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What Does Swelling In The Left Ear After Unprotected Oral Sex Indicate?

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Posted on Mon, 6 Mar 2017
Question: Hi Sir,

I have unprotected vaginal/oral sex (07/11/2016) with a lady whom I don't know.After that developed under my left ear a swelling and it was treated with mox clav.then I lost subcutaneous fat from thighs,arms and legs. Then my arm and under the foot became red than normal and Iam feeling a burning and chilling effect in my arms and foot and skin is peeling from my arms and under the foot.And a benign swelling appears in my right testicle and I saw urologist and he said that we can remove the same and nothing to worry and still I have muscle pain and a small swelling in my neck.When I woke up in the morning sometimes some red rashes are seeing in my chest and neck and after sometime it disappears.
I did p24 antigen test (Elecsys hiv combi pt Assay-Eclia) test on 28th day of above incident it was nonreactive and on 42nd day(6thweek) did Elisa/Eclia test which was also non reactive.but my lymphocyte count was fluctuating ie increasing.please find below the same

30/11/2016---38% WBC--5270 CELLS/CUMM
10/12/2016---44% WBC--6200
12/12/2016---27% (AFTER TAKING MOXCLAV FOR SWELLING UNDER EAR) WBC--6100
19/12/2016---36% WBC--5400
21/12/2016---40% WBC--6700
23/12/2016---39% WBC--5900
27/12/2016---52% WBC--6700
I have consulted a physician he asked me to check cd4 count and result will come on 2nd XXXXXXX I have learnt from different sites that accuracy of p24 at 28 day is above 99%.Is it true? Also what about Elisa test at 42nd day?.Please check my ask and reply precisely about my situation.

Thanking in advance

doctor
Answered by Dr. Sunil Jangid (48 minutes later)
Brief Answer:
It is absolutely right.

Detailed Answer:
Dear XXXX,

Welcome to HCM.

The risk of getting HIV from single act unprotected vaginal sex is already very less and your P24 antigen test after 28 days is negative which is surely 99% accurate and reliable. ELISA test after 42 days is also negative which is also highly reliable so nothing to worry at all because you are absolutely safe and risk free.

As far as lymphocyte count is considered it is also within normal range 4000-12000 so don't get worried or anxious for that. Red rashes on the chest and neck may be due to some allergy or infection for which consult dermatologist and follow the treatment regime. For any further query feel free to ask me any time and I am here to help you out straight way.

Thank You
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sunil Jangid (27 minutes later)
Hi Sir,
Thanks for your reply

Your reply is great relief to me and about cd4 count suggested by physician.is it possible to find clear cut information.what about the burning sensation and peeling of skins in arms and foot.Then when I have to do next HIV test?Because why I worried is I got all these symptoms after this incident otherwise I was healthy person and this incident was 1st in my life.A big blunder that I will not repeat in my entire life

Thank you
doctor
Answered by Dr. Sunil Jangid (1 hour later)
Brief Answer:
Get tested again after 3 months.

Detailed Answer:
Dear XXXX,

Welcome back and thanks for follow-up.

You can go for CD4 count as suggested by doctor and burning sensation in foot might be due to any vitamin deficiency for which take multivitamins tab and you will be fine soon so allay the fear or stress.

As such your result is highly reliable but still go for repeat test after 3 months to get 100% conclusive result as per international HIV guidelines. For any further query feel free to ask me any time.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (6 days later)
Hi Sir,

I have got CD4 report (25/12/2016) attaching the same

Absolute CD4 count is 389

CD4 % is 30.8

After getting CD4 report I did ELISA (which shows testing for both P24 and HIV1 and 2 Antibody,attached) on 31/12/2016 which is 54th day of exposure and result came as Non reactive.I have shown this to my doctor my BP was 100/150 and doctor said that CD4 count may go down because of the mental and physical stress he has given me Nitrest 10 mg for 10 days.Please check my reports and give me your views on this.Kindly tell me the exact things.
doctor
Answered by Dr. Sunil Jangid (16 minutes later)
Brief Answer:
Your reports are absolutely fine.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

Low CD4 count in your report is due to mental and physical stress or tension that you are taking as it is truely said by your doctor also. ELISA test after 54 days of exposure is also negative then you need not to worry at all as the result is highly reliable.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (2 hours later)
Hi Sir,

Is there any possibility as 8 weeks negative becomes positive after that? Iam asking only because of my anxiety
doctor
Answered by Dr. Sunil Jangid (44 minutes later)
Brief Answer:
Practically it is not possible.

