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Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV?

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ENT Specialist
Practicing since : 1991
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I had potentially unprotected (insertive) male on male sex in October of 2011. I say "potentially" because I was intoxicated but I thought at the time I had on a condom.

At the end of November of 2012 I started developing what I thought was a sinus issue that I get due to allergies 3 or 4 times a year. Symptoms have persisted off and on now for over three months. Some of my symptoms are as follows;

Stuffy nose
Post nasal drip - December
Itchy scaly eyebrows - november
Oral herpes - off and on now and for many many years
clogged ears - off an on since December
Night Sweats - December
Fatigue - December
Lack of Concentration, Dizzy, lightheaded - December
numb, tingly hands and feet - December and hot foot (bottom) now
High blood pressure - since December - now on meds
tinnitus - since December
Off and on loose stools and upset stomach - Once every few weeks since December
External hemorrhoid - came up a few weeks ago but has since gone away.
Dry mouth - now
possible oral thrush - not sure (rough patch inside left cheek)

I have strong mold, and tree and grass allergies. I live in an area of XXXXXXX (Austin) that may be the worst for allergy sufferers. I was much better in February but March has brought back the clogged ears, tinnitus, and severally stuffy nose. I have had this for 2 1/2 weeks now.

Back in December I was on 4 weeks of antibiotics for an infection which helped me heal. I am not currently on antibiotics but I am on steroid nose sprays, zyrtec and singulair and nothing seems to help. The ringing, clogged ears and stuffy nose are killing me.

Is this primary HIV or do I just need to get a better control on my allergy issues?

What I have now is;

1) clogged ears - I blow them out every so often during the day
2) Very loud tinnitus
3) Stuffy nose - constantly blowing out mucous
4) irregular bowel movements - not loose - just not healthy and not regular
5) canker sore on lip
6) irregular skin patch on inside of left cheek / Dry mouth - this is relatively new

I will get healthy for a few weeks - with limited tinnitus and then the pollen and molds kick up and I am back to this state.

I just need some relief to feel good. I take zyrtec and a steroid nasal spray and nothing seems to help.
Posted Tue, 30 Apr 2013 in HIV and AIDS
 
 
Answered by Dr. Sumit Bhatti 40 minutes later
Hi,

Thank you for your query.

1. Get the following tests done:
a. A plain CT PNS (Para Nasal Sinuses) with 1 mm coronal, axial and sagittal cuts on a multi-slice CT Scan Machine. This will help diagnose the stuffy nose, mucus and sinus issues.
b. A Pure Tone Audiogram (PTA) and an Impedance Audiogram (I/A or Tympanogram). This will help in the understanding of the clogged ears and tinnitus.
c. An ENT examination. The appearance of the inside of the nose and the appearance of the eardrum will help diagnose the problem. It will also help predict response to ant treatment given.
d. Routine blood tests, HIV & HbsAg test, Thyroid function tests (hot soles of the feet), autoimmune markers, Vit. B12, D3 and calcium levels. (numb and tingly hands)
e. Stool examination. Since you have irregular bowel movements.
f. A biopsy from the edge of the canker sore and one from the irregular patch on the inside of your left cheek. Get an HPV test run on the specimen in addition.

2. If you already have some of these reports, upload these and further treatment options may be discussed.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV? 3 days later
I appreciate your very complete suggestions.

I saw an ENT back in December and he did a CT Scan, Pure Tone test and examination. He just said that I have a sinus infection - sinusitis. He prescribed antibiotics in mid December for two weeks and then another round of three weeks in early January. This seemed to help and by the end of January O was feeling good. I still had the tinnitus. However, about that time was when I started experiencing the irregular bowels and irritable stomach.

February was a relatively good month and then around the 10th of March (which is when molds and pollen are very high here in Austin) I started getting the stuffy nose, yellow / green mucus clogged ears and tinnitus again.

Pollen levels are still high but going down and the stuffy nose has subsided considerably. No longer do I have yellow green mucus - but still blow my nose often. The clogged ear is still slightly present and the tinnitus is still active.

One thing is that I have started to develop a metallic taste on my tongue. I was also taking a steroid nose spray which I have stopped today because of the taste. The canker sore on my lips are gone and the sore on the inside of my left cheek seems to be going away but very slow (this could be from cheek biting). My tongue looks fine except at the very back where there appear to be some white stuff. Hard to tell.

