Viral and bacterial infection at the same time?
December 3, 2007 6:19 PM   Subscribe

So my girlfriend went to the "girl doctor" and was told that she might have chlamydia..ok shocking but no big deal. The doctor also noticed a bump on her rear end..and stated that it was a type of viral infection. Now the doctor tells her that its very uncommon to have a bacterial and viral infection at the same time. That it could be a sign of HIV..... Any truth to this? We are both freaking out now and the test results don't come back until wednesday.. She said she was tested before me and was clean.. I personally was never tested, but my ex-girlfriend was (the only other one I've been with) and she was clean of HIV and everything as well..
posted by anonymous to Human Relations (23 answers total) 1 user marked this as a favorite
HPV (genital warts) could present as a bump. It's viral, and common. As is chlamydia, which is bacterial.
posted by Stewriffic at 6:24 PM on December 3, 2007

It sounds like your girlfriend didn't get (or maybe remember) as much information from her doctor as she and you need to understand the situation well. Any way she can call them and get more information in the meanwhile?
posted by Stewriffic at 6:29 PM on December 3, 2007

"Bump" is pretty vague. Could be a boil, which is staph, which everybody and their dog has these days.

I've never heard that it was particularly unusual to have a bacteria and a virus at the same time. It's not like they're mutually exclusive, especially if your immune system is at all weakened - not HIV weakened, I mean a cold or, say, chlamydia. People get respiratory infections (bacterial) on top of the flu (viral) all the time.
posted by Lyn Never at 6:36 PM on December 3, 2007

IANAD, but I think it would be really irresponsible for a doctor to explicitly suggest HIV at this stage. The presence of bacterial and viral infections together should not be enough for him/her to scare a patient like that. Not to mention that a bump on her rear isn't necessarily the cause of a viral infection. Given both your histories (she tested clean, your only other sexual partner tested clean) it seems unlikely that it's HIV.

One suggestion: if your gf has health insurance, the plan may have a nurse advice line. She could call and pose the question to a nurse and see what they say. Or she could call the doctor and ask for a more detailed explanation.
posted by DrGirlfriend at 6:39 PM on December 3, 2007

Chlamydia and anal herpes? Yes, that person gets tested for other sexually transmitted diseases, including HIV. You should know that if you think about it for a minute. If a person was in a situation permitting them to acquire either of those diseases, that person was in a situation to acquire HIV.

One of the problems with proposing tests for other sexually transmitted diseases is that it can come across as very accusatory and judgmental. The doctor is interested in making sure that all the patient's illnesses get diagnosed and taken care of. The patient, however, can hear implied judgment or accusation about their sexual practices or partners.

You need to go get tested too. Stop doing rationalizations about how you only slept with this or that person and they did or didn't have this or that. If these rationalizations could be trusted to be correct, no one would ever have any sexually transmitted diseases. For example, did your girlfriend know she was getting chlamydia? No. Then how's she supposed to know the person she got it from didn't have HIV too?

Just go get the tests. Worry about the rest of it once you find out the results.
posted by ikkyu2 at 6:40 PM on December 3, 2007 [5 favorites]

Response by poster: I'm guessing the doctor meant HPV, not HIV. HPV is very common and can result in bumps in the genital area, especially if the immune system is compromised (like if she has chlamydia, incidentally). I've never heard of "bumps" attached to HIV, except as tangentially caused by opportunistic infections that take hold in response to the weakening of the immune system.

You should call the doctor and clarify this information. You should also get tested yourself, because you probably have chlamydia too and will need to be treated for it.
posted by Anonymous at 6:44 PM on December 3, 2007

IANAD, but I think it would be really irresponsible for a doctor to explicitly suggest HIV at this stage

I disagree completely. The exact opposite is true. Either or both of the people involved here could be infected with HIV without knowing it, just as (at least) one of them was infected with chlamydia without knowing it.

