Looking for answers, completely stumped

[Confused7765]

Hello everyone. in July 2014, I had a protected anal sexual encounter with a woman. The condom did not break / fall off, etc. after the encounter I developed a huge range of symptoms which to a degree all continue today, 1 year later.

Weeks 1-3: immediately after
anal and itching under scrotum
Persistent low grade fever
Night sweats
Fatigue
Weakness especially in arms
Extreme anxiety (panic attacks)

Weeks 5-12:
Imbalance / dizziness (bumping into walls)
Tremor in hands
Chest pain under sternum (alleviated by exercise)
Sensitivity to sounds

Weeks 12 and on:
Low testosterone

The most prominent things today are low testosterone, dizziness, chest pain.

Here are the things I've done so far.

Negative for all STDs at 5 month mark (gon,
Syphilis, clym, hep, a, b,c, hsv 2)
Negative for HIV at 5,10 weeks (4th generation test) 12 weeks, 6 months (rapid fingerstick)
PCP ran urine culture, cbc (normal)
Chest x-Ray (normal)
Neurologist referral: tested for vitamin deficiency thyroid, and heavy metals (normal)
Internal medicine doctor: 2nd CBC, testosterone serum, thyroid (normal except for testosterone which came back at 435)
Urologist referral for low testosterone, tested again. Came back at 470 and 190.
Was put on a very small dose of clomid, testosterone increased to 1305.

What else can I do to get an answer? I am worried because this has gone on so long. I am able to live my day to day life, but I'm so distracted by my body that it is difficult to enjoy almost anything. Advice is appreciated. Thank you.

[Confused7765]

So it's been about 13 months since the encounter with this woman. I feel close to normal, but really i've never been the athlete that I once was after this.

The chest pain is gone, and the dizziness has been excellent over the past 3 weeks.

I'm not sure if it's just a matter of time to get better? Or if I should be doing something to monitor my health. No doctor has been able to find anything abnormal on any test, and I have done so many. I am not sure if I should continue to pursue a diagnosis? Or just wait until things get better / worse?

[mkh9]

I said if you don't get a diagnosis with the physical see an infectious disease doctor. But you could just as well try a endocrinologist for testosterone problem. So, this is of course after trying everything else. I'm not really sure you need an infectious disease doctor. Maybe try the endocrinologist first. I'm mixed on this at this point. How about lets just see what happens after the physical, urologist , EKG (will likely be negative) but the 24 hour monitor is more important and the echocardiogram etc. If these are all negative we can regroup if you like.  Let me know if the anti-fungal spray/cream works.
mkh9

[mkh9]

Yes generally That is what I am saying. Regarding #1 the anal itching, could also be a dermatophyte (fungus such as one that causes jock itch).

I think that you should check these things you listed out. If they are all negative and you still have symptoms then perhaps see an infectious disease doctor. But a low grade fever not sure yet what is causing that. So hopefully, you will get some answers. Let know how it goes.

I hope it helps you get organized to focus on certain things. Perhaps this will help the doctor think about how to figure out what is going on. They tend to focus on certain things. If the do a CRP that will only show non specific inflammation. So that wouldn't tell much. I hope they do more than that.

You could try a over the counter anti-fungal spray or cream, for the anal area. Use it topically only (not inside). Get one that has Terbinifine in it not one that has fluconazole or ends in azole as lots of yeast and other fungi are becoming resistant to that. You would have to use it for about a week and a half several times a a day. Follow the package insert.
mkh9

[Confused7765]

So If I understand this correctly you believe that

1) originally the infection that I had was killed by my immune system (Possibly the flu or something else) and the anal itching was unrelated, likely pinworm or candidal skin infection
2) Lightheadedness / Imbalance, chest pain, low testosterone, weakness, are not related to the incident in July, could be a cardiac or inner ear issue.
3) Re-emergence of fever, anal itching when getting fatigued is not concerning. based on lab results and general activity level.

My plan is to get a physical this year with lab work to see if there is any other infectious markers. It's really hard for me to believe that there is no infection. Continue to see Urologist for Testosterone, look into ENT and EKG for dizziness and chest pain.

Thank you for all the answers you give on here. I want you to know that it really helps me and others out to be able to come here for advice.

[mkh9]

Its possible that it is pin worm since it happens all the time and mostly at night. But that wouldn't explain the other symptoms.  But the chest pain is probably from the costochondritis. But If you want to you can also get the 24 hour monitor and echocardiogram done.  Just because you are athletic doesn't mean you can't have a structural problem or an arrhythmia. That could cause dizziness too. I don't know if that is the problem. But you could rule it out. I don't know if any of these are the right thing. It is just some ideas that you could check. Your symptoms are general so you would have to do more testing to try to figure it out.
mkh9

[Confused7765]

It's possible that I was exposed to something at work. I work in the operating room. I have been tested through work for hepatitis C, TB, HIV etc.

I travelled to Jamaica last November and went to Belize 2 weeks ago. All the symptoms preceded those trips though.

Pinworms is a possibility I suppose. Would that cause the other symptoms? (Dizziness, chest pain) the anal itching would be constant for the most part. But it would certainly emerge at night at first.

No injuries to the arms that I remember, certainly no nerve damage or anything like that. My arms just feel weak and trembling. I can still lift similar weight than 1 year ago.