I Am A 36 Year Old Heterosexual Male. Eight Years
Still, my symptoms persisted and many do to this day. At week 12, just after my second STD panel, the pain in my glans slowly went away but was replaced with swollen lymph nodes in my groin and armpits. I still have these to this day, confirmed by a doctor recently. In the past seven years, I also had two more small brown blisters show up on my inner lip. When they first appear, they are mildly sore to the touch, but the soreness goes away after a few days. I am still remaining with a brown mark from one of the brown blisters, although it is not sore at all. About every 3-4 months, I suffer from blood in my stool that will last anywhere from a couple days to a couple weeks. The first time this happened, I had a colonoscopy, and they did not find anything wrong (I assume they were looking for a sign of cancer). The anal itching has subsided quite a bit, but I occasionally still have spells of it, and it seems I always have a moist feeling around my scrotum with a sort of
Still, my symptoms persisted and many do to this day. At week 12, just after my second STD panel, the pain in my glans slowly went away but was replaced with swollen lymph nodes in my groin and armpits. I still have these to this day, confirmed by a doctor recently. In the past seven years, I also had two more small brown blisters show up on my inner lip. When they first appear, they are mildly sore to the touch, but the soreness goes away after a few days. I am still remaining with a brown mark from one of the brown blisters, although it is not sore at all. About every 3-4 months, I suffer from blood in my stool that will last anywhere from a couple days to a couple weeks. The first time this happened, I had a colonoscopy, and they did not find anything wrong (I assume they were looking for a sign of cancer). The anal itching has subsided quite a bit, but I occasionally still have spells of it, and it seems I always have a moist feeling around my scrotum with a sort of
Possibility of Candidaisis and Herpes simplex are there
Detailed Answer:
Hi,
Welcome to ASK DOSTOR through HCM.
Thanks for posting your query.
First of all you had prorected vaginal intercoures anf an unprotected oral sex. Oral sex carries a low risk for both HIV/STIs.
Believe your problems are not anything serious and not to be worried.
Forget about Gonorrhea and Hepatitits B and other STIs like HIV/ Syphilis as your STD panel tests ruled out these possibilities with repeated tests.
Now the problems are two.
1. You had candidiasis tested positive. Oral sex can cause candidal infection. You had Tablet Flucanazole for the same. I would like to know the dose and duration of the treatment.
2. You had recurrent blisters over your upper lip on the inner aspect.It could be due to Herpes Simplex virus which can be transmitted through oral sex and kissing.
The anal symptoms (Itching and passing bloody stools) are very much unlikely due to your sexual act. Anal Itching could be sometimes possible due to the extended candidiasis in anal verge.
Lymph nodes over groin and axilla may be due to variety of reasons. Your family sugeon can take care if you follow him sincerely.
Dr S.Murugan
Possibility of Candidaisis and Herpes simplex are there
Detailed Answer:
Hi,
Welcome to ASK DOSTOR through HCM.
Thanks for posting your query.
First of all you had prorected vaginal intercoures anf an unprotected oral sex. Oral sex carries a low risk for both HIV/STIs.
Believe your problems are not anything serious and not to be worried.
Forget about Gonorrhea and Hepatitits B and other STIs like HIV/ Syphilis as your STD panel tests ruled out these possibilities with repeated tests.
Now the problems are two.
1. You had candidiasis tested positive. Oral sex can cause candidal infection. You had Tablet Flucanazole for the same. I would like to know the dose and duration of the treatment.
2. You had recurrent blisters over your upper lip on the inner aspect.It could be due to Herpes Simplex virus which can be transmitted through oral sex and kissing.
The anal symptoms (Itching and passing bloody stools) are very much unlikely due to your sexual act. Anal Itching could be sometimes possible due to the extended candidiasis in anal verge.
Lymph nodes over groin and axilla may be due to variety of reasons. Your family sugeon can take care if you follow him sincerely.
