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HomeAnswersCommunity Medicinehiv testingDoes random tenderness with swollen underarm lymphnode signify HIV infection?

I had negative HIV tests with a swollen lymphnode in my underarm. Am I in window period?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At May 17, 2020
Reviewed AtDecember 20, 2023

Patient's Query

Hello doctor,

I am a 29-year-old married male. I have a baby who feeds on breast milk. I had a sexual encounter eight months ago with a professional with a condom. I am 95 percent sure that my protection was intact. Then I started reading about the symptoms of HIV. Five days later, I went to a dermatology and venereology specialist and described the incident. He was confident enough that he advised me not to go for any testing. However, I am still fearful.

Around two months post-exposure, I felt tenderness in some parts like the back of my head, and arms, and one lymph node in my underarm was swollen. I also developed a cold and cough. I started sweating during that time as well. I appeared a bit thinner. I got panicked and went to the doctor again. He checked me and was still confident that I was not infected. But for my mental satisfaction, he prescribed me thorough testing which includes HIV1/2, VDRL, HBsAg, and HCV along with urine R/E, M/E, and C/S analysis.

On the 74th day post-exposure, I took all those tests, and were negative. After a lapse of a few days, I felt some skin irritation on my back and a burning sensation on my forearms. There were no skin changes. Again I got panicked thinking that I may be in the window period for HIV. But the doctor remained confident, and he advised me not to go for any repeat testing. But my sense of fear, anxiety, panic, guilt, and impurity continues.

On the 110th day post-exposure, again I repeated the tests, but I excluded the urine analysis this time. All the tests came back negative again. The HIV tests were fourth-generation combo tests both times. I am in the eighth month post-exposure. Still, I feel tenderness here and there. Recently, I developed small red blood vessel-like dots just underneath the skin on my hand and feet, which remains for five to seven days, and goes away leaving faint black spots. I again showed it to the same doctor. He is confident and repeatedly asked me to stop worrying. He also gave me anti-anxiety, anti-OCD, and anti-depressant drugs.

I am also taking sessions with a psychologist. But still, my mind is not free from the fear of HIV. I also fear that my wife and child might get infected by me. My questions are:

1. Do I need to repeat any test to outrule the probability of HIV?

2. Are there any probability of error from laboratory tests, given the fact that I took the tests twice?

3. Do I need to worry about the window period as there is conflicting information available on the internet?

4. Do I need to worry about the phenomenon of delayed seroconversion?

5. Do I need to opt for the tests from a different lab?

6. Do I need to worry about HIV anymore?

7. How to unroot the fear from deep inside my mind? Any other opinion on my history?

Please help.

Thank you.

Hi,

Welcome to icliniq.com.

The chances of transmission of HIV (human immunodeficiency virus) by the given description is almost nil. HIV tests are repeatedly negative and after three months of exposure it is conclusive. You are free from HIV. There is no need for you to worry about seroconversion. You can forget about the episode and lead a normal life. There is no need for any further HIV tests in any lab. Just relax. Do some yoga, exercises, meditation, etc.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you

Patient's Query

Hi doctor,

Thank you for your reply.

What is the reason for tenderness in some parts of my body? I have also done a complete blood analysis, where no severe deficiency was found, except for the lack of Vitamin B12, high cholesterol, and some problems with liver functioning. My eosinophil level was seven, and my lymphocyte was 19. These tests were also done on the 74th day post-exposure. Why does one painful swollen lymph node occur almost two months after exposure in the underarm? I felt a pea-sized lump twice during these eight months post-exposure on my upper abdomen. The lump was not painful itself, but tenderness was felt around the area of the lump. It lasted for five to seven days. Why is that? Is there any chance of error (technical, medical, or human) in the tests done by the lab (twice on the 74th and 110th day post-exposure)? The fear of HIV is killing me. Please help.

Thank you.

Hi,

Welcome back to icliniq.com.

Do not relate each and every symptom or illness to HIV (Human immunodeficiency virus). There are so many diseases or simple illnesses. Once HIV tests are negative after the recommended days, you are free from HIV. Do not worry about it. The symptoms are not specific and do not suggest HIV. The axillary lymph node can be due to any skin infection, or a wound anywhere in the arm or local chest area. So maintain hygiene and treat any local infection if any. Abdomen swelling may be due to any lipoma or other conditions. If it persists or enlarges or gets any symptoms, consult your doctor for examination and treatment. Take appropriate dietary supplements and treatments for deficiencies and excess of vitamins, cholesterol, etc. Forget about HIV totally.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello Doctor,

Thanks for your clarification. It helped me a lot.

