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Fatigue and weight loss with back ache after sexual activity

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I am certain I have a viral infection (because two doses of z-pacs didn't help my symptoms). I am fatigue and feel run down, have lost 8 pounds (from 198 down to 190), and achey in my lower back and legs, along with my throat not feeling normal (it doesn't hurt, but a bit stingy and just doesn't feel right). The symptoms started after being sexual active with someone, however I thought my activities were safe. I tested negative for Mono, CMV, Herpes, and HIV, however I know with some of those test it can take a while. My question is how many other viral infections are our there other than what I was tested for? I am a bit paranoid not knowing what is causing this..

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 28 Doctors Online


Thank you for asking your query at DoctorSpring.

 Lack of response to Z- pacs does not necessarily mean a viral infection. Although as you suspect a viral infection is a possibility, a resistant bacterial infection, and even a non-infectious cause also should be considered. There are hundreds of common viruses (which can infect humans) and you need not test for all of them ! And that is not the right approach either.

From an STD stand point the ones tested are adequate. You may get tested for Hepatitis B (if you were not vaccinated previously). Instead of focusing on the virus the approach should be to find out what is wrong. I assume you have done the tests after adequate interval.  ( at least 4-5 weeks after contact. Too early tests might not give correct results)

I recommend the following steps for the purpose.

  • 1.       A thorough Physical examination by your Doctor, including examination of genital area of candidiasis / lesions / warts. 
  • 2.       A routine blood test – Complete Blood count, Fasting Blood sugar
  • 3.       Urine Routine Test
  • 4.       Liver and Renal Function test (To be decided after the Physical examination)
  • 5.       You can take a OTC pain medication like Ibuprofen 400mg twice daily for the back pain and legs.

There is no reason to be paranoid. A basic blood test will rule out the common issues.

Hope this helps.

Please feel free to ask followup questions via email itself

Thank you

Patient replied :

Thanks for the reply. I did the test one day shy of 3 weeks after contact. I also got tested for hepatitis (and was vaccinated). 

Does mono and cmv also have an incubation period?

I was fasting, and everything checked out okay besides cholesterol. 

Another question I forgot to ask. Would there be red flags with other blood counts pointing to (but not yet showing) HIV?

I only gave her oral sex (and there was a lot of fluids but not any blood that I know of). I keep thinking worst case scenario. 




Yes Mono and CMV has an incubation period, but it should be covered since you got the tests in 3 weeks. If you have got the antibody based (ELISA) HIV test, 3 weeks might be bit early. You can re do the test after 6 weeks from now. 


The chance for HIV transmission is pretty low from oral sex. Its more of a textbook possibility in my opinion. You need not worry about that. Your symptoms are not suggestive of HIV seroconvresion or  for that matter an infectious disease. The blood tests will not give you any definite information on virus or bacteria. It can give general guideline on an infection is there or not.


Hope this helps

Please feel free to ask for clarifications/ followup Qs

Patient replied :

Thank you. I feel better that the chances are slim. I saw a report tonight that there was a recall with greek yogurt as there are a lot of reports of people getting sick from mold. I ate that same brand but don't recall the exact dates. Wonder if that was the cause.


I would not recommend any specific exercise without guidance. You can do mild - moderate aerobic exercise like walking, mild jogging etc. Make sure you are keeping a good posture while walking or sitting. Have proper back support. It is normal for this symptom to last longer. However it appears the symptoms is unrelated to the exposure. 


Hope this helps

Patient replied :

I am still not feeling well. I was better but started jogging and then not well again. You might need to read the previous email chain to refresh your memory.

I am still Lethargic, stiff and dull achey muscles, and I feel a bit out of it mentally (forget things). I first got sick August 15th after sexual contact with someone. Is it typical for a viral infection (if this is what it is) to last this long? It has been 9-10 weeks now of not feeling well.




Thank you for consulting me via DoctorSpring. 


I have gone through your query and our past email conversation. Sorry to hear that your symptoms still persist. I would like some additional information from you. Other than the above mentioned symptom do you have any other symptoms ? 

(if possible please list down your current symptoms) What about the backpain ? Were any blood tests (other than the viral markers) done ? Meanwhile have you lost any weight ? Is there any fever ?


Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
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 Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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