a viral infection. These usually last for a few months. With treatment they do not spread much. Again a photo is needed to come to a diagnosis.

Yes, typhoid can be long lasting if it is not diagnosed. Typhoid can also cause skin rash but is not pearly. It does not interfere with hiv infection.

Regards

Dr Vaishalee

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Brief Answer:
Upload

Detailed Answer:
Hi again

You can upload the photo by clicking upload button on the right side of your dashboard.

Alternatively you can send it in email at YYYY@YYYY and address it to my name: Dr Vaishalee

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Interestingly, the rash in the photos looks very much similar to the rash of small pox. I think that you are having complications from the small pox vaccine. Avoid touching the scab after the vaccine.

Since small pox is caused by a virus, antibiotics will not be effective. I think vaccinia immunoglobulin may be needed. Check with your doctor to confirm the diagnosis.

It is possible that the diarrhea and other symptoms are a sequel of small pox vaccine. Let us see what comes up on the tests.

Regarding the ear drum vibrating, you may be hearing the resonance of opposite ear-drum due to the headaches you are having.

Take care.

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Brief Answer:
Take it one step at a time

Detailed Answer:
Hi again

The ring seems to be tinea, another very common fungal infection. Yes there is some rash and swelling on the arm, but it looks more like an infection than hives. Hives are itchy and lots of swelling present. Infections have the reddish spots.

The colour and frequency of stools is not normal. We need to do something about it. I really think the diarrhea is a complication of smallpox vaccine. But we also need to rule out typhoid, etc. We also need to get stool tests done. Once we are able to rule common causes out, we do not have to think about those anymore.

The spot inside the cheeks and on tongue is not hairy leukoplakia. One way to diagnose it is with a biopsy. Since you are able to pinch it and drain its contents out, it seems viral infection(maybe small pox complication). I could see oral candida on the tongue, which can be considered normal flora.

There is definitely some low immunity in the background, but it does not seem to be HIV. We can get a hemogram done (a blood test) and immunoglobulin levels to see if some type of blood cells are reduced in quantity. In your case, acute stress seems to have caused low immunity and development of viral and fungal infections. I will recommend that you practice some relaxation techniques like breathing exercises to deal with it. Do not worry, you will live through this phase.

Medicines are available for these infections but have some side-effects and can worsen your health.

Regarding lifestyle, it is important that you drink and cook in safe drinking water with lowest ppm. It will help keep the swellings in the mouth and diarrhea in control while your immunity fights it. Regarding diarrhea and other related symptoms, also rule out other conditions and keep small pox vaccine side-effects in mind. It needs specific treatment.

I hope I was able to give an insight to your issues.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

About the rash like hives... Well these goes away quickly does it makes it an infection because of this trend?
A.     It seems to be lymphangitis than hives. It comes and goes correlating with the skin/lymph node infection (the draining site). Is it on the same arm that is having the skin rash/vaccine?

Does thyphoid fever can be the system and present itself without fever?
My doubt is that i dont have it due to lack of fever. However i feel spaced out almost delirious due to thyphoid, Derealization from stress, hiv or a related virus, bacteria or parasite...
A.     It is possible that you don’t have typhoid, hiv, etc. That is why I asked you to rule it out rather than rule it in (with tests). It is not in good interest to think that you have a disease until it is proven. It is also not in good interest to think about it unless you can do something about it (treatment is available /effective).

Another stressor to my day today... Last night i noticed that on the center of the hard palate was a small-looking scrape or somethig that bleed jist a little. This morning i was reddish but fair less.
it doesnt have any borders. Hope that it was from eating.
A.     Try using mouthwash to take care of oral infections. Also take some multivitamins until all the diseases/disorders have reduced in intensity.



The loose stools from the other day seems to go away for now. You know, i took a high mg vit 12 dissolving strip, i want to remember that it was that day that i started having the lopse stool... i just realized that.
A.     If you can tell me the constituents of the vit tablets you took, I will able be better able to help you. Some natural ingredients in multivitamins (that are not vitamins ) e.g, omega 3, 6, 9 are known to cause digestive symptoms.

