HomeAnswersInfectious Diseasesneedle injuryCan you get symptoms for needlestick exposure after two years?

Why do I have multiple symptoms after a needlestick exposure even after testing negative?

Share

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

iCliniq medical review team

Published At December 25, 2022
Reviewed AtDecember 6, 2023

Patient's Query

Hello doctor,

I am a paramedical staff. Two years back, I had my first ever dirty needle stick exposure, which has caused me great mental distress at this point. The patient was a young female who was admitted to drug use. I picked her up at a residence that did not look clean. She was staying with a male who I assumed was doing drugs. I forgot what her medical complaint was. I initiated an IV on the patient in the AC and did not successfully place it. The dumbest moment of my career was not retracting the IV immediately and placing it to the side for a couple of seconds to put a bandaid on the patient. When I went to pick up the IV, I accidentally poked myself on my right index finger. Bleeding was noticed, and I did not clean it immediately (second mistake).

After getting to the hospital, the patient was okay with being tested, and her test came out negative for HIV. I started my infectious disease protocol that night, and the urgent care I was sent to did not want me to take PrEP since the patient tested “negative.”

My initial tests were all negative. This is where it starts to get worse for me. About a week and a half later, after the dirty needle stick, I began to develop a mild fever and vertigo for two days that caused me to vomit and a swollen left armpit lymph node. This lasted for about four days before subsiding. The following symptoms that developed were weird rashes on my body. I developed what looked like liver spots on my back and a nasty-looking non-itchy rash on the back of my neck that almost looked like shingles but was not. It did take weeks for it to heal after multiple creams. The following symptom I had was left eye blurry vision that no eye drops were helping. I was eventually sent to a specialist that said I had herpes and gave me antivirals which relieved the issue. The next odd sign was a CBC draw that showed a slight decline in total WBC and a neutrophil count of about 200 per microliter below the expected cutoffs. I believe the total was around 1,350 per microliter of blood. About a week and a half ago, I developed body aches, chills, fever, dry cough, and sore throat out of nowhere. I was tested for COVID using a rapid test and PCR, and it came negative. The flu and strep were also negative. All the symptoms subsided except for the dry hacking cough that lasted eight days.

For the past three months, I have been developing this chronic rash on the left side of my chest that comes and goes with medication. I have seen a dermatologist for it, and she believed it was eczema. I was given an ointment, which cleared it up a little bit, but now it has returned. I have also developed bumps on my arms that one doctor believed to be vasculitis. I have also had herpes keratitis in my right eye and chronic dry eye syndrome in my right eye now, which causes me to blink. It would not go away. I had never developed any of these issues until after the dirty needle stick happened. I am getting no answer for anything. I have had a high ESR result with a normal CRP and no answer. It seems like my body is breaking down slowly, but I am getting no explanation. I have also been tested for diabetes, and that was normal.

Kindly help.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your test results submitted here are inconclusive. I would suggest you do a complete STI (sexually transmitted infections) panel test that includes tests for the following.

1. HIV (human immunodeficiency virus).

2. HbsAg (hepatitis B surface antigen).

3. HCV (hepatitis C virus) antibody.

3. HSV (herpes simplex virus) 1 and 2.

4. Treponema, Neisseria, and Chlamydia.

Other ivestigations to be done.

1. LFT (liver function test).

2. RFT (renal function test).

It is recommended to test for liver and renal function tests. Needle prick injuries seldom cause transmission of HIV. The HIV seroconversion rate of 0.3 % after an AEB (accidental exposure to blood) for percutaneous exposure is an average rate. Since the HIV (human immunodeficiency virus) test has come negative for both you and the suspected source, there is no need to panic. However, starting PrEP (preexposure prophylaxis) regimen is advisable, not PEP (post-exposure prophylaxis). Considering the high ESR (erythrocyte sedimentation rate), you are more likely to have an infection. Hence it is best to investigate comprehensively. Also, the tests done are at different time points. The rash appears like dermatitis.

I hope this helps.

Thank you and take care.

Patient's Query

Doctor, How are my results inconclusive when my doctor said they were negative. Also, I’ve had countless HIV and Hep C tests showing negative. My question is, this needle prick happened two years ago. How many times do I need to test before I get an answer? The ESR is high which is still not giving me any answers. I’m running out of answers and I’m losing my mind at this point. I’m really not sure what else I need to do because my doctor is starting to think I’m crazy with all these blood tests. I’ve attached my recent CMB with liver tests. Also why would I do PrEP? I’m a heterosexual male. What do you mean, the tests are done at different time points? What tests?
Thanks for your revert. You have done certain tests in May, certain in December 2021. Rest of the uploaded test reports didn't have dates mentioned. It would be ideal if you undertake all tests of suspected infections due to needle stick injury and take necessary treatments, as required. Whereas you have HSV positive, HIV, HCV are negative. HepB antibody is high. I couldn't find CMB test report. To reach a conclusion based on your laboratory tests, it would be required to upload all clinical reports of all dates and with dates, kept systematically. High ESR is indicative of an ongoing inflammatory and / or infective process. Pre- exposure prophylaxis ( PREP) (two drugs)is also meant for heterosexual adults and I am not sure why it can't be taken to prevent HIV when liver tests are normal. You should consult local physician for getting PREP locally..If you had tested positive, three drugs post exposure prophylaxis (PEP) would have to be started. The skin lesion and keratitis may or may not be due to HIV or other infections. If a dermatologist have opined skin lesion to be dermatitis, after seeing the lesion, it should be considered. Please clarify what you need from this consultation.

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

Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

Community Banner Mobile

iCliniq's FREE Newsletters

Expert-backed health and wellness information, delivered to your email.

Subscribe iCliniq
By clicking Subscribe, I agree to the iCliniq Terms & Conditions and Privacy Policy and understand that I may opt out of iCliniq subscriptions at any time.

Ask your health query to a doctor online

Infectious Diseases

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy