HomeAnswersHIV/AIDS specialistunprotected sexAfter having unprotected intercourse, I developed a low-grade fever, sore throat, oral hairy leukoplakia, and noticed enlarged lymph nodes on my neck. Kindly help.

What are the possible causes of fever, sore throat, oral hairy leukoplakia, and enlarged lymph nodes following unprotected intercourse?

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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.

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Published At October 11, 2023
Reviewed AtOctober 11, 2023

Patient's Query

Hello doctor,

I had unprotected vaginal intercourse six and a half weeks ago with a male of unknown an potentially high-risk status. One week after the encounter, I visited a doctor and was prescribed Ciprofloxacin for a urinary tract infection. About two weeks after the encounter, I noticed my inguinal lymph nodes in the groin were excessively enlarged, and I had a burning pain in them. I went to the doctors and had a fourth generation combo lab test done 16 days post-exposure and the results came back negative. However, they also conducted a Hepatitis C Virus, polymerase chain reaction (PCR) test, and while antibodies were suspected, they were not detected according to the lab results. I was diagnosed with trichomoniasis and prescribed a 2000 mg dose of Metronidazole, which I took as directed. About three weeks after the encounter, I ran a low-grade fever and experienced a sore throat for about a week. Additionally, I developed oral hairy leukoplakia and large raised papillae on the rear of my tongue. Lymph nodes under my jaw, behind my ears, on my head, and in my throat area are all enlarged. I was given Azithromycin for five days, but my lymph nodes did not decrease in size. The doctor prescribed oral dose of Nystatin for the thrush, but it has not resolved completely. Over the past three weeks, I have lost my appetite and have been forcing myself to eat. Despite this effort, I have lost 15 pounds in three weeks. At 35 days post-exposure, I had another fourth generation DUO (Dual) test, and the results also came back non-reactive. At 43 days post-exposure, I had a rapid finger prick Alere Determine test, which showed negative results. My inguinal and neck and throat lymph nodes are still very enlarged (confirmed by the doctor), and I am still uncertain about the cause of these symptoms. When I received my negative results back, 40 days after the possible exposure, I was diagnosed with bacterial vaginitis and given Metronidazole for one week. I am currently still taking it, but my lymph nodes have not decreased in size. Could you please advise me if my second DUO tests at 16th and 35th days post-exposure are conclusive? Also, I would like to know if the rapid test at 43 days is reliable in ruling out any infections or conditions related to the encounter. Kindly provide your suggestions.

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. Firstly, I would like to inform you that the majority of people infected with HIV (human immunodeficiency virus) develop antibodies within three to eight weeks. Approximately 99.9 % of infected individuals test positive within three months, and rare cases of late seroconversion at six months have been reported in the literature. Modern test kits used today are highly sensitive and specific, providing accurate results. Your negative HIV test results at 16th and 35th days are highly conclusive. However, I suggest you confirm this by repeating the HIV Antibody test at three and six months after your last exposure. I also suggest you get tested for Ebstein barr virus (EBV) serology, especially considering your lymphadenopathy symptoms. This test can help identify the presence of EBV antibodies and provide further insights into your condition. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

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

Dr. Ravinder K. Sachdeva
Dr. Ravinder K. Sachdeva

HIV/AIDS specialist

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