Dr S.Murugan
I was prescribed Fluconazole, although I do not recall the dosage. I initially finished the prescription the doctor gave me, but it did not relieve me of my candida symptoms. Instead, I went to a pharmacy and purchased Fluconazole myself and used it for several months. I also used Itraconazole for some time. Although I am not a medical professional at all, I have a theory that the candida infection was an overgrowth caused by a primary infection that disrupted my gut flora by weakening my immune system. I also had streptococcus a few weeks after I was diagnosed with the candida on my scrotum. I know that candida and streptococcus live inside the human gut, but they can overgrow under certain conditions. I believe that condition was from another infection that has yet to be identified. What are your thoughts?
I have tested negative twice for HSV-1 and HSV-2. I have never had a lesion on my genitals. Futhermore, the lip lesion began at the exact same moment as the candida overgrowth and pain in my penis glans. I believe they are all connected.
It is just my personal uneducated hypothesis that the candida is/was also in my intestines, not just my scrotum. I believe the candida (acquired as a secondary infection due to another primary infection) is what is causing my occasional bloody stools with occasional mucus. I still believe that all of these symptoms are related.
Please let me know your thoughts. I also have another question. Would a lymph node biopsy tell me whether I am fighting an infection?
I was prescribed Fluconazole, although I do not recall the dosage. I initially finished the prescription the doctor gave me, but it did not relieve me of my candida symptoms. Instead, I went to a pharmacy and purchased Fluconazole myself and used it for several months. I also used Itraconazole for some time. Although I am not a medical professional at all, I have a theory that the candida infection was an overgrowth caused by a primary infection that disrupted my gut flora by weakening my immune system. I also had streptococcus a few weeks after I was diagnosed with the candida on my scrotum. I know that candida and streptococcus live inside the human gut, but they can overgrow under certain conditions. I believe that condition was from another infection that has yet to be identified. What are your thoughts?
I have tested negative twice for HSV-1 and HSV-2. I have never had a lesion on my genitals. Futhermore, the lip lesion began at the exact same moment as the candida overgrowth and pain in my penis glans. I believe they are all connected.
It is just my personal uneducated hypothesis that the candida is/was also in my intestines, not just my scrotum. I believe the candida (acquired as a secondary infection due to another primary infection) is what is causing my occasional bloody stools with occasional mucus. I still believe that all of these symptoms are related.
Please let me know your thoughts. I also have another question. Would a lymph node biopsy tell me whether I am fighting an infection?
1. Lymphocytes 56% (a limited panel of antibodies was performed due to low cell yield)
2. Mixed population of B-lymphocytes (5%) and T-lymphocytes (51%)
3. No B-Cell surface light chain restriction is detected
4. CD45 negative 44%
5. Events/Debris: (may represent degenerated cells/unlysed red blood cells, debris, etc)
6. Each marker in this analysis was used to assess for potential antigenic abnormalities or to evaluate detected abnormalities.
7. right groin lymph node shows fibrous tissue and minute fragments of lymphoid tissue with vascular congestion and rare possible follicles.
8. There are no definite Reed-Stenberg cells, metastatic carcinoma or granulomas identified.
9. The findings suggest a reactive lymph node".
I have recently run tests such as a comprehensive metabolic panel, c-reactive protein, ESR, TB, Antinuclear Antibody IFA (ANA), Thyroid, Cascade, CBC and Diff. All of these tests came back normal.
1. Lymphocytes 56% (a limited panel of antibodies was performed due to low cell yield)
2. Mixed population of B-lymphocytes (5%) and T-lymphocytes (51%)
3. No B-Cell surface light chain restriction is detected
4. CD45 negative 44%
5. Events/Debris: (may represent degenerated cells/unlysed red blood cells, debris, etc)
6. Each marker in this analysis was used to assess for potential antigenic abnormalities or to evaluate detected abnormalities.
7. right groin lymph node shows fibrous tissue and minute fragments of lymphoid tissue with vascular congestion and rare possible follicles.