Waiting to diagnose it until they show symptoms of advanced AIDS threatens their chances of survival and enables them to transmit the disease unknowingly to all their future partners. In what way would it be considered "responsible" in a physician to let this happen?
posted by ikkyu2 at 6:45 PM on December 3, 2007

I'd listen to ikkyu2. He is a doctor. Get tested.
posted by Ironmouth at 6:57 PM on December 3, 2007

ikkyu2: I agree with you completely that the patients should be encouraged to get tested for HIV, especially if they have contracted some form of STI. However, I do not think it's ethical (or nice) for the doctor to suggest that since this person has a bacterial infection and a possible undiagnosed viral infection at the same time, they might have HIV. Had the doctor said it the way you eloquently (and bluntly) put it above, I would have agreed completely.

To the OP: You haven't been tested, but your ex was clean. Your girlfriend was tested right before what is this, a case of Immaculate Chlamydia? Did it just jump out of no where and attach to her (or your) genitals?

Both of you will need to be treated for the Chlamydia or you will continue spreading it back to each other. Make sure you both follow the instructions for your medication and finish the entire bottle of pills. And perhaps consider condoms for a while?
posted by nursegracer at 6:58 PM on December 3, 2007

Note that the CDC's says the following about Chlamydia:

Women are frequently re-infected if their sex partners are not treated.
posted by Ironmouth at 7:01 PM on December 3, 2007

If it's HIV, I don't understand why your girlfriend wasn't given a rapid test. With OraQuick, you get a pretty good idea in 20 minutes.

Call your local public health center tomorrow and see if anyone offers these tests. Go together and both get tested.
posted by sbutler at 7:06 PM on December 3, 2007

ikkyu2: I never, ever said that the doc should not have tested her for HIV. Testing for HIV is indeed the right thing. But it should be presented as a precaution -- pretty much the way you described in your response. Based on the doc's reasoning, telling her it might be HIV right off the bat seems premature.
posted by DrGirlfriend at 8:10 PM on December 3, 2007

I think there has been some miscommunication. Both chlamydia and HPV (genital warts) are very common. I don't see why a woman couldn't have both at the same time, especially since HPV is one of those viruses that basically sets up house and refuses to leave. So it could be that she had HPV already, got the chlamydia, and when the chlamydia was noticed she happened to be having an HPV outbreak, too. Maybe her immune system was busy with the chlamydia so the HPV took the opportunity to party. That said, the presence of any sexually transmitted disease says "Test for HIV, too."
posted by PatoPata at 8:22 PM on December 3, 2007

There's nothing particularly unique or startling about having both a viral and bacterial infection at the same time. That sounds like an odd thing for a doctor to say. I would imagine most doctors encounter that on a semi-regular basis. It is not, in and of itself, a sign of HIV, beyond the fact that it could potentially indicate a weakened immune system.

However, the presence of at least one and possibly two sexually transmitted infections is a very good reason to test for more STIs, certainly including HIV. They all have the same transmission route, so the presence of one is a strong indicator that other STIs could be present.

And, get your butt to your doctor or local STD clinic or Planned Parenthood and get yourself tested for everything as well.

If the HIV specifically is causing you anxiety, see if there's a rapid test site near you. You can send a text message to KNOWIT (566948) to get the location of a nearby test site. Rapid HIV tests take closer to 20 minutes to get results, but not all sites are using them yet.
posted by gingerbeer at 8:38 PM on December 3, 2007

Could it be that the doctor said she had an immuno-suppressive condition AND that she should be tested for HIV and other STDs? These are not equivalents but the terminology might have through her.
posted by acoutu at 9:05 PM on December 3, 2007

I guess a lot has been said already that I agree with, but I'll throw my two cents in: good that the doctor tested for HIV, bad that the doctor phrased it in such a way.

My former "girl doctor" once tried to shame my unmarried, sexually active self (in a monogamous relationship of more than two years at the time, with all appropriate tests done on both sides at the beginning of the relationship) by telling me that I "probably" had chlamydia. It turns out that the "symptoms" I was concerned about were just due to my birth control prescription, and I found out later that my complaints were very common for that particular pill. I left the doctor's office in tears and it still upsets me now that she misled and misinformed me in such a judgmental way. My tests came back negative, and I guess being tested isn't really a bad thing, but it was a week of nail-biting anxiety that was so ridiculously undeserved because of the way my doctor presented it.