Detailed Answer:
Dear XXXX,

It is not possible to get positive result after being negative at 8 weeks so allay the fear or anxiety as you are safe and risk free. Be relaxed, forget about the episode and move ahead in life happily.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (20 hours later)
Hi Sir,

2 more things

1) As I asked in my first conversation dated 28th dec after this exposure thers was swelling appeared in my left salivary gland it was treated with moxclav and roothealer but it is still have some irritation and there was some irritation in my gums in some days.

2) Inside both arms and under the both legs there is redness,dryness and veins are showing out sometime.It is related to loss of subcutaneous fat.If subcutaneous fat losses whether the overall weight will loss? But my weight still remains constant that is 84 kg

3) I have read in the net that normal CD4 count is above 400 and mine is 389.Is there any negative situation is this

Please tell me the exact situation
doctor
Answered by Dr. Sunil Jangid (9 minutes later)
Brief Answer:
It can be due to some other reason.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

Redness or dryness in arms and legs can be due to some allergy or skin infection. If subcutaneous fat losses then it is not always correctthat your weight will also loss so don't get worried or tensed for it.

Low CD4 count is mostly due to stress or tension of HIV that you have nothing else. There is no any negative situation in that so just calm down, forget about the episode and move ahead in life happily.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (20 hours later)
Dear Sir,

One more query

Actually in a infected either P24 or antibody should be there after 1 or 2 week.Is it correct?When P24 is not detectable antibody should be detected by elisa test.Is it right? Because I did elisa on 23rd day which mentions it tests both p24 and hiv1 and 2 antibody and on 28th day did p24 test which was also duo.When i have to test again 10th week or 12 thweek 84 day or 90 day

Also which other STD tests I have to do?

I did VDRL on 44th day it was non reactive
doctor
Answered by Dr. Sunil Jangid (2 hours later)
Brief Answer:
Go for repeat test after 12 weeks.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

You have to go for repeat test after 12weeks to get 100% conclusive result because the window period for HIV varies from 15 days to 3 months and your VDRL is negative then I don't think you need to go for any other STD test so be relaxed and move on.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (10 days later)
Hi Sir,

I have did Elisa on 68th day it was negative.

I have did LFT attributes are within the limit except SGPT which is at higher side (72).Before this incident all attributes are within the limit
also my doctor give me Nitrest for 12 days and I have consumed 7 nos then started gum pain and dry mouth and I tested FBS and PPBS it was at 133 and 153.Normally my FBS was between 100--107 and my PPBS is below 100 but suddenly it was shoot up.I have told this to my doctor and he gave me surbex gold for 30days.One thing I forget to mention earlier is at first I went to see a urologist and told him everything and he prescribed Azithral 500 Inj (which was not taken due to test reaction) Doxy1 LDR forte (14 no).Flavospas-200 and after consuming this two tabs my arms and foot became red. it is still there and subcutaneous fat under my thighs,legs and hands lost.So please give reply for below querries.

1) what is ur view about 68 day elisa test.Is there any chance of change in the result at 84 day?

2) why only SGPT in higher side suddenly?

3) What will be the probable cause for sudden increase in my FBS and PPBS?

4) whether doxy causes the lost of Subcutaneos fat and redness in palms and foot.If it is the reaction of this medicine how we can know that? Any test something like that?

Please reply for this
doctor
Answered by Dr. Sunil Jangid (2 hours later)
Brief Answer:
ELISA test result is highly reliable.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

ELISA test after 68 days is highly reliable and there is no chance of result being changed after 84 days. Your SGPT is also normal not high because normal limit is 40 but when it is more than 2or3 times then it is considered significant to take some treatment.

Sudden increase in FBS or PPBS can be due to any metabolic disturbance and the side effect you had mentioned may occur due to doxy but it is very rare for this consult your physician to isolate the cause and follow the treatment regime. If still any query is there feel free to ask and I am here to help you.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sunil Jangid (25 minutes later)
change in fbs/ppbs and sgpt is there any relation with hiv infection?

I saw in some sites that doxy may cause loss of subcutaneous fat.Is it correct?

how can we know whether I have any reaction caused by doxy?

whether loss of subcutaneous fat leads to increase in fbs/ppbs?
doctor
Answered by Dr. Sunil Jangid (30 minutes later)
Brief Answer:
There is no relation of HIV and FBS, PPBS, SGPT.

Detailed Answer:
Dear XXXX,

There is no relation between HIV and the change in laboratory parameters like FBS, PPBS and SGPT so don't think much or get stressed. To rule out any of drug reaction you have to consult your physician to decide whether it is due to drug reaction or not. For any further query get back to me again any time.