I am trying to accept the fact, but every time I start to overcome the anxiety, something triggers the fear again and again. This time I have observed a new red rash over my thighs, forehands, and chest. The first rash appeared on my chest, then under my right thigh, and a few tiny ones on the upper side of both my thighs. This time it is a bit swollen, like an insect bite. Today again I found smaller ones on my forehands. They appear a bit different from the ones I have on my chest. The rashes on the thighs and forehand have a mild itchy sensation. Now I have many of these. I am attaching photos of them. I am frightened again. Please guide.

Thanks a lot.

Hi

Welcome back to icliniq.com.

Thank you for the query.

The rashes can be due to irritations, allergies, or bites. These are not specific and do not suggest HIV (human immunodeficiency virus). You can use a milder soap if required. You can take antihistamines like Cetirizine after consulting your specialist doctor. The chances of transmission of HIV by single unprotected sex with an HIV-positive woman are very low. If she is negative, there is no chance. You need not worry about HIV.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

Can I be 200 percent sure about my HIV status? Can I continue my normal marital relationship with my wife without any fear or anxiety of transmission? I have a breastfeeding baby as well. Your reassurance is bliss for me.

Thank you.

Hello,

Welcome back to icliniq.com.

If the HIV antibodies test is negative after three months of exposure, you are free from HIV. As per the description, it is negative after three months of exposure. You are free from HIV. You can have a normal relationship with your wife.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you

Patient's Query

Hello doctor,

Please take a look at the pictures. These small red dots have been appearing intermittently on my hands and feet for quite some time now (approximately two to three months after the exposure). Generally, these non-itchy dots stay for five to six days and fade away by leaving a very faint black spot on the skin like any other cut, sores, allergies, infections, etc. Another feature is that they are not exactly on the skin's surface but beneath the upper layer. And if I stretch the skin, the red color can not be seen. These are some of them taken at different times. What are these? Why are they appearing? Is there any correlation with HIV? What can be done for treatment? Is there anything to worry about?

Thank you.

Hello

Welcome back to icliniq.com.

Thank you for the query.

I have gone through the two photos and details (attachments removed to protect the patient's identity). It is not related to HIV. Please do not relate every symptom or lesion to HIV. It is usual to relate to HIV due to anxiety. Relax. Forget the episode. These can be due to irritation or allergy to any substance, dryness, soap, detergents, chemicals, etc.

1. Do not wash with harsh soaps or detergent.

2. Avoid irritation or friction.

3. Use moisturizing soap or cleanser if required to wash hands.

4. Avoid frequent handwashing.

5. Use moisturizing cream if too dry.

6. If you are too itchy or irritated, you can use antihistamines like cetirizine.

If it persists, then you may need to consult a dermatologist for examination and management. Do not worry about it seriously; it is unrelated to HIV.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

Here are some more pictures for your examination. Please see these. The thought that triggers my fear is why I told you about everything occurring after the incident. These dots appear in a few numbers for some days, then disappear. They are again coming back after a few days. Doctor, please drag me out of the fear once and for all. Also, I saw some videos where the women say they are HIV positive, but despite years of exposure to their husbands unknowingly, they still did not infect their husbands or partner. They are saying that female-to-male transmission is highly unlikely or a myth. All in all, please help me to get out of the fear.

Thank you.

Hello,

Welcome back to icliniq.com.

Do not worry about HIV. HIV antibodies test negative after three months of exposure is conclusive. These are not related to HIV, relax. Do yoga and meditation, and sleep well. Forget about the episode. Transmission is possible from either male or female. The chances of transmission by single unprotected intercourse are low.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you

Patient's Query

Hello doctor,

Thanks for the guidance.

Again new complications arose. Look at the pictures attached. Is it bleeding gum or a sore? I do not know what it is exactly. I read that these are some of the acute symptoms of HIV. I brush regularly nicely, scrap my tongue, and use mouthwash sometimes. I try to maintain good oral hygiene. I am also taking vitamin C. Please help.

Thank you.

Hello,

Welcome back to icliniq.com.

Thank you for the follow-up query.

I reviewed the photos (attachments removed to protect the patient's identity). It may be due to stress or anxiety. These symptoms are non-specific and are not expected to HIV. Continue to take vitamins B and C.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

I am not experiencing much stress or anxiety nowadays. Besides, I have been taking anti-OCD anti-depressant medicines for a few months now and also taking sessions with the psychologist. I am constantly trying to make my mind free of anxiety. The venereologist I visited has also repeatedly nullified my negative thoughts. But still, these things are occurring, which can be seen by eyes without any plausible reason. I am attaching my test reports this time. Why all these are happening? It is bothering me. Please advise.

Thank you.

Hi,

Thank you for the follow-up query.

The HIV test is negative, and it is after three months of exposure. In fact, after almost eight months of exposure. It is conclusive you are free from HIV. Do not worry. Forget the episode and relax; do exercises. These symptoms may be due to stress or drugs, or deficiencies. Just relax. You are free from HIV. Get involved in activities of your interest; then, you can forget the episode. Continue medications as your psychiatrist advises, and get altered after his consultation if required. Just forget HIV.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

I hope you are doing well and also remember my history. I have been feeling tenderness in my right armpit since yesterday. I can also feel smaller than a pea-sized lump there. I have been feeling it since yesterday. Today the tenderness is there, but it has reduced. The lump is almost gone today. On my left armpit, I can not find any lump but faint tenderness is there today. The same happened almost six months back on my left armpit, which I described earlier. There is no rash, injury, or fever. What is the reason for this? What should I do? Is there any chance of a wrong diagnosis?

Thank you.

Hello,

Welcome back to icliniq.com.

The symptoms and some swelling in the armpit do not suggest HIV. The tests diagnose HIV. The tests are negative after three months of exposure. You are free from HIV. Do not relate everything to HIV. Just forget about HIV and lead a normal life.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

I am writing to you again. As you advised, I am trying to lead my normal life. But some bodily behavior triggers the anxiety intermittently. As I told you in earlier queries, small red dots have been occurring on my hands and feet the same phenomenon is still appearing. It appears in a few numbers with a few days' gap in between. This time it has appeared in quite a few numbers on my hands and feet. There are seventeen in total, to be exact. It has no itchy feeling, neither it has any other sensation. It is just appearing on these areas and going away with a faith brownish mark on the area. I showed the pictures to the dermatologist and venereologist whom I met after the incident. He said it was happening because of weather changes or due to skin dryness and gave me NMFE lotion to apply. I have been using the lotion since then almost every day. But still, it is appearing. As I told you, I have sent you pictures of the same phenomenon previously. Again I am attaching the images of them. It is taken today. Please look at them again and advise me on how to deal with them. Does it have anything to worry about? Does it have any correlation with any disease? I am worried again.

Thank you.

Hello,

Welcome back to icliniq.com.

Thank you for the query.

I have reviewed the photos and details (attachments removed to protect the patient's identity). Your doctor suggested that it may be due to dry skin or irritation. Avoid harsh soaps, detergents, irritants, chemicals, etc. Use mild soaps or moisturizing soaps in which you are comfortable. You can use any moisturizing cream or lotion two to three times a day. If itchy, you can take an antihistamine like Cetirizine when required per day after consulting your specialist doctor. Do not worry or relate it to HIV. Relax.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor,

The red dots appear daily on my hands and feet—this time in larger numbers, unlike when it appeared in a few numbers. Every day I can find new dots on my hands and feet. Each dot takes five to seven days to heal and turn brown colored. It is not itching. Neither does it have any other sensation. As I have sent you photos earlier, it looks like small red dots just beneath the upper layer of the skin. Coincidentally as far as I can remember, it appears a few months after the incident. I cannot remember these things happening before. As you and the doctor I met in person told me, I am applying moisturizer, even coconut oil, on my skin, but it is still appearing. As I said, this time in more numbers. Please help, guide, and advise.

Thank you.

Hello,

Welcome back to icliniq.com.

Thank you for the query. As suggested earlier, it may be due to dry skin or irritation.

1. Avoid harsh soaps, detergents, irritants, chemicals, etc. Wait to wash too frequently. Avoid anything which can cause dryness or friction.

2. Use mild soaps or moisturizing soaps in which you are comfortable.

3. You can use any moisturizing cream or lotion two to three times a day.

4. If itchy, you can take an antihistamine like Cetirizine, when required, one day at night.

Do not worry or relate it to HIV. Relax. Look for any allergies or irritation from food or substances you come in contact with.