8. There are no definite Reed-Stenberg cells, metastatic carcinoma or granulomas identified.
9. The findings suggest a reactive lymph node".
I have recently run tests such as a comprehensive metabolic panel, c-reactive protein, ESR, TB, Antinuclear Antibody IFA (ANA), Thyroid, Cascade, CBC and Diff. All of these tests came back normal.
Get well soon.
Detailed Answer:
Hi,
Welcome back.
I cannot take classes about candidiasis. I sincerely advise not to search in Internet, it may confuse you.
Candidal infection has multiple predisposing factors including diabetes Mellitus. Not to worry about whether you acquired the same from your gut or not? Apply clotrimazole cream externally twice daily for 4 weeks. A course of anti-fungal drug Tablet Fluconazole 150 mg twice weekly for 4 weeks can be taken under your doctors supervision. If necessary ask your sex mate or wife also to take the medicine.
If you are taking any other medicines, furnish the details. Rule out Diabetes Mellitus. Sexual abstinence is a must during the treatment.
Vesicular lesions over lip is common with HSV 1 infection. The results of HSV may not support the diagnosis sometimes.
Your lymph node biopsy indicates that it got inflamed. That's all. It could be due to any infections. Consult your doctor and get well soon.
Dr S Murugan
Get well soon.
Detailed Answer:
Hi,
Welcome back.
I cannot take classes about candidiasis. I sincerely advise not to search in Internet, it may confuse you.
Candidal infection has multiple predisposing factors including diabetes Mellitus. Not to worry about whether you acquired the same from your gut or not? Apply clotrimazole cream externally twice daily for 4 weeks. A course of anti-fungal drug Tablet Fluconazole 150 mg twice weekly for 4 weeks can be taken under your doctors supervision. If necessary ask your sex mate or wife also to take the medicine.
If you are taking any other medicines, furnish the details. Rule out Diabetes Mellitus. Sexual abstinence is a must during the treatment.
Vesicular lesions over lip is common with HSV 1 infection. The results of HSV may not support the diagnosis sometimes.
Your lymph node biopsy indicates that it got inflamed. That's all. It could be due to any infections. Consult your doctor and get well soon.
Dr S Murugan
I have already had a diabetes test. All results were normal.
One question: If I have a lymph node biopsy, would the biopsy tell me whether I am fighting an infection?
Thank you.
I have already had a diabetes test. All results were normal.
One question: If I have a lymph node biopsy, would the biopsy tell me whether I am fighting an infection?
Thank you.
Repeat biopsy may be needed at times
Detailed Answer:
Hi
Welcome back.
If it is through Fine needle aspiration technique, we can not rely the biopsy result 100%. If it is an excision biopsy we can rely maximum. Sometimes there may be controversy. Second and third opinion and repeat sections may be necessary to have conclusive report.
Dr S Murugan
Repeat biopsy may be needed at times
Detailed Answer:
Hi
Welcome back.
If it is through Fine needle aspiration technique, we can not rely the biopsy result 100%. If it is an excision biopsy we can rely maximum. Sometimes there may be controversy. Second and third opinion and repeat sections may be necessary to have conclusive report.
Dr S Murugan
And if so, what can be done to identify the infection?
Thank you for all your help.
And if so, what can be done to identify the infection?
Thank you for all your help.
Biopsy supports clinical diagnosis. Sometimes lead to diagnosis
Detailed Answer:
Hi,
Welcome back.
Lymphnode biopsy will reveal whether it is an acute or chronic infection. Certain infections like Tuberculosis and syphilis are revealed or suggested by hsitopathological examination. Other investigations like serology and other investigations, the diagnosis can be confirmed. It can rule out malgnancy. Some other unusual and unique problems can only be diagnosed or the diagnosis is confirmed only by the biopsy examination.
Dr S.Murugan
Biopsy supports clinical diagnosis. Sometimes lead to diagnosis
Detailed Answer:
Hi,
Welcome back.
