low wbc and CD4, HIV negative

[chris816]

Hi guys;
I am having low wbc (3800) and low cd4 count (428),but tested hiv negative. I am having white tongue, rash on face and chest, diarrhea, muscle pain, and .... Tested negative for TB, ebv, hiv, hep a,b,c. what do u think that i should do? I am getting side infections easily and worried to lose my job. Any idea?
tnx

[mkh9]

The other thing is doxycycline side effects can be rash and diarrhea. But usually not for this long. Although, I took ds bacterim and it is 6 months later and I still have low platelets and high lymphocytes from it. The doctor said it was from that.
mkh9

[chris816]

really??? this much long??

[mkh9]

I was taking about the blood cells being off. I don't think the rash and diarrhea are caused by this, but if the blood cells are off it can take a long time and or mine seems to be permanent or taking >6 months to go away. I think the rash and diarrhea is something else.

The other thing is if it isn't infectious (an I am not sure what it is yet) maybe it could be allergy related. Have you changed to eating anything new? Maybe that would cause you to break out and have diarrhea. It can happen if you continue to be exposed to something you are allergic to. I am just batting things around since this is difficult and not straight forward.

mkh9

[chris816]

As you know, people with infections, since they have weak immune system, are getting allergies related stuff more than others, I agree that the rashes could be allergy related as a result of decrease in wbc. I havenot changed my eating habits.

[mkh9]

Okay thanks. I don't think you have Ehrlichia after reading more as I think you would be more sick. But if the doctor didn't test you for the co-infections of lyme it probably would be good to get. Also the parasite tests. It sounds more like one of these than parasitic but then some parasites can give you a rash and diarrhea but not likely the muscle pain. How bad was is the muscle pain? Did you get over that?
mkh9

[mkh9]

A lot of these tick related illnesses are chronic and you can get treated with Doxycycline but still don't get a high enough dose to get rid of it. You could talk to some of the people on the Lyme forum. Most of them have co-infections. Jackiecalifornia is very knowledgeable there. They don't always test for Anaplasma either. That is another one. I am just giving you options for testing. I hope you don't mind. To me it isn't an easy diagnosis. I am not a doctor just a microbiologist. So hopefully, your doctor will help. But I'm just trying to inform you of things that have similar symptoms.
mkh9

[mkh9]

My lyme friend said that she first had diarrhea all the time and rashes when she got lyme but that she was negative on the test and didn't have the usual lyme rash. She didn't know she was bitten by a tick. Her immune system got worse and worse and then she saw a "lyme Literate doctor" those that actually believe in lyme and know that it is difficult to detect because it gets inside of the lymphocytes and doesn't always show up on blood tests etc.  So she had her blood work sent to Igenex and they are the main lab that tests for lyme the co-infections for it. So if you are negative you may want to retest if they don't figure out what this is.  Get the doctor to send your labs to IgeneX. If they won't you can see a "lyme literate doctor or LLMD but they are very expensive and don't take insurance. You can talk to her if you like she is on here. Her nickname is mojogal. You can message her.
mkh9

[mkh9]

Also, mojogal said you could have Lyme or Bartonella. Okay. take care,
mkh9

[chris816]

i took lyme and rocky mountain in labcorp. results will come tomorrow and i will let u know.
you are a very good person, thank you

[mkh9]

Glad to help. I hope  you can figure out what is going on.
mkh9

[chris816]

they both came out negative!

[chris816]

i also had stool sample, parasite negative

[mkh9]

Chris816,
That is great. But as I mentioned you might want to recheck the lyme through IgeneX and the co-infections. It may be bartonella or one of the other Coinfections. The ELISA test they use isn't as accurate as the test that IgeneX uses. http://www.igenex.com/
You can read about them on their web site. They state their accuracy.
I would repeat the stool test in a week or two. If negative  I would say you are negative for stool parasites. I don't know if you want to do blood parasites. I don't think you have been exposed to those except via tick bite you can get babesia. But the PCR test is more accurate then a parasite test.

mkh9

[chris816]

thank you, i took pcr for lyme

[chris816]

is there a possibility to have a unknown viral infection which is not regular and compromises immune system?