Thank you.

Patient's Query

Hello doctor,

The red dots on my hands and feet still appear in large numbers than before. Every night I can find new dots on my hands and feet. As I told you earlier, these are not causing any itching or other sensations. These dots started appearing a few months after the incident, causing me great anxiety and fear. It has not happened before. As you advised and the, I am applying NMFE moisturizing lotion coconut oil all over my body, including the affected areas. I observed whether friction or food allergy is causing the same, but I could not find any. I am taking the same food I took almost from childhood. The incident occurred last year, and I took the fourth-generation test after 74 days and 110 days post-exposure. I could not find any reason for this. Why are these appearing? Please help. Your advice will help me to a great extent.

Thank you.

Hi

Welcome back to icliniq.com.

These are not due to HIV, as the HIV tests are negative after three months of exposure. These can be due to irritation or friction or allergy etc. but not due to HIV. These tend to take time to go. Get examined by a dermatologist for evaluation of these lesions. Skin lesions sometimes take time. Do not relate it to HIV.

Thank you.

Patient's Query

Hello doctor,

Contacting you after a long. As you can see from my history, I was suffering from HIV phobia even after a negative 4th Gen test after three months of exposure. That is history now. I am now doing well in my life. But just need your opinion about something. I tried anal sex with my wife today without a condom for a while. She is 100 % faithful to me; I also never had any sexual exposure other than my wife since I last tested. We cleaned our private parts thoroughly soon after the act with Dettol, Betadine, etc. Is there anything to worry about since we both trust each other? Is it fine to have anal sex without a condom?

Thank you.

Hello,

Thank you for the query.

If both trust each other mutually it is very good. Anal sex is the choice of the couples. If you both have no issues you can go ahead. Meanwhile follow hygienic measures. There are chances of minor injuries to both (may be until you get used to it) and chances of fecal or urinary tract infections. Follow aseptic precautions.

Thank you.

Patient's Query

Hello doctor,

Can we have anal sex without condom? We use antiseptic moisturizing cream as lubricant.

Thank you.

Hi,

Welcome back to icliniq.com.

It is the choice of couples. If you follow all aseptic precautions and hygiene before and after intercourse you can think of it.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Patient's Query

Hello doctor

You can see my history above. I had exposure with an unknown partner just a little more than four years ago as I described you earlier. I did 4th generation HIV test from SRL on the 74th day and the 110th day after the exposure which came back as non-reactive.

Recently, I have been getting symptoms like a mouth ulcer a couple of times, and severe indigestion problems like gas formation, abdominal cramps, repeated urge to pass stool or stomach upset, skin problems, etc. I visited a physician for the problem of indigestion, and am taking medicine as per his advice, like Pantoprazole with Domperidone and Esomeprazole with Domperidone regularly for almost one month. But my abdominal problems remain. My wife is also having the problem of indigestion and gas formation. I have controlled my mind to a great extent so that fear does not grip me and tried to remain calm all this time. But as these strong symptoms started to occur just four years after the incident, the fear again got hold of my mind. Please, suggest if these things are anyhow related to HIV. Am I really free from HIV? Please help.

Thank you.

Hi,

Thank you for the follow-up query.

Once the HIV tests are negative after 90 days of exposure and done in a reliable laboratory, it is conclusive. There is no need for further HIV tests, provided, there is no further risk exposure. As per the details given, there is no further risk exposure in either of you. So do not worry about HIV. Please continue treatment as per your physician's advice. You can also consult a gastroenterologist if it persists. So do not worry or relate to HIV.

I hope this information helps provide some insight into your symptoms.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you

Patient's Query

Hi doctor,

Thanks a lot for your reply.

I had only one exposure with an unknown person with a condom which I am 95 percent sure had proper protection. Then I did the fourth generation. HIV test from a well-known laboratory twice, on 74th day and 110th day post-exposure. Can I rely on the test, and be 100 percent sure about my health status?

Thank you again.

Hi,

Thank you for the follow-up query.

Yes, You can rely on these test results. It is conclusive. There is no need to worry about HIV, just forget the episode, and relax. Get involved in activities of your interest. Do yoga, meditation, and exercises. Please continue the treatments and advice of your physician or gastroenterologist.

Wish you safe and good health.

Please do not hesitate to reach out if you have any further questions or concerns.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra

Dermatology

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