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Having abdominal pain. CT scan, blood and urine test done. Is there any HIV possibilities?

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General & Family Physician
Practicing since : 2005
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I'm a 43 yr. old white male from the Chicagoland area. I have been athletic and healthy my whole life until Nov. 20,2011 when something went wrong! A bit of background, I do not smoke or take any drugs.I'm more of a weekend drinker,depending on who i'm out with i may just have a couple drinks or if i'm out watching a game we may go heavier with beer and shots,sometimes too much. I'm not taking any medications and i'm the type of person that would barely take an aspirin hardly ever. Here's my story. On Saturday Nov. 20,2011 i went out to dinner with my wife and another couple. I returned home and a few hours later i woke up about 1 am with SEVERE abdominal pain and dry heaving.The pain lasted the whole day and by monday i felt like it might go away.The next day on tues., I took my family to the Bahamas for Thanksgiving and on the night before(on WED) i had another episode. This time along with the severe abdominal that woke me up again around 2am, I was experiencing violent vomiting and diarrhea for hours.I did not notice any blood.Just kept going thru out most the night. The pain lasted the whole day and maybe after 24 hrs. plus started to feel like it was going away again by Fri. Just over 2 weeks later on Mon. Dec.12,2011 i woke up in the early am,maybe 2 am again with the 3rd episode.This time was like the first with SEVERE pain in my abdomen and dry heaving but NO vomit or diarrhea.Just dry heaving. The pain always felt maybe a little to the left of my belly button.I went to the ER that morning and they tested blood,urine and a CT scan. They gave me antibiotic for what appeared to be possible inflammation in the small bowel & pain medicine.The next day I went to see My Family Dr on tues Dec. 13th 2011 where he switched my antibiotics. After i took them for the first time that late afternoon around 4ish i later had black stool, i didn't notice any foul oder. Took the antibiotics again that night around 11pm. went to the bathroom again later that night and still black.On Dec. 21st,2011, I went up to see a GI Dr. for an exam. He noticed from my ER test results that my platelet count was real low 53,000.My abdominal pain was very mild by this point and i haven't had anymore more attacks since the ER visit. Now we were on the search of why my platelets were low. I had more blood test and the platelets went down a little from 53,000 to 50,000.I now went to see a Hematologist about my platelets on Dec. 27th 2011. That Dr. did not feel based off the other test that my liver or spleen were the cause. She also felt the pancreas enzymes looked normal. We did more blood 2 weeks later. At this point i have been off the meds since Christmas Eve and haven't taken anything since XXXXXXX 9th,2012 I went to see My Family Dr. again,this time about my heart cause i was waking up with a racing heart. Maybe cuz' the stress. Only happened in my sleep and would stop racing a minute after waking up.
Took an EKG test and didn't see anything abnormal but did send me to wear a Holter for 24 hrs. to monitor heart activity.Everything with my heart checked out okay. XXXXXXX 11th,2012 wed. The Hematologist called to say the blood looks good but the platelets dropped again for the 3rd test in a row,down to 45,0000 from 50,0000 and the HIV ab1/2 blood test was negative. I looked at a past history of my platelets from 3 yrs. ago and they were at 189,000. XXXXXXX 16th 2012 , I went in for a bone-marrow biopsy.They took Marrow,Bone fragment & Blood. I also went to the lab for more blood work for Hepatitis Test and a Viral Load quantitative RNA test for HIV. Results came back non reactive on all but the platelets remained at 45,000. XXXXXXX 20th 2012 fri. My joints have been sore for sometime and my neck is a little stiff. My left knee which is bad to begin with is making it difficult to walk at times XXXXXXX 30th tues. I went to GI Dr for a scope down my throat. I went to him a year earlier for a colonoscopy due to my father having a small amount of colon cancer. My results were negative and my scope was as well.Feb 15th 2012 my Platelets went up for the first time from 45,000 to 54,000. March 15th 2012 thurs. Platelets up again from 54,000 to 60,000. April 13th 2012 results down from 60,000 to 57,000. Sun April 22nd my hands and feet are starting to tingle and ache.This is still continuing today and has been about a month now.May 15th 2012 tues. I went to see my Family Dr. about the tingling in my hands and feet & He ordered more blood work. I tested Positive XXXXXXX Low Vitamin D (22.3), and platelets slight drop again from 57,000 to 55,000. I went to the Rheumatologist for more blood and urine test. In addition to all the symptoms above, i now noticed what appears to be little red bumps on my tongue and the right side of my jaw was starting to ache a bit.I have a few bumps on the sides of my tongue that started to appear around early XXXXXXX The bottoms of my feet have been causing me some pain for almost 2 months now. My b12 normal,metabolic normal, thyroid normal, Rheumatoid arthritis negative. He did test for Lupus and Lyme disease which came up negative and additional blood work. Which he said all looked pretty good. I have NO skin rash. I do have an uncle that has MS. My platelets have remained low between 30,000 and 60,000, I am very fatigued and taking afternoon naps cause the lack of energy.The bottoms of my feet are still a bit painful and difficult to get out of bed in the morning for about 2 months now.My hands are not as bad but a little joint pain.Sometimes i feel that I have to think about recent events more than usual. My memory at times is a little foggy. Occasionally my neck and back get stiff.
This all started in Nov. of 2011.I'm 43 years old and felt like i was still in my 20's until that one night in Nov. out to dinner. Everything has gone down hill since that night. I'm not sure if something with the food could've triggered something that is the cause of this? It just seems odd that I felt great and 20 yr.'s younger with no medical history at all,then all the sudden i woke up in severe abdominal pain a few hrs after a late dinner at a restaurant. From that point on i went from no history to now carrying a folder full of test files over the past 7 months. Another question,How ACCURATE is HIV test? I had an HIV 1/2 AB screen at 87 days since possible risk that came back NONREACTIVE result. I also took an HIV RNA Quantitive HIV PCR Quant,Log 10 Hiv and the results came back Not Detected. This test was 94 days after possible risk. Are these ACCURATE results? Am i out of the woods with those test? Just to recap, my platelets have been in the 40k-60,000 range. I just tested Positive XXXXXXX 1:1280 and a Vitamin D level at 22.3. Pain in the bottom of both feet lasting about 3 months so far,mild ache in both hands,extreme fatigue in the afternoon,mild headaches that come and go only lasting a few minutes,occasional stiff neck.I feel at times i have a little bit of foggy memory where i have to think harder about what i may have done last week.I can remember but it seems to take time to really think about it. I have not noticed any fever or weight difference at all.No loss of appetite.My stomach has been causing a mild belly ache the past few weeks that just feels a little off.It's been nearly 8 months so far and the frustration and stress of not knowing what's wrong is killing me I keep reading about Fibromyalgia,CFS or H Pylori. Can any of these be a cause or is that something that could develop because of something that brought it on? I'm Lost and very scared especially about if there's any HIV possibilities? Thank You, XXXXXX
Posted Tue, 7 Aug 2012 in HIV and AIDS
Answered by Dr. Shanthi.E 4 hours later