Thank You
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sunil Jangid (12 hours later)
Hi Sir,

Shall I trust on ur statement that 68th day result will not change after? Because Iam fully stressed
doctor
Answered by Dr. Sunil Jangid (5 hours later)
Brief Answer:
You can take second opinion if you wish.

Detailed Answer:
Dear XXXX,

I have not seen any such case who turned positive at 3 months after being tested negative at 68 days but still if you want second opinion then you surely can go for it. Again I will say allay the fear or stress of HIV as you are absolutely safe and risk free.

Thank You
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sunil Jangid (1 hour later)
Thank you Sir.Iam not going for any second opinion
doctor
Answered by Dr. Sunil Jangid (9 minutes later)
Brief Answer:
You are most welcome.

Detailed Answer:
Dear XXXX,

You are most welcome any time if you need any of help in future also. Wishing you happy and healthy life ahead.

Thank You
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sunil Jangid (6 days later)
Hi Sir,

On 75 th day I did CMIA test it was non reactive (Report attached)

In 2011 I had surgery for Dyslipidaemia ( D12-L1,L3/L4,L4/l5,L4/L5,L5/S1--IVDP)

The above sexual exposure took place in Dubai and on the next day I went to sea in a speed boat and I was in the front and I got a lot of hit in the backside and there was pain in my backside.This is for your info. My question is

1) in your view what will be probable cause for the loss of subcutaneous fat from my thighs,arms and legs? If any injury happened due to hits that I received in the speedboat which create some nerve problems that in turn create this condition?

2) On 30th Nov my Monocyte was count was 5 then it increased to 10 and from dec onwards it was decreasing and even reached 0 and now it is in 1.What this tells?

3) still redness is present in my palms and under the foot and in night the inside palms becomes red and veins come out (only in nights)

4) now also I have tingling effect in my thighs,buttocks and hands.Whether it means again iam losing subcutaneous fat?

5) What about the reliability of CMIA test at 75 thday? whether it looks for P24 and HIV1 and 2 antibody?

Hope you will reply for this 5 questions
doctor
Answered by Dr. Sunil Jangid (2 hours later)
Brief Answer:
The result is highly reliable.

Detailed Answer:
Dear XXXX,

Welcome to HCM.

The reason for loss of subcutaneous fat is not your past injury, it may be due to some other reason and monocyte count is also within normal range so no need to think so much or get worried about same.

Tingling in thighs and redness of palms can be due to any vitamin deficiency or other reason for which consult your physician and follow the treatment as per the advice and you will be fine after some time.

The CMIA test after 75 days is highly reliable and it will detect for both P24 antigen as well as antibody so just calm down and move ahead in life. For any further query feel free to ask and I am here to help.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (2 hours later)
Hi Sir,

The 75th day CMIA test is conclusive? Is there any chance to change the result? If infected either p24 or Hiv antibodies should be there at 75 th day.Am I right? some people are telling 6 month is the window period.Is it right or not?.When I have to do next test at 84 day or 90th day and which test CMIA or ELISA?
doctor
Answered by Dr. Sunil Jangid (15 minutes later)
Brief Answer:
No possibility of result change.

Detailed Answer:
Dear Shimmy,

There is no possibility of result being change after 75 days negative result. The window period varies from 15 days to 3 months then you need to go for repeat CMIA test after 90days to get 100% confirm and conclusive result so be relaxed and move on.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (15 hours later)
Hi Sir,

You have not answered my question regarding 6 month window period?

Whether I have delayed seroconversion as I have all symptoms like loss of subcutaneous fat, low CD4 count of 389,Swelling in lymphnodes,tingling and burning sensations in arms and legs.

Please tell the exact things.Iam strong enough to accept the truth.This will be the last post Iam putting here.Next after 90 days that is on 7th feb I will inform you the status of my CMIA test.
doctor
Answered by Dr. Sunil Jangid (5 hours later)
Brief Answer:
Late sero-conversion is not possible.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

I had already told that the window period for HIV varies from 15days to 3months and late sero-conversion after this period is not possible. Nonreactive CMIA test after 75 days is 99% accurate but to get 100% conclusive result you need to go for repeat test after 90days nothing else.

The symptoms of swollen lymphnodes, burning or tingling in palms along with low CD4 count might be due to excessive stress or anxiety so just calm down, forget about the episode and get back to me with HIV test report at 90days. If still any query left feel free to ask me any time and I am here to help you always.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (13 minutes later)
thank you Sir
doctor
Answered by Dr. Sunil Jangid (50 minutes later)
Brief Answer:
You are most welcome.