It's good that she was tested. Regardless of her results, it's a good time for you to get tested too. Try not to freak out until the tests come back. Easier said than done, I know.
posted by adiabat at 9:42 PM on December 3, 2007

I agree with ikkyu2 in that the doctor definitely should test for HIV and pretty much every STD known to man, particularly if one STD is already diagnosed. But this:

Chlamydia and anal herpes?

As the OP says that the doctor told her she "might" have chlamydia (i.e., it hasn't been officially confirmed by diagnostic tests yet), and the "bump" on her "rear end" wasn't diagnosed, and could be anything from a boil on her buttock to HPV to herpes, it sounds a little... you know, judgmental. For all we know, she could just have bacterial vaginosis and a staph infection. (Which is why people shouldn't seek a medical diagnosis on the internet.)

Anyway, to answer the OP, it's not necessarily uncommon to have a virus and a bacterial infection at the same time, but the doctor should test for HIV anyway, you should be tested for everything too, and you should both be treated if any of the tests are positive.
posted by bedhead at 11:26 PM on December 3, 2007

The doctor was an insensitive bonehead. The need for testing is obvious and covered.

I had some docs freak out over me back in the mid 80's. I had some odd purple bumps. Being gay, having purple bumps was seriously suggestive of Karposi's Sarcoma, a common AIDS-related opportunistic infection in those days. I was sweating bullets for 2 weeks, waiting for the results. Turned out it was nothing more than a skin oddity more typical of Mediterranean women (and I'm neither of those).
posted by Goofyy at 5:36 AM on December 4, 2007

What do you want us to do? Wait until your test results come back on Wednesday and then act accordingly. Good luck.
posted by Caper's Ghost at 5:44 AM on December 4, 2007

All judgments of the "girl doctor" are as inappropriate as trying to diagnose something over the internet. We have no idea what the doctor said to her patient. The truth is that the doctor may well have been as sensitive as humanly possible and the patient heard something entirely different, once her hearing was affected by fear.

To answer the question: viral and bacterial sexually transmitted infections together are quite common. Having both together do not indicate that HIV is present, but they do suggest that the patient has been engaging in sexual practices which enable HIV transmission. A patient with one or more acute STIs should absolutely be tested for HIV.
posted by OmieWise at 6:32 AM on December 4, 2007 [1 favorite]

The best answer you can get is go to the doctor to get answers. Everything else is speculation and conjecture.
posted by Silvertree at 10:51 AM on December 4, 2007

If the doctor did speculate, that was unnecessary; she probably should have just said, let's test for everything and see where we are (and a regular across the board STD test is pretty standard from obgyn's I've gone to).

Likewise, it does no good for you guys to speculate while you wait for the results. The symptoms of most diseases are not completely clean cut, can present differently in different patients, etc. So for now, it's just a lot of "might", "could be", etc. It can be hard not to freak out while you're waiting for test results, but at least recognize that's what's going on :). You'll deal with whatever you have to deal with once you have results.
posted by mdn at 11:18 AM on December 4, 2007

Of course I defer to ikkyu2, who is a doctor. I am not touching on the medical here. You both should be tested, as the gynecologist and others here reccommended. Obviously, there has been some risky sexual behavior. But that's not a moral judgment on you, NOR DOES IT MEAN YOU PROBABLY HAVE HIV (only that it's possible, which you always knew, since you'd had sex). Don't freak out, don't worry, don't be upset - many people have these moments in life, and many worry for nothing. For those that get positive results, well, worrying didn't help anything. Getting tested was good medical advice that sounds like it was delivered in a scary way - happens all the time. Find a rapid test in the meantime, to ease your mind. Good luck and feel better.
posted by bunnycup at 3:54 PM on December 4, 2007

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