Thanks for posting your query.

I read your query in detail. I am sorry that you are facing this. However, I do not think that this is a complicated health concern that cannot be addressed.

Firstly XXXXXXX when you had the initial first attack, did the CT reveal anything positive like an acute Appendicitis or colitis? CT is the best investigation and if that has showed nothing, then I do not think there was a problem initially. It could have been a simple episode of food poisoning.

Second, please do not think about HIV anymore. You have had enough tests for it. You are HIV negative as of now, is what I feel unless you have a future possible exposure again.

Thirdly, your platelet count of 40,000 to 60,000. This is not a good sign. Rarer causes of this are always rare. However, a common cause of low platelet count is an attack of acute viral illness like Dengue, Chikungunya, etc. These commonly cause a fall in the platelet count.

A Rheumatological cause can also lead to low platelet count when it is associated with inflammation and acute phase reactions. A positive XXXXXXX of 1:1280 definitely suggests an underlying Rheumatological disorder. A rheumatologist will be able to easily zero in, on the disorder based on further specific tests.

Your vitamin D level is not very low. The lower limit of normal is 25. It may be secondarily low due to the underlying bones and joints pathology.

Please do not be scared. You should make an attempt to lead the previous healthy life that you lived, once again now.

A consultation with a Rheumatologist will solve most of your problems. Please make sure that your platelet does not fall to below 0000.

It is also better to get a viral serology done to rule out recent viral infections, if any.

Hope this helps.

I wish to see you back in good health soon.

Please do write back for follow up queries that you may have.