Lymphnode biopsy will reveal whether it is an acute or chronic infection. Certain infections like Tuberculosis and syphilis are revealed or suggested by hsitopathological examination. Other investigations like serology and other investigations, the diagnosis can be confirmed. It can rule out malgnancy. Some other unusual and unique problems can only be diagnosed or the diagnosis is confirmed only by the biopsy examination.
Dr S.Murugan
1. Will the lymph node biopsy detect a viral infection?
2. Can you comment on the remark on my biopsy that states there are 56% lymphocytes? Is this within normal ranges?
I also just took an immunoglobulin test. Igg, Igm, and Iga were all normal ranges. Is this evidence that I do not have an infection?
Also, as I stated before, all of my other blood tests including CBC/Diff are all in normal ranges. If I have had swollen tender lymph nodes for 8 years due to an infection (bacterial or viral), shouldn’t this show in my blood work?
Thank you, Doctor.
1. Will the lymph node biopsy detect a viral infection?
2. Can you comment on the remark on my biopsy that states there are 56% lymphocytes? Is this within normal ranges?
I also just took an immunoglobulin test. Igg, Igm, and Iga were all normal ranges. Is this evidence that I do not have an infection?
Also, as I stated before, all of my other blood tests including CBC/Diff are all in normal ranges. If I have had swollen tender lymph nodes for 8 years due to an infection (bacterial or viral), shouldn’t this show in my blood work?
Thank you, Doctor.
All infections cannot be interpreted with routine blood examinations alone
Detailed Answer:
Hi,
Welcome back.
Viral infections are not predicted specifically with biopsy report except certain diseases like infectious mononucleosis.
IgG, IgA, IgM absence indicate that the there is no possibility of that infection after the window period.
About the 56% lymphocytes can better be explained by the pathologist rather than a clinician.
Some minor infections and certain viral infections can escape from normal routine blood examinations. They may need special tests like serology, PCR or culture tests etc.
Dr S Murugan
All infections cannot be interpreted with routine blood examinations alone
Detailed Answer:
Hi,
Welcome back.
Viral infections are not predicted specifically with biopsy report except certain diseases like infectious mononucleosis.
IgG, IgA, IgM absence indicate that the there is no possibility of that infection after the window period.
About the 56% lymphocytes can better be explained by the pathologist rather than a clinician.
Some minor infections and certain viral infections can escape from normal routine blood examinations. They may need special tests like serology, PCR or culture tests etc.
Dr S Murugan
I am unclear on what you mean by the immunoglobulin test result. Are you saying that, since my immunoglobulin test came back normal, then there is no infection present? Including a viral infection? This was a generic immunoglobulin test; it was not specific to any one antigen.
I know that the problem with a PCR test is that it is specific to the virus in question which makes this a problem when the virus has not been identified. How does a serology test work? Is it more generic? Does it look for the presence of any and all antibodies? Or is it like the PCR test in which it only identifies antibodies for certain infections? And the same question for a viral culture...how does the culture work?
Thank you for your time, Doctor.
I am unclear on what you mean by the immunoglobulin test result. Are you saying that, since my immunoglobulin test came back normal, then there is no infection present? Including a viral infection? This was a generic immunoglobulin test; it was not specific to any one antigen.
I know that the problem with a PCR test is that it is specific to the virus in question which makes this a problem when the virus has not been identified. How does a serology test work? Is it more generic? Does it look for the presence of any and all antibodies? Or is it like the PCR test in which it only identifies antibodies for certain infections? And the same question for a viral culture...how does the culture work?
Thank you for your time, Doctor.
Along with clinical findings the lymph node biopsy will be usefules
Detailed Answer:
Hi,
Welcome back.
There is no such indicator to point out a viral infection in lymph node biopsy.
Specific Immunoglobulin test to detect any infection is only of use, not the general assessment of Immunoglobulins.
If the lymph node biopsy suggestive of something, then the related PCR test or culture test will be useful either to confirm or rule out the conditions.