I guess my diet including rice, rice has been the golden egg.
Anyways i want to point this observation... I definetly feel like im spaced out and is afecting me at work etc. Some people look at me and state you are look pale are you ok?
A.     My intellect says that whenever a systemic infection occurs, it does affect all organs including brain. Second reason can be electrolyte imbalance, nutritional deficiencies, improper food, malabsorption due to diarrhea, etc. Mostly we should give the infections some time to clear up. Once it is clear or at least reduced, you will feel much better.



Since theres too much to talk about making this a complex dilema i also forgot to mention that i have noticed some milia spots on right lower lashes area...
A.     Yes I noticed the white spots. Milia are mostly temporary and go away on their own. It seems to be white heads blocking the gland secretions. Can wash the eyelashes with shampoo that contains tea tree oil. It should help.

Regards

Dr Vaishalee

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Brief Answer:
My sincere advice

Detailed Answer:
Hi again

I will answer your specific concerns here.

vit Zn
l glutamine
multi vit chewables
have been used more recent

then i was using vit e
but stop using

then was using vit c
probiotics
Q10 use from time to time
fish oil
Cranberry pills
b12

A.     Among the vitamins mentioned above fish oil is definitely known to have side-effects of diarrhea, even bleeding in intestines giving the green colour to stools.
The safe vitamins among the above choices are multivit chewables, vit c, vit b12. It is not appropriate to think that whatever is on the shelf of a pharmacy is safe to use.

In fact fish oil should be withdrawn after knowing its side effects. The dilemma is that it is commonly included in food items, even in baby food, and so many kids are suffering. So you are not alone.

Why im tired or feel like dont belong?
A.     Need to get tests done to rule out common causes of tiredness.

Why im sensing a lower intermitent sharp pain on lower back, on border of hip area?
A.     For any sharp pain in abdomen it is important to at least get an ultrasound done.


I might have suffered depression too to the extreme of depersonalization...
A.     It is due to ongoing health issues. Medicines are available but removing the stress is the cure to your depression.


I want to be specific about things that i see to provide better description and prognosis.

So here i am recapping on stool experiences copor textures etc.
The way i put this in perspective in consistant. Some times loose other normal. One day beige other green and ocasionally brown.
A.     Tests needed to check about the cause of green colour.


I dont know if little "grind dark looking pepper" small -Salt size-evenly means anything along with the other observations.
A.     Everything has some explanation. Lets see what comes up in tests.


I still feel weird i can not feel free or feel part of this world or people around ...Feel delirious somewhat in the night cry...
A.     Just so you know that you are not alone and if you are brave, you will live through this phase.

Can go to sleep... Though but im afraid of pooping because of the obvious thigns i have mentioned
A.     Take more of fruits and consume pure water to combat the diarrhea. It is one thing that is cheap, harmless and very effective. In the stores, Aquafina, kinley (Water produced from reverse osmosis technique) is considered very clean water with lowest PPM. It will also help to keep water-borne infections in check.

Take care of yourself.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

I think the red spots are just indicative of presence of infection, maybe folliculitis with candida, staphylococcus, etc. Bruising maybe because of the thinning of the skin due to infection and makes it more susceptible to bruise after trivial trauma.

Similarly red spot in the mouth also indicates the same process.

The tests that you need to get done are:

For diarrhea, pain abdomen - stool culture, stool for occult blood, stool for ova and parasites, barium enema, ultrasound abdomen, urinalysis and microscopy and maybe even sigmoidoscopy (it is an invasive procedure and is not done as the first step).

Blood tests - hemogram (TLC, DLC, ESR), hemoglobin, BUN, Sr Creatinine, SGOT, SGPT, Sr Bilirubin, blood glucose, VDRL, Widal test, tuberculin skin test, HIV test, serial blood cultures, febrile agglutinins, culture of any pus or other fluids from skin infections, CT Brain, coagulation profile, vitamin K levels.

These may be included along with other test as prescribed by the Hospital physician.

Dr Vaishalee

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Brief Answer:
Some drug reaction

Detailed Answer:
Hi again

From the images it seems that you are having urticarial rash, most probably urticarial drug reaction. Do you have itchiness or other symptoms of urticaria like difficulty breathing etc?
The urticarial rashes come, itch, swell and go only to appear somewhere else. The sequence may go on for weeks.
The ring-like lesion, since it went away in a matter of days, seems like Erythema multiforme.
Anti-allergics like benadryl are the mainstay of treatment.

