Dr. Julie E. Mangino, M.D.

This could be any one of a number of different types of infections including HSV-2. I would go to an urgent care clinic and share the info you have shared as you really need to have an exam. It is impossible to tell if this is HSV or syphilis, chlamydia or a simple yeast infection or bacterial vaginosis. If you have not ever had Herpes infections before it can be quite painful. There are medications to treat all of these issues but an exam and testing will confirm.

Before returning to work you should be asymptomatic for at least 24 hrs.and not require any anti pyretics like ibuprofen or acetaminophen.You are not there yet; you must wear a mask for 10 days since the onset of symptoms irrespective of your symptoms.

If you take a point of care test or a regular blood test at 4 weeks since your exposure, the likelihood of accuracy is at 95%. If you wait x 6 weeks it is 99% accurate. If you have had any other sexually treated infection within the last 6 months; you should be tested for HIV. Pre exposure prophylaxis (PrEP) for HIV, when taken according to recs: daily Descovy or Truvada or every two months of Apretude/cabotegravir by injection is highly effective to prevent HIV.

I have seen these types of reactions in the past, including on myself although still uncommon. If it's just itchy in that location and she has no shortness of breath or any other symptoms, topical Caladryl (it's benadryl combined with calamine) and is over the counter may help in the area to counter the itching. It may be gone in the next 36 hours as well. If it's painful, and she has no contraindications and does ok with anti inflammatory medication like acetaminophen/tylenol or ibuprofen/aleve, that may help her as well.

Hello...it sounds like your coughing spell may have led to a possible rib fracture. I think it may be what is causing this pain, but not 100% positive. It would be worthwhile to share this information with your primary care doctor as well. I saw that you are almost 65 and do you have osteopenia? That could also contribute to a potential rib fracture. Often rib x rays don't show a fracture but they might. If it is such it takes about six weeks to heal and it is a slow process meaning that one day the pain will become less annoying. I dont know what other medications you take but sometimes a tylenol or motrin (not all day long) may help to sleep at night; ice early on but I know it's cold out and/or a heating pad later after the first 48 hrs and obviously as you recover from bronchitis you will cough less. I also don't know if you have any bleeding disorder so another reason to check this out with your PCP. Thanks. dr M

Good evening! It is hard to say without knowing your sexual history. Did you have oral sex with a new partner where this could be a new infection? Have you ever had syphilis before, to your knowledge? Is this your first donation and first ever testing for syphilis? The test that was done shows that you have antibodies for syphilis; if you have had syphilis before it may well stay positive. I hope this answers your question.

I am not sure why you have diarrhea alternating with constipation and the duration for this. I would try to eat a balanced diet with oatmeal, fruits and vegetables even out these symptoms. I would not put any probiotics in to your rectum, avoid enemas. If you have constipaton, miralax has worked for some patients. If you have diarrhea, taking in bananas, rice, oatmeal may help control. Avoid all concentrated sweets: candy cake cookies pies and pastries as these can reak havoc on your gut with the high sugar content.

If you are on antiretroviral therapy and your undetectable with good immune response (CD4), you should be able to get botox. Just make sure it is a reputable place ie clean needles and support if you have any untoward side effects.

I think you are being very careful which is excellent. I would be sure to wear bug spray (to avoid any insect bites) and do not approach any of these dogs, as you are doing. I doubt that they are cared for with rabies vaccines. If you sustain any sort of a bite, you should immediately request medical attention and presume that whatever wound you have will require oral antibiotics (most likely) and post exposure prophylaxis (prevention) injections for rabies. I think IF the scratches are healing, you are probably OK; if not you should seek medical attention. If you have access to antimicrobial soap, chlorhexidine gluconate, it's pink and doesnt lather well, may want to use that after a regular soapy shower and rinse it off. It has residual antimicrobial properties so even though your skin is dry, it still keeps working.

A rapid HIV test from 10 weeks and 5 days from the encounter should be accurate. It may be advisable to go to the Health department or your primary care doctor to get a blood test as well. You may be interested in pre exposure prophylaxis; there are two oral drugs as well as injectables that are very effective to prevent HIV.

