Hello Doctor, I am a 30 year old male with

Patient

Q: Hello Doctor,

I am a 30 year old male with no history of health issues or medication. 78 days ago I made the worst drunken mistake of my life. I had unprotected oral and vaginal sex with a white middle aged female of unknown status in the USA.

Two weeks after this event, I began to feel ill with the following symptoms, many of which are non-specific. There were also symptoms that did not develop, which I would have expected in illnesses such as the cold or flu.

Nausea
Weakness
Swollen Lymph Nodes in the neck
Post Nasal Drip
Slight Dry Cough
Complete Loss of Appetite (Lost 15 pounds in 2 weeks)
Sensitivity to temperature
Brain Fog (People at work asking me "Is everything ok?")
Mild night sweats
No Fever (Though I felt like I had one, I measured constantly)
No Vomiting
No significant sore throat

After about two weeks of dealing with these symptoms in various degrees I developed the following symptoms:

Extreme Dry Mouth (Night and Day, couldn't even speak)
White coating on back of tongue (can be brushed off)
Irregular Soft Stool (Colors were at times green, yellow, some white patches, some grey patches)
Occasional Diarrhea
One night I could hear my stomach churning the entire night to the point I couldn't sleep
Dull pain right under the sternum
Tingling in my face and legs

Today is Day 78, and most of the symptoms I have mentioned have subsided. The prominent ones which remain are dry mouth, soft stool with occasional diarrhea (color improving to light brown), white tongue at the back, that dull pain right in the center of my abdomen under the sternum and no real interest in food despite having gained back most of the weight I lost.

My PCP told me that's it's probably just a "bug" and that I'll get over it. However, I'm very concerned given my actions.

I've had the following tests done at these intervals after exposure:
4th Gen HIV Duo @ Days 33, 50, 72 - Negative
Hepatitis B @ Days 33, 50 - Negative
Hepatitis C @ Days 33, 50 - Negative
Chlamydia @ Days 33, 50 - Negative
Gonorrhea @ Days 33, 50 - Negative
Syphilis @ Days 33, 50 - Negative
Herpes I @ Days 33, 50 - Positive (no signs of sores or blisters)
Herpes II @ Days 33, 50 - Negative
Micro Urinalysis & Complete @ 40 Days - Normal
TSH @ 40 Days - Normal
Lipids @ 40 Days - Normal
Metabolic Panel @ 40 Days - Normal
CBC @ 40 Days - Normal
Sjogren's AB SS-A & SS-B @ 68 Days - Negative
CMV IGG & IGM @ 72 Days - Negative
HTLV I-II @ 72 Days - Negative
xTAG GI Pathogen Panel @ 55 Days - Negative
https://www.luminexcorp.com/clinical/infectious-disease/gastrointestinal-pathogen-panel/product-details/
EBV @ 72 Days - IGM Negative, Early Antigen Ab IGG Positive (19.1, max 8.9), Ab VCA IGG Positive (134, max 17.9), Nuclear Antigen Ab IGG Positive (166, max 17.9)

Is it possible that a recently active EBV infection caused my symptoms? Could it be something else, bacterial, fungal? I'm quite worried as I have never been sick like this before. I have an endoscopy scheduled in 2 weeks.

Thank you for your insight and input.

-Dan

Symptoms:  Nausea
Weakness
Swollen Lymph Nodes in the neck
Post Nasal Drip
Slight Dry Cough
Complete Loss of Appetite (Lost 15 pounds in 2 weeks)
Sensitivity to temperature
Brain Fog (People at work asking me "Is everything ok?")
Mild night sweats
No Fever (Though I felt like I had one, I measured constantly)
No Vomiting
No significant sore throat

After about two weeks of dealing with these symptoms in various degrees I developed the following symptoms:

Extreme Dry Mouth (Night and Day, couldn't even speak)
White coating on back of tongue (can be brushed off)
Irregular Soft Stool (Colors were at times green, yellow, some white patches, some grey patches)
Occasional Diarrhea
One night I could hear my stomach churning the entire night to the point I couldn't sleep
Dull pain right under the sternum
Tingling in my face and legs
Doctor

A:   Hi,

Thanks for your query and an elucidate history.
Read and re-read your history carefully and understood your concerns.
The symptoms related to your gastrointestinal tract may be due to infection.
Since xTAG GI Pathogen Panel @ 55 Days - was Negative, it is difficult to say which one.

Your Symptoms did match EBV infection and the tests of Early Antigen Ab IGG Positive (19.1, max 8.9), Ab VCA IGG Positive (134, max 17.9), Nuclear Antigen Ab IGG Positive (166, max 17.9).

I would advise you to consult the Specialist in Infectious Diseases to correlate your symptoms, signs and have correlation with the reports that you have to give you an appropriate management.

I hope this answers your specific query.
Get an opinion of the Specialist as mentioned ASAP.

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