Could I have an overgrowth of candida? I read that this is something that is seem in HIV cases? Can normal healthy people get this candida buildup?
 
 
Answered by Dr. Sumit Bhatti 47 minutes later
Hi,

Thank you for writing back.

1. Normal healthy people can also get a candida build-up.

2. Allergic fungal rhinosinusitis (AFRS) must be ruled out. Which steroid spray were you on? A metallic taste may be due to a post nasal drip, funga infection, nasal sprays or acid reflux.

3. Are you currently on any antiretroviral medication?

4. Crofelemer (Fulyzaq) is a new drug for diarrhea due to antiretrovital drugs.

5. Does your Pure Tone Audiogram show any hearing loss?

6. You may follow up with the results of the other tests mentioned above.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV? 12 minutes later
1) I'm normally healthy other than these issues listed above. Perhaps a touch of anxiety and stress with work, family and the scare of HIV.
2) The steroid spray is dymista
3) I am not currently on antiviral medication - I have not tested for HIV
4) I don't really have diarrhea. my bowel movements have just been a bit irregular.
5) The audio test showed some slight hearing loss - possibly due to sounds from guns and hunting
 
 
Answered by Dr. Sumit Bhatti 23 minutes later
Hi,

Thank you for writing back.

1. Get an HIV test done. It will help get over the anxiety.

2. The azelastine in Dymista gives that bad taste on the tongue. Request your doctor to change the spray.

3. Try probiotics for your gut problem.

4. Noise induced hearing loss (NIHL) will usually show a sharp dip in hearing levels in the 4 to 8 kHz range. The Tinnitus may be due to this NIHL.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV? 7 days later
Thank you Doctor for your responses.

1) I'm very fearful of the HIV test. All logic says that the one brief encounter would not likely infect me yet the consequences of a positive result keep me from being tested. Do you think it is more anxiety than anything?

2) I stopped the Dymista. The bad taste in the tongue has stopped but my mouth doesn't feel completely healthy. I had some rough spots inside my cheek but they werent really white and didn't really look like thrush. A once over with the tooth brush and it goes away. The mouth just feels unhealthy.

3) The gut is still a bit of a problem. I seem to have a diarrhea once a day but once everything is out no problems until the next day. some days the stool is more consistent and no diarrhea (today). Over the weekend however both days I had diarrhea in the am.

4) The clogged ears and the ringing is just the worst. particularly at night after a long hard day at work.

5) the warm right foot continues to be a mystery.

I can't help but think that my body is telling me something is wrong. Perhaps it is just that I am working too much, stressed from work and family life, not exercising enough and also worried that I have some bad disease.

Any advice?
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Hi,

Thank you for writing back.

1. You are correct in assuming that the chances of being HIV + after a single exposure is very low. The result of your HIV test is the key to your problems. The entire management will change as per the test results. Your anxiety will also disappear with a negative test. Today, anti-retroviral therapy has made management of HIV similar to any chronic disease.

2. You may uses a plain steroid spray without the azelastine. Use a medicated mouth wash for two weeks. Over use, over cleaning will also cause such symptoms.

3. Get the stool test done. f it shows the stool is formed or normal, this is probably due to change in normal gut flora or anxiety.

4. Get your ear tests done.

5. Get your Thyroid function tests (hot soles of the feet), autoimmune markers, Vit. B12, D3 and calcium levels (numb and tingly hands) done soon.

Chronic stress and anxiety can cause the most bizarre symptoms.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV? 15 hours later
So would you feel good about the chances of a negative result going into the HIV test?
 
 
Answered by Dr. Sumit Bhatti 8 hours later
Hi,

Thank you for writing back.

1. There is usually some confusion even with a negative test result in the initial months due to the 'window' or incubation period.

2. A test that is negative after one and a half years is very reliable.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Having dizziness, light head, dry mouth, external haemorrhoid, stuffy nose. Had unprotected sex. HIV? 7 hours later
I guess my question is given the symptoms is this likely HIV or something else including anxiety.
 
 
Answered by Dr. Sumit Bhatti 8 hours later
Hi,

Thank you for writing back.

1. There are many common medical conditions that have similar symptoms to HIV.

2. The HIV virus knocks out the body's defense (immune) system and allows other infections and cancers (that are normally controlled by the immune system).

3. You also had a 'potential' exposure. Hence anxiety and chronic stress is also a contributing cause.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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