Above answer was peer-reviewed by
Follow-up: Having abdominal pain. CT scan, blood and urine test done. Is there any HIV possibilities? 4 hours later
Being that i never had any medical history before this, i was always leaning towards it being related to that night in Nov. after dinner when i had the 1st episode a few hrs. later. If it was food poisoning,is it possible to only have severe abdominal pain with dry-heaving and then a 2nd episode 4 days later that had pain again this time with vomiting and diarrhea. and then a 3rd episode another 2 weeks later? Is there any other infections/contaminations that could be tested that have been lingering for 8 months in my system? My history was probably nothing more than school shots,now i carry a folder full of test all from that night til' now.I was told that the CT scan showed possible inflammation in the small bowel at the time of the ER after the 3rd episode.The HIV 1/2 AB screen at 87 days since possible risk that came back NONREACTIVE result and the HIV RNA Quantitive HIV PCR Quant,Log 10 Hiv and the results came back Not Detected.This test was 94 days after possible risk. Are these ACCURATE results after 87 & 94 days???? Since these test were taken after i had symptoms of abdominal pain,vomit & diarrhea,does this mean i should've shown enough antibodies to detect possible HIV? I have not had any risk since then.Also,i have never noticed or felt like i had a fever at all this whole time.I thought at first i may be out of the woods and just monitoring my platelets for about 5 months when all of a sudden the bottoms of my feet burning started and has been there everyday for 3 months now.I.m lost and so far every Dr. i've seen doesn't seem to have an answer.Thank you, XXXXXX
Answered by Dr. Shanthi.E 12 hours later

Please be patient and bear with me. We shall find a solution to your problem. I am sure that there is nothing seriously wrong with your health.

Yes, it is possible that the first episode was a food poisoning that continued into the second episode 4 days later. The third episode may have been due to inadequately treated previous infection or a fresh episode of colitis again.

The CT scan revealed inflammation in the small bowel, please confirm what lead to this inflammation. Is there a primary cause to it, did the treating physician say anything about the cause of this inflammation?

The HIV tests that you have undergone are accurate at 87 and 94 days, more so at 94 days. 90 days is sufficient for someone infected with HIV to develop detectable levels of antibodies in the blood.

Please let me know your latest platelet count.
XXXXXXX it is my humble request to you to write in brief about your current symptoms.

I would like to know more about the pain and burning in the bottom of both feet, in both hands, about the fatigue, headaches that come and go, the stiff neck. Are these symptoms still persistent?

You have not lost weight and there is no loss of appetite, it means to say that there is no long-standing infection in you, which has lasted for more than 3 months.

A positive XXXXXXX of 1:1280 is very non-specific and is seen in so many rheumatoligcal conditions. Further testing in the form of anti-CCP antibody, anti-Ro antibody, anti- RA 33 antibody are required to confirm on the cause. XXXXXXX alone cannot confirm on any rheumatologic disease. Please go ahead and get further tests done. I hope you have got your blood sugars tested and they are normal.

The first incidence that occurred in Nov 2011 might be just a co-incidence.

I wish you healthy life.

Awaiting your response.


Above answer was peer-reviewed by
Follow-up: Having abdominal pain. CT scan, blood and urine test done. Is there any HIV possibilities? 21 hours later
My current symptoms are: both bottoms of feet still burning! It's been everyday,all day for the past 3 months. It's worse in the morning when i first get out of bed. My stomach has been a bit achey for the past month that comes and goes thru out the day. My platelets when last checked in mid may were 55,000 and i also tested positive XXXXXXX My neck is usually pretty stiff with just an overall acheyness thru out my body. Not any pain with that just overall ache. I have NOT lost any weight or appetite at all during this whole mystery sickness. When i went for the CT scan in the ER back in Dec. 2011 i was not told the cause of the inflammation in the small bowel and was only put on Cipro and Metronidazole for 10 days. I have not taken any meds since Dec.24,2011. I'm scrambling for answers and very scared since no one has been able to tell me anything in 8 months. I never had good sleeping habits. I go to bed late and usually up early.Does any of this sound like, CFS,Fibromyalgia,H Pylori? Thank You for your Help! XXXXXX
Answered by Dr. Shanthi.E 3 hours later

Thanks for writing the details.

CFS is a possibility as you never had good sleeping habits and it is a diagnosis of exclusion.

There is a strong possibility of Fibromyalgia too as it is associated with conditions of systemic inflammation like RA, SLE and mostly is seen in conjunction with high XXXXXXX titers.

I do not think it is H. Pylori.

Your platelet count is still on the lower side. It may be consumed in the inflammatory process occurring in your joints.

Fibromyalgia is more probable in your current situation than CFS. The management of Fibromyalgia involves a multi-disciplinary approach.

You should proceed along these lines.

Please do write back for follow up queries that you may have.

I wish you early recovery.


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