Dr S Murugan
Along with clinical findings the lymph node biopsy will be usefules
Detailed Answer:
Hi,
Welcome back.
There is no such indicator to point out a viral infection in lymph node biopsy.
Specific Immunoglobulin test to detect any infection is only of use, not the general assessment of Immunoglobulins.
If the lymph node biopsy suggestive of something, then the related PCR test or culture test will be useful either to confirm or rule out the conditions.
Dr S Murugan
Everything needs different applications and done in diffetrent stages
Detailed Answer:
Hi Mgeist,
Welcome once again.
It is not so.
Lymphnode biopsy will reflect either acute infection or chronic infection or any other pathology like malignancy, Benign tumor, Tuberculosis, syphis etc.
We have to examine the primary site of drainage (Say, throat, nose, chest, genitals, gluteal region or limbs etc.) If there is ulcer, lesion or pus from which we can do culture or somtimes culture from blood, urine and stools also.
For viral culture it is something different. It can not be done in all medical laboratories. It can be done only with certain sophisticated virological labs as it has to be culture in living cells or yolk sac.
Dr S.Murugan
Everything needs different applications and done in diffetrent stages
Detailed Answer:
Hi Mgeist,
Welcome once again.
It is not so.
Lymphnode biopsy will reflect either acute infection or chronic infection or any other pathology like malignancy, Benign tumor, Tuberculosis, syphis etc.
We have to examine the primary site of drainage (Say, throat, nose, chest, genitals, gluteal region or limbs etc.) If there is ulcer, lesion or pus from which we can do culture or somtimes culture from blood, urine and stools also.
For viral culture it is something different. It can not be done in all medical laboratories. It can be done only with certain sophisticated virological labs as it has to be culture in living cells or yolk sac.
Dr S.Murugan
A viral culture can be performed on a lymph node. I have an appointment with an Infectious Disease specialist in a couple of weeks. Can I request that my lymph node be cultured for a viral infection at a laboratory that has the capabilities to do so?
Also, are there any other ways a lymph node can be analyzed to determine whether it is fighting a viral infection?
I apologize for the multiple questions, but please understand I have been dealing with this issue for a long time now and I am in desperate need of an answer/diagnosis.
I thank you very much for your time spent helping me.
A viral culture can be performed on a lymph node. I have an appointment with an Infectious Disease specialist in a couple of weeks. Can I request that my lymph node be cultured for a viral infection at a laboratory that has the capabilities to do so?
Also, are there any other ways a lymph node can be analyzed to determine whether it is fighting a viral infection?
I apologize for the multiple questions, but please understand I have been dealing with this issue for a long time now and I am in desperate need of an answer/diagnosis.
I thank you very much for your time spent helping me.
The virus can grow only in living cells
Detailed Answer:
Hi,
Welcome back.
A biopsy specimen is usually sent in Formalin in which the virus will die. But it is possible to look for the presence of any virus in the lymph node in a fresh, unpreserved specimen. That too where a viral culture facility is available. The virus can multiply only in living cells. The viral culture facility directly from the lymph node is available only at selected institutions, better to contact your local labs for that.
To my knowledge, there is no other way to find whether the lymph node is fighting against viruses except the biopsy findings which may reveal the presence of inflammatory cells. The presence of these inflammatory cells may vary with different types of infections.
Dr. S Murugan
The virus can grow only in living cells
Detailed Answer:
Hi,
Welcome back.
A biopsy specimen is usually sent in Formalin in which the virus will die. But it is possible to look for the presence of any virus in the lymph node in a fresh, unpreserved specimen. That too where a viral culture facility is available. The virus can multiply only in living cells. The viral culture facility directly from the lymph node is available only at selected institutions, better to contact your local labs for that.
To my knowledge, there is no other way to find whether the lymph node is fighting against viruses except the biopsy findings which may reveal the presence of inflammatory cells. The presence of these inflammatory cells may vary with different types of infections.
Dr. S Murugan