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Lightheaded, dizziness, sinus infection and oral herpes after several protected sex. Could it be HIV?

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HIV AIDS Specialist
Practicing since : 1974
Answered : 2718 Questions
Good afternoon Doctor. I hope you can help me with the concerns I have regarding some potential symptoms.

I'm 42 and otherwise a healthy male. Two years ago I had several protected encounters with Transexual Sex workers and then one male sex worker. During the encounter with the male sex workerI think - but an not sure - that I used protection (intoxicated). This was in late October 2011

I do have bad seasonal allergies problems and have had for most of my life. On Thanksgiving 2012 I started getting a sinus infection. I also began to get oral herpes - which I have also had off and on for many years. At the same time I got itchy flaky eyebrows - which have since gone away. The sinus infection appeared to get better but then in mid December I started having clogged ears and tinnitus. I then went to an ENT who speculated that I had a sinus infection and gave me two weeks of antibiotics. I have felt horrible ever since. Some days I am very dizzy and out of it. I also have some hot flashes and feel like I sometimes have peripheral neuropathy in my hands and feet - sporadic. A few nights I have woken up with minor sweating - but again this is sporadic.

After two weeks on antibiotics and a CT scan it appeared I still had the infection. I get some post nasal drainage every day. The doctor put my back on antibiotics for another 2 weeks.

While the dizziness and lightheadedness is better I still have some times throughout the day where I feel it. I have had some loose bowl movements but this could be attributed to the amox K Clav that I'm taking (finished the last two weeks today).

Just today when I feel like things are improving I get a red/purple colored lesion between my upper lip and nose which appears like it has something hard underneath. It is about pimple size but is darker and doesn't act like a pimple (no white-head) or oral herpes. I also have had a very stiff neck (where the neck meets the back of the head) which comes and goes throughout the day. At times I feel like I have swollen lymph nodes under the jaw - but can't really feel them.

I don't rule out that this is all caused by anxiety / stress but the symptoms seem to overwhelmingly point to HIV. I realize that diagnosis based on symptoms is unreliable. But these appear to be overwhelming and I am scared to death.

Do these symptoms seem like HIV to you? Or is this just a really bad sinus infection?
Posted Sat, 16 Feb 2013 in HIV and AIDS
Answered by Dr. S. Murugan 3 hours later
Thanks for writing to us.
All symptoms described by you are not specific to HIV infection. As you have already symptoms of sinusitis and oral herpes infection, we cannot attribute your symptoms as acute infection of HIV.

Real immune deficiency symptoms of regular HIV infection do not manifest so early ( given that the only possible exposure you had was in October 2011). Also, your symptoms neither fit with acute infection and also with regular HIV stages. So I feel your symptoms are unlikely to be due to HIV.
The reddish spot in between your upper lip and nose may be an early furuncle or a cellulitis associated with lymphadenitis below your jaw. It will also vanish with appropriate antibiotics as per the direction of your physician.

But it is better to rule out HIV more confidently, as one of your sexual encounters is suspected to be risky, by doing a HIV Rapid test or ELISA test.
I assure that the result would be nonreactive. But it would help us allay your anxiety once and for all. So kindly submit yourself for a HIV screening and make sure you have protected sexual intercourse in the future.
Good luck to you.
DR S.Murugan
Above answer was peer-reviewed by
Follow-up: Lightheaded, dizziness, sinus infection and oral herpes after several protected sex. Could it be HIV? 18 hours later
Thank you Dr. for your answer. It does help me with my anxiety to hear from medical experts.

Let me please follow up with a few clarifying questions. As I discussed above, I finished my rounds of antibiotic pills yesterday. I remain on an antibiotic nose spray.

While I feel like I'm trying to eat a lot, I feel like I am losing body mass. My weight has remained at around the same weight but I feel like I have lost some inches. Since I have been on high cut back considerably on my salt intake this could be the cause of loosing some inches around the waste. However, My stomach still feels upset and while I would not classify my bowl movements as diarrhea I would classify them as very loose.

I am also still getting hot flashes throughout the day. It is only 67 outside but I tend to get hot at odd times while walking outside.