Also we need to figure out what caused it. If it is a medicine, then you need to stay away from the medicine.

Take care

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Since it is not itchy, the chances of urticarial rash are low. For now, we will take it as infections/bruises and take steps accordingly. Like we discussed earlier, you need to go for tests and we can discuss the reports.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

I did a liver and thyroid function test check and results are ok.
A.     Good
The only thing was cholesterol was at 210. I believe i can reduce it however i think it run in family.
A.     Can be controlled with diet and exercise. Avoid high calorie foods like milk products (cheese, butter, cream, ice creams, chocolate, etc). Exercise at least 20 min a day.

On the other hand the 11 week eia hiv test was neg.
A.     Good

lastly my mental state is odd. what i describe sound like is found in the inrernet as: spaced out, un real, and dazzy like feel along with a tired like symtoms.
A.     Seems like slowed mentation. Can be due to many reasons –mostly seems like some infection that is releasing toxins and the toxins are affecting the brain. Otherwise, it can be anemia, depression, etc. Hypothyroidism and liver disease have been ruled out already. Slowly learn to live with it. It should not affect your work. If the cause is found and taken care of, then the state may get better. Do not take any more over-the-counter supplements for it. They will make it worse. Try focusing techniques – meditation works. Otherwise puzzles and video games also help.

During some time in the last several weeks i had some anal itch may be found during night or morning. Some during day time but not as much. I had watched stools to see lumps or things clues to anything. All i hace seen is what i had showed and described you earlier.

A.     Here I will try to explain a little. Try to see the reason behind it. The anal itch is due to a fungal infection. The infection may also be there in the gut causing the altered stools. It was caused due to lowered gut immunity because of the medicines taken (fish oil may be the culprit), antibiotics can also cause it. Drinking pure water will help. Many people with similar symptoms are feeling better with it. Can try Vaseline or a diaper rash cream for the itch.

I have eaten ok like yesterday we went to a chineese rest as group i stayed with simple stuff rice noddle over rice with veggies and had some small strips of meat. It had a bunch of onions and garlic chunks too. That was good!.
A.     Try cooking and eating at home.

No issues and this morning bowel was good. I noticed some white pellet size chunks but the next stool was about 30min after that. That was last nights rice with furikake seaweed some XXXXXXX with bread stuffing and XXXXXXX desert. All ok there. Stool was ok too.
A.     Good good

Feel ok, tired though i wish for a cafeine load...
A.     Little bit caffeine is ok. Do not overdo it. Get tested.

Well after waking up i aslo noticed a red spot on my right inner side of the elbow and some little ones on that same wrist from the picture...
A.     Ok, not a big issue. Can try acnemol (over the counter cream found in skin care isle in pharmacies) for it.

Other than that i need to go out
A.     Yes, go out and have fun.

Take care

Dr Vaishalee

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Brief Answer:
Hi

Detailed Answer:
Hi again.

I went through the reports. The reports are very reassuring till now. The white blood count is so normal that I am thinking that the cause maybe non-infectious. Maybe auto-immune or rheumatologic.

Regarding slowed mentation, anemia has been ruled out till now. Urinalysis is also normal. Thus no urinary infection, etc.

Anyways how are your other symptoms now?
What have you been trying for your symptoms lately?
Is the health improving overall?

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

The symptoms are I still am having feelings of spaced out.... This is horrible is affecting me in many ways. Just afraid of many things . Feel of like a movie dying etc...however i still get some red spots here and there...

i believe improving overall... Lile i stated the hiv test at 11weeks-
A.     It is good that the condition is improving. If it gets better without much intervention, then it is the best thing.

but auto inmmune?
Reumatoid?
A.     I was thinking of these conditions as they can have similar presentations like rashes etc. Auto-immune condition is when body’s immune system attacks the organs. But it can result in a few positive tests. For example if the liver is getting afftected, then liver tests will be positive. These conditions are not so easy to diagnose, serological tests are done if suspicion is high.