It's highly unlikely, especially if nothing was bloody and your skin is intact, no open wounds. However, any time you are cleaning out anything that has been used by others, would always wear gloves. You have nothing to lose as they are cheap and if you are cleaning out a basement or an attic I would also wear an N95 mask. This will help you avoid any fungi or bacteria that may get aerosolized.

The best preventive actions against both hepatitis A and hepatitis B is vaccination. Hepatitis A is transmitted by the fecal oral route (ie food workers who inadequately wash their hands, or food sources contaminated by Hep A in restaurants). This is prevented by a two shot vaccine; you get one at time zero and then a second shot at 6 months. Hepatitis B is transmitted by blood primarily ie via transfusions (no transmission in the US as blood is screened for active infections) but could be transmitted if transfused blood in a country where Hep B is endemic. It could also be transmitted by injection drug use and dirty needles. Entecavir/Baraclude is used to treat chronic infections along with tenofavir and lamivudine. It's much better to be vaccinated against Hep B and there is a new and very effective vaccine Heplisav which is also a two injection series at time zero and at just one month. Prevention is the goal with these vaccines.

Based on the two non reactive test results, you are HIV NEGATIVE, which is excellent news. It's best to know the current status of the partner you are sleeping with and/or ensure condoms are being used if the partner is male. If you resume being sexually active, you may be interested in Pre Exposure prophylaxis, known as PrEP. You take a tablet daily to avoid acquiring HIV. If you do sleep with someone and are potentially concerned about acquiring HIV, I would test sooner than 3 months ( max of 2 weeks) AND especially if you are developing any symptoms; hopefully knowing the status of your sexual partners makes each partner feel more at ease.

Seems very UNlikely. I would wash your hands, wash your clothes that touched the car and go ahead and splurge on a drive thru car wash to remove all of the potential residue from the car. I suspect most of the secretions and excretions are UNDER your car.

I would present to your primary care doctor. I do not know if it's associated with shaving (an infected hair follicle) or some sort of skin abnormality that is not an infection but associated with an exposure of your skin to a new product, or a lesion that has been there a long time but now that it is bigger it is more noticeable. If your primary care doctor is unsure, a dermatologist may be needed. Your primary care doctor knows what medications you are on that may also potentially be contributing?

I do not htink you have anything to worry about from that remote encounter. I would however, assuage your fears and get retested. You can go to any HD and ask to be tested for HIV, Hep B and Hep C....and put these concerns to rest.

AGREE; you should get tested for COVID and flu and if not up to date on those two vaccines, get them next week when you feel better. Vaccination is the best way to protect against resp viruses. Also if you KNOW you had covid within the last 6-12 weeks, it's less likely to be covid and you can wait on the vaccine for a few more months.

I would not worry about this for one more second. Unless you had a lot of open skin cuts, I would not be at all concerned…..even if you did, the risk of any blood borne viruses getting transferred to you is imperceptibly small, ie like zero! Have a great holiday season!

Yes; if you remember when you test for viruses like influenza or Covid, the nasal swab is in the same area that you snorted the cocaine in to. We don't test for the common cold virus but that too is easily transmitted from that body site as well as the hands that transfer the bills.

hello: I feel your pain. I had influenza and fluid behind my ear in 2017 and had similar symptoms of diarrhea from azithro as well as severe 330AM dry heaves. I finished the darn 5 day course but vowed I would never take it again and would never take an antibiotic for "any ear issues" unless i had pain to go along with it. I was not symptomatic from my ear but obviously a lot of nose blowing with influenza, just like with your Covid infection. Sadly, you could get C diff from azithromycin and only 2 days of it; I would give it another 24-48 hrs unless: the diarrhea becomes worse, fever, nausea and unable to hold down food or liquids, vomiting and more than 3 loose stools in a day. And then you need a test....I doubt the diarrhea is from COVID (w/ azithro on board- it hangs out in the system for >60 hrs after the last dose,) so find Covid as cause a little less likely, although some pts get diarrhea with Covid. Are you on paxlovid for the COVID as that can give pts diarrhea too? BUT I would continue that. No antibiotics are Cdiff free, however, in my years of experience, I have not seen C difficile with doxycycline as an antibiotic to remember. Best!