Couple all this with the fact that I just can't seem to break the post nasal drip and mucous in the nose and I am still convinced that my symptoms are what might be present during stages of HIV. When I read on the internet that the following are symptoms of HIV after the acute phase -These symptoms usually include:
Swollen lymph nodes.
Extreme tiredness.
Weight loss.
Night sweats.

These all seem to match what I have.

I realize a test would determine once and for all - however, a positive test result would be devestating to me and my family.

Why can't I seem to break what seems to be causing me to have all of these type symptoms?
Answered by Dr. S. Murugan 5 hours later

Welcome back with your follow up questions.

Irritable bowel a condition manifesting as various abdominal and bowel manifestations are known to occur due to anxiety and stress. Therefore all your symptoms like not able to eat, stomach upset, loosing body mass, extreme weakness are simply due to your anxiety and fear for HIV.
Other symptoms like nasal discharge and hot flush are not very specific only to HIV. Chronic nasal pathologies can very well produce similar symptoms.

I understand website gives various information which are scaring and only adds anxiety. Hence the only solution to all your questions is to get screened yourself for HIV. I am confident that you will have a negative result and you will be relieved. Furthermore, HIV is no longer a devastating disease. It is a well manageable disease like any other disease, so nothing to worry about that very much. The current treatment offers HIV infected individuals a fairly good quality of life and a means to live long without any problem even with HIV as any one.

So relax yourself and get your HIV test done and you will feel happy and relieved to see the result as nonreactive. Don't get confused with the readings in the website.

I hope that I had cleared your doubts. Let me know if you have other enquiries.
If all your queries are answered, please close this discussion.

Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Lightheaded, dizziness, sinus infection and oral herpes after several protected sex. Could it be HIV? 38 hours later

Again - thank you for your answers.

Today (friday) I am three days off my second two week round of antibiotics. It seems like my lightheadedness is returning now.

Most symptoms have seemed to subside, however, a few still remain.
1) lightheaded, foggy
2) still have post nasal drip and blowing clear mucous from nose - this has been going on for almost two months now. I started taking Zyrtec - D yesterday.
3) still feel like I'm eating a lot just to maintain my weight.
4) Still have constant ringing in my ears (tinnitus)
4) good news is - The XXXXXXX between my lip and nose seems to be going away without any treatment.

I'm sorry to keep asking these questions - but I just can't seem to shake whatever is bothering me. Molds and Cedar are high here where I live and I know that I am allergic to both - but can allergies be causing all of this? And for almost 2 months? I have never had this much of a problem before.

Thank you for your response.
Answered by Dr. S. Murugan 7 hours later

You are welcome to ask questions.

Yes, allergic rhinitis can cause a picture like this and all symptoms explained by you can persist for even years together for some people.

Still, I advise you to get HIV test done and see the nonreactive result and get relaxed. Don't imagine things.

You will be alright.

Above answer was peer-reviewed by
Follow-up: Lightheaded, dizziness, sinus infection and oral herpes after several protected sex. Could it be HIV? 46 hours later

Again thank you. I feel as if I'm just searching for symptoms sometimes and know that the best way to be sure is through a test.

The last few days I have been very very tired by the end of the day. Fallen ink asleep very very early. I generally have a bowl movement (loose) immediately when I wake up and then another just after I eat breakfast. I don't have a bowl movement again for most of the day but my stomach is constantly churning almost to the point of being upset. This particularly happens after I eat.

Also - as I stated earlier I have lost some body mass. My pants are beginning to fit loosely yet I haven't been trying to lose weight.

Finally I tend to get a sore next at the end of the day. I just don't feel right. Not like myself at all. It is very troubling.

Many of these symptoms are also present in people with HIV. How can you be so sure that mine are not given that I have had potentially high risk exposures?

With high regards for your patience with me.
Answered by Dr. S. Murugan 3 hours later

Very happy to answer your feed back questions.

All the symptoms explained by you like feeling of loss of body mass, altered bowel habits, lethargy, your disturbed mind set can also occur in anxiety related issues. Even irritable bowels can be precipitated by the same anxiety.

Therefore the only solution for all these problem will be to XXXXXXX your physician and get examined yourself. The HIV test will clarify and prove beyond doubts about your HIV status - thus allaying all your fears about HIV. You will be alright then and can concentrate on your regular day today routine.

Wish you good luck.
Dr S.Murugan
Above answer was peer-reviewed by
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