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Balanitis and seborrhoiec dermatitis

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I slept with a girl on 6-06-2012. This is when my nightmare started. I have done very broad testing. I obviously thougt I contracded HIV. As I have had all kind of symptoms! I cheated on my current girlfriend, and she now has same symptoms as I do. symptoms are following:
I have balanitis or atleast a male yeast infection. Dermatologist says I have seborraich dermatitis on scalp and glans, and dishydrosis on palms and soles. Girlfriend has the same. My 3 year old daughter has peeling soles and palms, just the same as I do. Scabies have been ruled out, as me and girlfriend have extremly itchy scalps! We all had a circular rash, it´s was not that noticable, but I think it is called erythema multiform. Clearly I have suffered anxiety, but this is not the cause of my symptoms as my girlfriend and daughters are also struggling with similar symptoms. my girlfriend is a blood donor and bloodwork is normal as is mine. I have neurological symptoms, espesially numb hands and sometimes feet when I wake up, have had this problem for some months. Now my girlfriend has been waking up with numb feet? I am at my wits end with this symptoms, and clearly this is no STD. But what in the worl is this?????
I will now post my testing 17 months after risc incident:
ENDOCRINOLOGY
Hep B surface Ag (HBsAg) Negative
Hep.C Core Antigen <3.0 fmol/L
< 3.0 fmol/L HCV Core Antigen Not Detected
>= 3.0 fmol/L HCV Core Antigen Detected
HIV 1 & 2 / P24 Ag screen Not detected
Combination testing of HIV-1 and -2 antibodies
and HIV p24 antigen, allows for earlier
detection of HIV infection.
Cytomegalovirus Ab(IgG) 454.8 AU/ml
< 6.0 AU/mL is considered non-reactive
>=6.0 AU/mL is considered reactive
Please note change in units due to change in
methodology effective 12/09/11
Cytomegalovirus Ab(IgM) Negative
Comment Result suggestive of previous CMV infection.
HTLV I & II Negative

IMMUNOLOGY
Mycoplasma pneumoniae IgG 1.91 AU/ml <10 = Negative
Mycoplasma pneumoniae IgM 5.4 Index <10 = Negative
No evidence of recent infection
Please note new units of reporting and reference
range due to change in methodology.04/11/2013
Epstein-Barr virus screen .
EBNA IgG antibody * 265 U/ml (< 5 U/ml Negative)
EBV Early Ag ab.(IgG) <5 U/ml (<10 U/ml Negative)
EBV VCA ab.(IgM) <10 U/ml (<20 U/ml Negative)
Comment Results suggestive of past ( latent )
EBV infection.
HERPES SIMPLEX ANTIBODIES .
H.S.V. I (IgG) * 42.6 Index
H.S.V. II (IgG) <0.500 Index
COMMENT : Serological evidence of HSV infection at some time
Negative : <0.9 Index
Equivocal: 0.9 - 1.1 Index
Positive : >1.1 Index
Please note: Methodology changed 12/08/2013.
B.burgdorferi IgG <5.0 AU/ml Positive = >15
B.burgdorferi IgM Negative
Comment In early disease, up to 50% of patients may be
antibody negative. Specific IgG/IgM antibody
start to become detectable 3-6 weeks after onset
of erythema. Advise second test if indicated.
SPECIAL PATHOLOGY
GASTROINTESTINAL PATHOGENS: ENTERIC ORGANISM RAPID DETECTION
Specimen : Stool .
Adenovirus 40/41 Not detected
Rotavirus A Not detected
Norovirus GI/GII Not detected
C. difficile toxin A/B gene Not detected
Salmonella Not detected
Shigella Not detected
Campylobacter jejuni/coli/lari Not detected
Escherichia coli O157 Not detected
Enterotoxigenic E.coli (ETEC) Not detected
Yersinia enterocolitica Not detected
Vibro cholerae Not detected
Shiga-like toxin producing -
E.coli (STEC) stx1/stx2 Not detected
Giardia lamblia Not detected
Cryptosporidium Not detected
Entamoeba histolytica Not detected
Assay information: The xTAG? Gastrointestinal Pathogen Panel is a
qualitative multiplex PCR test intended for the
simultaneous detection of nucleic acids from
multiple gastroenteritis causing viruses,
parasites and bacteria. Performed on Luminex 200.
Note: The C. difficile assay targets DNA
sequences encoding toxin A/B.
Non-toxigenic strains will not be detected.
IMMUNOLOGY
SYPHILIS CONFIRMATION .
VDRL Negative
TPHA Negative
FTA Negative
Sample Type: Urine
C. trachomatis (NAAT)Urine Negative
N. gonorrhoeae(NAAT) Urine Negative

MICROBIOLOGY
Urethral swab .
Microscopy No organisms seen
NO WBCs seen
Culture ++ mixed skin flora
NO N.gonorrhoeae or Candida species isolated
Mycoplasma/Ureaplasma Negative
In addition, I have done an immunlogical panel, and docto told me everthings looks very good, only D-vitamin was a bit low.......

