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Suffer Fever , Chillness, Weakness, Vomitting, Diarrhoea And Red Pathces In Her Mouth. What Could This Be?

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Posted on Thu, 17 Oct 2013
Question: Dear doctor

I am again with few new dobut. I had moved on but certain incidents made me ask you again because i was at my parents home. I am very terrified now since while I was at home i had piles but it was painless so couldn't notice and accidently it came to my notice while washing ass(sorry for grossness) so i washed hand completely and there was no visible blood on my hand and i used hand to stop tap and for flush . After 3 min my sister used the toilet and she was in her period (since she was not entering worship room as per our culture) so is there any possibility of infection through this way. since after two weeks she has classic ARS symptoms like fever , chillness, weakness, vomitting, diarrhoea and red pathces in her mouth. I know it is very unlikely but since she is my sister so i am very much worried and feeling guilt. I did not tell my family about my case and I should have told about it and may be due to my hesitation i have done bigger crime. We are also looking boy for her marriage so due to this incident my tension are on sky. It seems there is no end to my problems.

Because of this new problem my tension again XXXXXXX to sky with gulit of infecting her. So after 76 days or almost 11 weeks i got tridot test for calming my mind and ruling out that possibiliyt and it was negative. How good or conclusive is tridot test? Here in this forum some doctor say it is outdated test but in the city whereever i went i found this test only and laboratories are not offering elisa test. Only few laboratories are offering elisa test and they have webcam so i am little worried. Can I take it as conclusive test at 11 weeks or should i get myself tested again. Is it comparable to elisa in performance? and is it good for hiv 2 type also. Because i had pcr test for hiv type 1 only.

What is conclusive time 12 weeks or 3 months. Some site say 12 weeks and some say 90 days. Because if it 12 weeks then i can have some relief since only 7 days difference and if it 90 days then again torutue for 15 days. What is conclusive if suppose i have test exactly after 90 days , will it be considered conclusive or should i wait some days past 90 days. Since i got tridot at 11 weeks so can it be taken close to conclusive including hiv type 2. Or after 90 days which test shoud i opt?

Why does some people have to wait for 6 months for conclusive test? Does my case come under this category due to possibility of hiv 2 type?

Sir right from that incident my skin has turned weird, now after pressing or scratching it just turned bright red and remain for some time. This I never seen before, Is it related with any viral infection or bacterial infection. I have some time body itching and it appears blackening of skin on my body is increasing. Do you suggest any test for it.

Sir should i get tested for hep B and hep C also ? I have taken vaccine for hep B earlier all three dose at adequate interval so even after vaccination can i get hepatitis B. And for Hepatitis C what test is good after 3 months. Can I get hep c from oral sex of 3 sec. These viral marker test are very expensive so I am waiting for next month salary so your suggestion will be very helpful.

sorry again for so many questions and sorry again for bothering you.
doctor
Answered by Dr. Dr. Prasad J (53 minutes later)
Brief Answer:
HIV infection is unlikely....

Detailed Answer:
Hi,

I reviewed your discussions with the last doctor and I agree with his comments. HIV is unlikely in this situation.

Though elisa is more accepted test than tridot, there is no significant difference between both these in a case where the risk of exposure is very low as in your case. I will take the results of tridot at 11 weeks to call you as HIV negative.

Yes, I agree with you that window period duration is believed to be 3 months to 6 months. But most experienced HIV specialist consider reports at 3 months to be valid and do not advice a repeat test at 6 months especially when risk of exposure is low. So I don't think you should be worried about window period and repeat tests.

Moreover it is impossible that you would infection family members by touch as the virus is very fragile and dies within few minutes in external environment. So do not be concerned about your sister getting HIV.

As far as Hepatitis is concerned, oral sex is not the preferred route of transfer. It needs proper body fluid exchange either to intercourse or via needle pricks. Therefore I do not think you need to be worried about Hepatitis too.

I hope this answers all your questions. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (5 hours later)
Dear doctor

1. Regarding infection of my sister, i washed my hand , and there was no visible blood on the hand , i made sure, then i turned the tap off and used the flush. After 3-4 minutes my sister used the toilet. She was in her period. I really dont know how long hiv can survive since there are different claims, some say it die immediately, some says survive few minutes , and earlier I had read it died immediately , therefore i touched the tap and flush button. Otherwise I would never do that. Since after 2 weeks she had fever with almost same symptoms, i got paranoid. so in this scenario where there was no visible blood and washed hand was used could hiv survive in minute amount. scientifically i myself wouldn't believe but here since my sister is concerned i am being worried. Please in this scenario reevaluate the situation. sorry for repeat question but for peace of mind it will be very helpful.

2. Would tridot accuracy be less if there was high exposure? which test would you suggest in that situation and when?. I understand my exposure was less and there are hardly any validated or reported case of transmission through cunnilingus , here my exposure was only 3-4 sec clitoris licking but since my all symptoms started at exact same time and mimicked every thing .There is not a single symptoms which was left even angular chelites and worst part is my inverted cd4 ratio which was only 0.2 (have only been seen in hiv infected cases and in acute infection also) so I am mentally very disturbed . Because of all these I doubt my results sometimes. Thats why i asked how accurate is tridot because i didnot read about it before. So after all these symptoms and reports(negative DNA, RNA PCR and 4 gen DUO test at 26 and 41 days and 11 weeks negative tridot) are you seriously consider me hiv negative ? please give your candid reply.

3. I still feel weakness in shoulder and get tired soon, pain in lymph nodes in neck and still these nodes are swollen and visible. Strange redness of skin on any touch which last for some time. White coating in mouth inside (little) still here after 80 days . Does ars or related symptoms last such long? What other infection can cause , any clue becaues all these daily remind me of hiv infection. Because of hiv fear i am not meeting other doctors in city , I fear discrimination since not all doctor treat any possible infected person and I have to save my identity also.

Please answer all the questions. Thanks again.
doctor
Answered by Dr. Dr. Prasad J (5 hours later)
Brief Answer:
Clear your mind about HIV

Detailed Answer:
Hi,

Technically speaking HIV is transmitted only when there is body fluid exchange. It does not pass intact skin. HIV can have potency to stay viable for a few minutes. But there is no chance it would be both viable enough to be transmitted to your sister thrift the described events. Moreover as I said HIV cannot pass through intact skin.

As far as tridot is concerned it is close to 99.5% sensitive in picking up HIV infection. That implies the chance of it missing the infection is close to zero. However the sensitivity depend on the time of testing. Therefore the need to repeat test a few times. We combine other test to take care of this limitation. PCR test and dual combo test are the combination tests. Now since they are negative on two different occasion, it's sufficient to convince your doctors about your HIV negative status.

The pain and other set of symptoms could very well be sure anxiety and your fear of HIV. Therefore at all nationalised testing centre we also combine counselling sessions along with testing. If your symptoms are affections you feel free to visit a clinical psychologist.

Hope this answers your questions.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (8 hours later)
Dear doctor

Sir my sister was in her periods and not attending worship, I was wondering that after having washed my hand with water some minute amount could have been left and may remain on tap or flush button. Since she used toilet just 3-4 minutes later and was in her period so there could be possible blood to blood conncetions. and then she had high fever(only for three days) , chills, sore throat, red patches in her mouth and all these made me paranoid. Just consider this case.

Thanks for reply regarding hiv probability, I can relax now, becasue i was going for marriage and I dont want to spoil her life and future so I was being a little cautious. This was the only and only mistake of my life so taking some time to adjust.

Now I will find another doctors for other symptoms, these could be anxiety ridden but my lymph nodes are still swollen and I had sonography for that and my neck hurts because of them, and for other symptoms i will get them diagnosed . Thanks again for your reply. Good Day.
doctor
Answered by Dr. Dr. Prasad J (17 minutes later)
Brief Answer:
Lymph node could be due to other reasons...

Detailed Answer:
Hi,

Glad that you found something useful from our last conversation.

As far as transfer of HIV is concerned, as I said HIV would only spread if there is a broken skin. It is unlikely to spread with intact skin and mucosa. I say that your sister is not infected because of the following three reasons:
1. Various tests done over the last 12 weeks (close to it) have proved your HIV status as negative.
2. The probability that HIV was viable throughout the wash room incident is almost zero.
3. Should we consider the least likely possibility of HIV being viable, I don't see any mode through which this virus could have entered her. Mere touching isn't enough for virus to be transferred. Further there have been no incidents of a person getting the virus through foreign body other than an infected human or their body fluids.

Lymph nodes can remain enlarged for a while following acute infection. In relatively less common set of people, enlarged lymph nodes stays for life. If the node is bothering you in anyways, I think you need to get it checked. The doctors can pick up samples from the node and study them through a process called FNAC to confirm the reasons of enlargement.

Hope I make sense. Will be glad to verify further if you are not convinced.
If all your queries are addressed please close this discussion.

Good day!!
Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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Suffer Fever , Chillness, Weakness, Vomitting, Diarrhoea And Red Pathces In Her Mouth. What Could This Be?

Brief Answer:
HIV infection is unlikely....

Detailed Answer:
Hi,

I reviewed your discussions with the last doctor and I agree with his comments. HIV is unlikely in this situation.

Though elisa is more accepted test than tridot, there is no significant difference between both these in a case where the risk of exposure is very low as in your case. I will take the results of tridot at 11 weeks to call you as HIV negative.

Yes, I agree with you that window period duration is believed to be 3 months to 6 months. But most experienced HIV specialist consider reports at 3 months to be valid and do not advice a repeat test at 6 months especially when risk of exposure is low. So I don't think you should be worried about window period and repeat tests.

Moreover it is impossible that you would infection family members by touch as the virus is very fragile and dies within few minutes in external environment. So do not be concerned about your sister getting HIV.

As far as Hepatitis is concerned, oral sex is not the preferred route of transfer. It needs proper body fluid exchange either to intercourse or via needle pricks. Therefore I do not think you need to be worried about Hepatitis too.

I hope this answers all your questions. Let me know if you need clarifications.

Regards