Detailed Answer:
Dear XXXX,

You are welcome any time if need any help in future and I am always here to help you out. Be relaxed, forget all these and move ahead in life happily with your family.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (17 days later)
Hi Sir,

I have did Elisa test on 92nd day and it was non reactive .(COI:0.378---Reference-- <0.9: nOn reactive)

I have consulted with my physician (MD Internal Medicine) and he asked me to wait till 6th month as my CD4 count is low as 389 and the signs of subcutaneous fat loss etc.What is your opinion on this?

Is the Elisa test at 92nd day is conclusive or not? At this stage any other test I have to do for HIV? I did CBC also on 92nd day

HB--13.8
TC ---4880
Lymphocyte--39
Monocyte--5
Neutrophil---53
eosinophil--3
ESR---11mm/hr
Platelet--1.87
RBC--4.80
mcv--84
mch--28.8
mchc--34.2
rdw--12.6

Please give me your exact opinions on the same
doctor
Answered by Dr. Sunil Jangid (9 minutes later)
Brief Answer:
The result is 100% conclusive.

Detailed Answer:
Dear XXXX,

Welcome to HCM once again.

You have done ELISA test after 92 days of exposure and the result is negative then it is definitely conclusive and reliable because the window period for HIV infection varies from 15 days to 3 months so be relaxed and no further test is required.

Your CBC report is absolutely fine and low CD4 count may be due to HIV anxiety or stress nothing else. You can go for repeat CD4 count for your satisfaction. For any further query feel free to ask me any time and I am here to help you out.

Thank You
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sunil Jangid (31 minutes later)
Then according to you what may be the reason for loss of subcutaneous fat?

still in inside palms it is red in colour and in the night veins in the palms are coming up.Why this?

What other tests I have to do for other STD's as I want to check all because my sexual exposure was with a foreigner (Thailand).

Kindly reply on this
doctor
Answered by Dr. Sunil Jangid (3 hours later)
Brief Answer:
Take your physician opinion.

Detailed Answer:
Dear XXXX,

Welcome back and thanks for follow-up.

For loss of subcutaneous fat and thin palm veins consult your physician and follow treatment regime. You can get tested for Chlamydia, Gonorrhea and Syphilis as far as other STDs are concerned. Nothing to get worried so be relaxed and move on.

Thank You
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Sunil Jangid (41 minutes later)
So according to you there is no need to further testing for HIV.The elisa test I did on 92nd day is conclusive.

according to you loss of subcutaneous fat is not related to HIV?

but what are other conditons which causes loss of subcutaneous fat?

Kindly reply
doctor
Answered by Dr. Sunil Jangid (21 minutes later)
Brief Answer:
Yes absolutely.

Detailed Answer:
Dear XXXX,

The ELISA test result after 92 days is definitely conclusive so no further testing is required. Loss of subcutaneous fat can occur at injection site in diabetic patients or those who are taking steroid injections frequently but not related to HIV so no need to get worried or tensed as you are 100% safe and risk free from HIV.

Thank You
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sunil Jangid (19 minutes later)
Hi Sir,

Thanks for your valuable suggestions.

One more suggestion I need Shall I change my physician as he is not saying anything just giving me surbex gold and Dazid (which Iam not taking) and asking me to wait for another month.Shall I consult a doctor speciality in infectious disease.What is your opinion on this.Iam living in XXXXXXX Do you know any doctor dealing with this as I saw in your profile that you are closely working with NACO and you might know some doctors in XXXXXXX who is dealing with this.Kindly help
doctor
Answered by Dr. Sunil Jangid (8 minutes later)
Brief Answer:
If you are not satisfied then consult another doctor.

Detailed Answer:
Dear XXXX,

If you are not satisfied with your physician then definitely you can consult another physician or infectious disease specialist. I don't know any one personally in your city but I can suggest to consult Dr. Sumesh XXXXXXX Pazhaya Road, Near ICICI Bank, XXXXXXX for further management. He is very experienced physician.

Thank You
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. Nagamani Ng
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Dr. Sunil Jangid

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What Does Swelling In The Left Ear After Unprotected Oral Sex Indicate?

Brief Answer: It is absolutely right. Detailed Answer: Dear XXXX, Welcome to HCM. The risk of getting HIV from single act unprotected vaginal sex is already very less and your P24 antigen test after 28 days is negative which is surely 99% accurate and reliable. ELISA test after 42 days is also negative which is also highly reliable so nothing to worry at all because you are absolutely safe and risk free. As far as lymphocyte count is considered it is also within normal range 4000-12000 so don't get worried or anxious for that. Red rashes on the chest and neck may be due to some allergy or infection for which consult dermatologist and follow the treatment regime. For any further query feel free to ask me any time and I am here to help you out straight way. Thank You