Brief Answer: Seems autoimmune or fungal Detailed Answer: Hi Thanks for posting your query on XXXXXXX These symptoms seem to correlate more with fungal infections. The ulcers can also be a part of some auto immune condition. Vaginal ulcers can have many causes. Were these ulcers painful? A biopsy of the ulcer could have been done to find he cause. You have mentioned that all tests were negative. I am not sure which tests you have performed. I think you should also get tested for autoantibodies. Herpes virus can also cause symptoms similar to the some of those mentioned by you. Thus you can also get tested for herpes antibodies. tingling itching on face----Can be due to fungal infection, seborrhea initial stages itchy body,scalp----can be due to seborrhea, dry skin, allergy, eczema itchy palms and soles----allergies, Raynauds syndrome, scleroderma oral ulcers----Can be many causes, if infections ruled out, then it can be autoimmune, scleroderma, rheumatologic condition like SLE, herpes virus seborrhea----etiology unknown dry eyes,mouth,nose----can be any cause that led to reduced secretions, it can be autoimmune, medicines, allergies, etc vaginal ulcers----many causes, a biopsy needed painful swallowing----maybe due to decreased secretions in mouth dizziness weakness----can be anything like anemia, electrolyte imbalance, etc rash on face and back----needs to be examined but can be due to seborrhea possible oral candidias----ok raised taste buds----can be due to infection of mouth like candida Hope it helps Let me know if I can assist you further Dr Vaishalee

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Brief Answer: Can followup for HIV subtype e Detailed Answer: Hi again, I divided your complete query into different phases and tried to analyse the situation. The overall scenario seems that you had a bacterial infection, which resolved either itself or with antibiotics. The treatment resulted in fungal infections or skin and oral mucosa which are happening recurrently. You have done some workup for some sexually transmitted infections and ANA and all of them came back negative. You want to keep checking for HIV infection in future - which is ok. If the test is available for the subtype e, you can get it done. Now one thing is sure that you got affected after the sexual exposure with CSW. Since chlamydia and herpes have been ruled out, I am thinking that it may be Ureaplasma urealyticum or Mycoplasma. Ureaplasma is known to cause non-chlamydial, non-gonococcal urethritis, especially in men. It can be diagnosed by getting culture of specimens done. But if you have taken antibiotics during this period it may have gotten reduced or cured. Hope it helps Dr Vaishalee

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Brief Answer: It is conclusive Detailed Answer: Hi again, Since the DNA-PCR at 6 months was negative and CMIA at 8 months was also negative alongwith other tests, I think it is not advisable to worry about it any more. It is very much conclusive at this point that you do not have HIV. Relax and move on with your life. Dr Vaishalee

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Brief Answer: Still the tests were negative Detailed Answer: Hi again The parallel symptoms are coming and going and these are not staying. Window period means the time between infection and appearance of antibodies. Now the test that is able to diagnose HIV even before appearance of antibodies is DNA-PCR. It will pick any DNA circulating in the blood. It is usually done in window period only, since the other tests may be false-negative at this time. Fortunately DNA-PCR was negative for you. Your test reports were very reassuring. You may repeat the antibody test after the window period has elapsed to be more sure of the status. Regards Dr Vaishalee

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Brief Answer: ANA negative not specific Detailed Answer: Hi again, ANA is just one of the many tests done to rule out conditions that have circulating antibodies. If you have not done other basic tests like complete blood count, immunoglobulin levels, urinanalysis, etc you should get them done. Those tests will help figure out if the symptoms are due to bacteria, allergy or other reason. There are tests available for other antibodies too. But we need to take it one step at a time. You have ongoing symptoms but DNA or RNA are not detectable in the blood. It is very re-assuring. Your symptoms may be for other reasons. Whatever the reason is, you need to improve your immunity. Immunity can be improved by taking enough fruits and vegetables in a day, take hygienic diet and pure drinking water (helps avoid infections), multivitamin supplements, regular exercise, low stress life, etc. Regarding your question on window period for subtype E (crf01_ae), I was not able to find any recent report or publication on window period. Though it is very common in Thailand. A repeat testing should be helpful to rule out late presentation. Even if you are infected, you cannot take medicines unless the infection is proven. So until it is proven by any means, live your life. Take care. Dr Vaishalee

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Brief Answer: I will go with the test reports Detailed Answer: Hi again, Your tests are very much giving you a direction. I would not go for the diagnosis for which the tests were negative. I would rather try to treat the gram positive diplococci. These germs can be gonococci. I hope you have already gotten treated for these bacteria with antibiotics. Candida and other fungal infection like symptoms may have appeared after the antibiotic treatment. I would suggest that if you have cleared the infection, then try to reduce the after-effects of antibiotic use with my recommendations in the previous reply. You need to improve your immunity and stop worrying about infections. Regards Dr Vaishalee

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Brief Answer: Seems like candida Detailed Answer: Hi again, It does not seem to be bacterial infection, as nothing showed on throat swab, biopsy and antibiotics did not help. Moreover medicines are just for props. It can be fungal or viral infection. Viral infections are known to cause symptoms of fever, headache, malaise, etc. The symptoms are usually relapsing (come and go) and cause general discomfort. Thus your symptoms do not correlate with a viral either. The remaining etiology is fungal. In my opinion, you developed candida infection because of taking antibiotics and involved stress. Skin peeling can happen due to fever or viral infection of the throat. It is nothing serious. Acne may have happened due to some type of bacterial or fungal skin colonization. It is also nothing much to be concerned about. Can try salicylic acid based face wash or lotion to take care of it. Pain in throat can be due to inflammation after the bacterial infection cleared up. It can also be due to candida. It is hard to cure candida. Since candida is a part of normal flora, it does not show up on swabs. The aim should be to reduce it and not to eliminate it completely. Though antifungals are available, these should be used only in the presence of bad infection. For mild infection as in your case, simple lifestyle measures that increase immunity will help reduce the infection. Drinking pure water (lowest TDS) helps. Vitamins help. A consult with Ear, nose and throat specialist will also help rule out any local cause. Hope I was able to clarify my point. Let me know if you have any more doubts. Dr Vaishalee

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Brief Answer: Yes you should Detailed Answer: Hi again, It is worthwhile to still followup for HIV as it will remove your doubt. I have seen people followup for upto 3 years, though it does not come positive if it has been negative till 1 year after exposure. Regards Dr Vaishalee

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Brief Answer: Herpes virus Detailed Answer: Hi again Herpes virus can cause pain on swallowing and skin rash, but in your case it has been ruled out. Otherwise there are many viruses that can cause respiratory infection along with rash, but these viral infections clear up within 2 weeks. A virus that stays is HIV, T-cell lymphoma virus, human papilloma virus, among the common ones. But these usually do not mimic the same course as HIV. Viruses that can present with mouth ulcers, malaise, rash and fever with a history of exposure are HIV, infectious mononucleosis (CMV, EBV, Toxoplasmosis), primary herpes simplex, enterovirus, rubella and parvovirus. Hope it helps Dr Vaishalee

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Brief Answer: IgM positive means active infection Detailed Answer: Hi again, If CMV and Rubella IgG tested for positive, it just means that she has immunity against both conditions. It may have come back positive due to past infection or vaccination. There is no vaccine for CMV but infections are common and not to be worried about. If IgM had come back positive, I would be worried a little. Regards Dr Vaishalee

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Brief Answer: Go with the reports Detailed Answer: Hi I understand your concern. I would really suggest that you do not worry about HIV. Go with the result of reports. If the reports are normal, there is nothing much to worry. My diagnosis at present is that you contracted a bacterial infection as shown in your reports. You were successfully treated with antibiotics as the infection is not present now. You are only having some alteration of normal flora at present that is showing as pain while swallowing and some acne. It may have bouts of superinfection with bacteria or viruses that cause usual colds and flu. Nothing worrisome. Dr Vaishalee

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Brief Answer: Thanks for consulting Detailed Answer: Take care. Dr Vaishalee

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