Category: Infectious Disease Specialist

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Category: Diabetologist
 31 Doctors Online

Hello,

Thank you for choosing DoctorSpring.

I am sorry to hear that you are your girl friend is troubled by a number of recent onset symptoms. I will try my best to help you out here :

The good news is that I do not see any signs , symptom patter or blood tests results are NOT suggestive of a serious infection.

balanitis or atleast a male yeast infection - Probably a STD.
seborraich dermatitis on scalp and glans - Non infectious
dishydrosis on palms and soles. - Non infectious
My 3 year old daughter has peeling soles and palms, - Non infectious
We all had a circular rash, - If the rash is persisting it could be a dermatophyte infection. A kind of fungal infection
Neurological symptoms : The neurological symptoms are non specific. Need not indicate and infection at all. It could be due to mild peripherlal neuropathy or a compression neuropathy from bad posture. Unless this is (1) persisting for more than 1month (2) assoaited with other neurological signs like weakness you need not worry about it for the time now.

I understand you are trying to find a root cause or a single etiologic bacteria or virus which is causing all these findings. But from the above information a single infection is highly unlikely. The blood tests are suggestive of previous viral infections. In view of this I would recommend a basic blood panel investigation which should include :

1.Complete Blood count
2.ESR, CRP
3.Liver function tests
4. Renal function tests
5. Peripheral smear study

If you have any of these reports available please share it with me. I would also like to know when was the last HIV test done, and when was your last high risk sexual encounter (unprotected sex)

Hope this helps
Feel free to ask followup


Patient replied :

Hi, these are the results of the immunological panel (see attached)
My last hiv test was 17 months after risc, no risc since then. It was p24 antigen/antibody test. It should be very reliable I am told, but do you question this?
Yes i tend do agree with multiple pathogens.
I had also a hepatitis vaccination 3 months after exposure, which i had an reaction, I am struggling with numbness in hands and feet afterwards, maybe this is my main issue, it could that my immune system is damaged after the vaccination. I have read that adverse reaction are rare, but GBS, and MS are linked to the hepatitis vaccine, I am schedueled to meet a neurologist in 1-2 months, maybe this will lead me to a diagnoses, I hope so

kind regards


The blood panel looks good. Let me note down few of my observations here. I think you are bit over concerned / worried about the symptoms . The positive fact is that you are well evaluated and all the parameters are within normal limits. Only the neurological symptoms, if persisting needs evaluation. Glad that you are consulting a Neurologist. This should shed some light into the problem. There is no life threatening or damaging signs or symptoms. So you can just observe how the symptoms evolve over time. Most likely this will disappears on its-own.

The combo HIV test you have done is good enough. But you can go for a repeat simple antibody test after 6 months just to be sure. I do not think a reaction to Hep A vaccine will manifest like this. Sure, in rare cases it can cause MS /GBS, but this neuropathy pattern is not suggestive. If persisting a NCS (nerve conduction study ) might be a good idea. Your Neurologist will suggest this if required.

Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Yes, There is one more question I would like to ask. Me and my girlfriend and my 5 and 3 year old daughters are having peeling on our palms and soles, also all our scalps are itchy. My dermatologist told me I had dishydrosis on my Palms and soles, and mild seborraich dermatitis on scalp and glans. My girlfriend has just recently had her blood donated, and her blood is testef with the NAAT test. So my 17 months past exposure and my girlfriends is also negativ, so Hiv is not the explanation her. I was thinking at the start about scabies, but there noting in my finger webs or waistline e.t.c so I think the derm. was correct on this not beeing scabies. Is it possible somehow that we have staph on our skin? Why do we keep peeling??? Probably I have to go back and get my skin scraped for analysis. can you give me some ideas to get tested for? staph,fungal......Yes I will go for 1 more hiv and syphilis test, just to get this permanently out of my OCD brain. Also my and girlfriend have headaches all the time and chills, could this be urinary tract infection even if my complete std´s panel is negativ???
I can upload you some pictures, but keep them confidential alright :)
You can see mild peeling on this pictures, but it´s more severe some times. the derm on this site it was keratolysis exfoliativa, but how can we all develop the same condition at the same time????
also a picture of my balanitis, which is better looking now than this pic.....


kind regards.......


Since you 3 have the skin peeling, look for any allergens that are causing this. May be some soap or cleaning fluids or disinfectants which all of you might be coming in contact with. I agree with your Dermatologist. This does not look like scabies, although scabies would be my first suspicion for an dermatological illness that occur in a group . Staph or fungal infection is unlikely to cause this. You can test for a fungal infection (Candida specifically ). Bacterial infection will not cause this and anyway there will be plenty of bacteria on the skin surface.

If your girlfriend has chills with pain while passing urine she can be having a UTI. But in that case the urine routine test would have show some features / findings. Headache is unrelated. Probably a tension type headache or migraine headache.
As I said do consider an allergic reaction.

keratolysis exfoliativa is very possible. But still it is usnsual for all of you to develop it. That's why it makes sense to look for allergens or irritants precipitating this condition.

Hope this helps
Thank you


Dr. Jaydeep Tripathy
Category: Diabetologist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Senior Residency in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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