Why do I get itching and burning sensation in hands with muscle pain after risky sexual exposure?

Patient's Query

Hello doctor,

Before three months, I had unprotected sex with a sex worker in her monthly (menstrual) period. After sex, I noticed bleeding from my cut penis. After one week, pain subsided. And after a month, I had sex, and again noticed bleeding from penis wound. I again had protected sex with sex worker before 20 days.

I has itching and burning sensation on both hands after first risky exposure. I observed red blood spots on my hands, shoulder, legs, and chests that come and disappeared within one hour after second risky exposure. Currently I am on Fexofenadine, Telfast 180 mg oral medicine for three weeks. Now I stopped and did not found any hives.

After 100 days of risky sex exposure, I am having bicep muscle pain and also pain in little fingers joint. I also have itching on hands, chest, and stomach with low mood.

My reports details are below:

1) HIV test report negative after 30, 80, 89, and 100 days.

2) Syphilis is also negative by VDRL.

3) HSV 1,2 and Chlamydia antibodies are negative.

I also asked the sex worker to check HIV after 90 days. Her report is also negative. Why is there itching on my hands, chest and bicep muscles pain? Please advice.

Answered by Dr. Ravinder Kaur Sachdeva

Hi,

Welcome to icliniq.com.

The recommendations are to get the fourth generation HIV rapid test at the third or fourth week of the exposure. If the result is negative, get a confirmatory HIV rapid antibody test at 90 days (three months) of last exposure. Your negative HIV test result at three months of unprotected sexual exposure will be considered conclusive if there is no further unprotected exposure.

If the condom had been used consistently and correctly during protected sex, the chances of acquiring HIV and other STIs (sexually transmitted infection) are nonexistent.

The possibility of fungal infection seems very high from the history and one of the attached picture (attachment removed to protect patient identity). The attached pictures, however, are not clear. Also, if there are lesions on hands, chest, and genitals, please send a clear picture of all the sites.

I suggest you to get the following tests:

1. Complete blood count with ESR (erythrocyte sedimentation rate).

2. LFT (liver function test) and serum creatinine.

3. HBsAg (hepatitis B surface antigen).

4. Anti HCV (hepatitis C virus).

5. PCR (polymerase chain reaction) for gonorrhea.

6. Urine culture sensitivity.

7. Serum vitamin D3 and B12 levels.

Although your test results for HIV seems negative, if there is any doubt about the last exposure, please repeat the HIV rapid test (fourth generation).

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