Stool look ok
A.     Good

I sent another image for your consideration
A.     It looks like a cystic subcutaneous swelling-maybe epidermal cyst. But the diagnosis can be made on examination only.

I also want to mention that the Army PA i contacted didn't want me to get any tests. He stated that he rather send me to psyc. He highlighted that i dont have resons why to get tested for pancreas and, head and body MRI.
I get several symptoms that im observing and i cant get tested to rule out? At the minimum one is taking care of onesself and doing these tests out of a routine check is a valid reason to have these completed.

CT scan has been done but CT scan can see quicker soft tissue but can miss small tissue in development like MRI.

Im expressing my frustration too here...

Anothrr day feeling like im in a dream.
A.     I can understand your frustration. I think you should consult a neurologist and convince him enough that he prescribes you one. Usually it is prescribed if there are neurological symptoms like headache, neck pain, etc. Or it is prescribed if there is evidence of cerebral or cerebellar lesion. Altered mentation is an indication for MRI, hope you find someone who can help you with it. MRIs can be expensive and may take long time to get an appointment at some centers. I will also suggest you to continue taking vit B12 tablets.


is an EIA test at 11 weeks results; at 84day 12 weeks will change?
A.     Usually does not change.

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Red spots at various places suggest a viral infection, maybe hand-foot-mouth disease or maybe autoimmune in nature.

It is very common to have a viral infection and still not know the exact diagnosis, since viruses present with a wide range of symptoms.

Since you are suspecting HIV and test EIA test is repeatedly coming negative, I think we can go for a more accurate test called as PCR-DNA. It will catch the DNA of the virus if it is present in blood.

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi

PCR-DNA test is used to detect infection in early stages even before the antibody response is build up. It can detect viral DNA as early as 10 days after exposure. This test is also done to eliminate the need for repeat EIA tests.

EIA is used to measure the antibody levels which may not be positive in window period.

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

It is a good sign, but PCR-DNA can be done to clarify the doubts sooner.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Are these normal to you?711 image was several months back. The others today. Any signs?

A.     Yes these images are normal. Not much of change from 711 image. No signs of any infection except from coated tongue. Coated tongue is a very non-specific finding, does not mean much, except that you need to take hygienic food.

I hope you have made the following changes in your lifestyle:

- Take hygienic, nutritious diet and pure drinking water. Water from reverse osmosis technique is the purest and you can easily find it in the bottled water shelf in grocery stores.

- Eat more of fruits and vegetables - atleast 5 times a day

- Do regular exercise at least 20 min a day. Exercise can include walk, yoga, gym, cycling, swimming etc.


Regarding PCR-DNA test for HIV, you need to check with local HIV counselling center and they will be able to advise.

Regards

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

After HIV infection, the virus is released in the blood. As a result the body immune system tries to fight against this virus and starts producing antibodies.

This antibody becomes detectable after 3 weeks to 12 weeks and is picked by EIA.

So testing after 12 weeks after exposure should come positive if infection has occurred.

Thus negative EIA test at 13 weeks is very reassuring.

Dr Vaishalee

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Brief Answer:
Hi again

Detailed Answer:
Hi again

Yes if you think are reassured, then we can stop the HIV testing now. And repeat the test once in 6 months or 1 year just to confirm.

Dr Vaishalee

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Brief Answer:
It seems like an oral infection getting worse

Detailed Answer:
Hi

I have seen all images sent by you.

The red papillae are not a new growth but are happening due to some oral infection. This infection is wearing out the superficial lining of the mucous, thus exposing the capillaries of the papillae.

Thus if oral hygiene is taken care of, it may help reduce the lesions.
Consult a dentist for this issue. Maybe periodontal disease may be responsible. Thus professional cleaning of teeth may help.
Rinse your mouth with mouthwash.
Avoid taking supplements that may make it worse. Since some medicines (supplements) can reduce immunity and lead to all these issues.

Regards

Dr Vaishalee

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Brief Answer:
Did not get the images

Detailed Answer:
Hi

I did not get the latest images. The ones that I received seemed like the ones I received a few days ago. Please update.


Dr Vaishalee

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