[yangyangk]

did you have sex then

[mkh9]

Chris816 , there is no such thing as a normal virus but if you mean something commonly found? Then something like EBV (Epstein Barr virus) could potentially lower your immune system. It can cause some serious problems in some people. There may be other that I don't know of.
mkh9

[mkh9]

Chris816, see above. Also, just so I don't have to go back and read the whole string of questions. Do you have fevers that come and go? There is a new strain of relapsing fever caused by Borrelia hermsii but it is treated for about a month with doxycycline and so you should have been cured by it if you had it since you took doxy. But I don't recall if you had doxy for a whole month? Just checking. Also, wondering how you are doing now?
mkh9

[mkh9]

Hi, I didn't get your message. I may have answered your question elsewhere if you wrote it some where else. But Since your white count is low you are more susceptible to getting infections. Did you have any abnormal cells on the complete blood count? Like premature red or white blood cells? what did the report say, or can you type out the rest of the CBC results here and give the reference ranges or was the rest normal? You should see an infectious disease doctor if you haven't yet as one idea. Have you been anywhere where you could have had exposure to a parasite? That could give you diarrhea.  You need to find the root of the reason why your white count is low. The other doctor would be a hematologist.  Have you gone hiking lately? Or a while ago and where? Drink any fresh water like from a stream or anything like that? Have you had any high fever? Any unprotected sexual exposure? Been bitten by any insects, ticks or anything since your symptoms started?
thanks,
mkh9

[chris816]

hi;
tnx for the response, let me go one by one:
1-no abnormal cell in cbc
2-all cdc normal this is what i have:
WHITE BLOOD CELL COUNT 4.3
RED BLOOD CELL COUNT 5.67
ABSOLUTE NEUTROPHILS 2047
ABSOLUTE LYMPHOCYTES 1819
ABSOLUTE MONOCYTES 366
ABSOLUTE EOSINOPHILS 52
ABSOLUTE BASOPHILS 17
all in range, however, i used to have 6.5 wbc count when i was healthy, problem starts here:
ABSOLUTE CD4+ CELLS 428 LOW
ABSOLUTE CD8+ CELLS 962  High
3- for parasite, i had stool test, nothing found!
4- I hike 3 times per week, i am a hiker
5- no fresh water drinking
6- all protected sex, STD tested negative
7- no bite, just visited an infection disease doctor and doctor ordered  rocky mountain and Lyme, waiting for the results
8- TB neg, no cancer, ebv neg, herp neg, hep neg,

what do u think?

[mkh9]

Your CD4 and CD8 really isn't very far off and same with the WBC count. All just a little off. Maybe recheck in a few months? Maybe you had some reaction to something you took? Did you have any antibiotics or any other medications before this including OTC pills/herbs?
Did the rash on face and chest go away? Did you have a fever with it? What did it look like? If you are well now it might have been a transient virus too. Possible exposure to something while hiking? Like poison ivy /oak? Did it itch?
mkh9

[mkh9]

Also, the rash and diarrhea maybe you didn't go swimming? Maybe chemical or something in the water? Just thinking.
mkh9

[chris816]

i took Doxycycline for 6 weeks, for prostate infection, but that was around 10 months ago, and this stuff happened a little bit after that and still going on.
the rashes still going on, lots of small bumps on the chest, and sometimes big ones on different places with white liquid inside.
i am still not fine and have all of the symptoms i mentioned.
i do not go swimming.

[chris816]

i will check again this month, my symptoms getting worse.

[mkh9]

Could be a staph infection. Could the white stuff in side the bumps be pus? Maybe it is resistant to doxy. You should try to get them cultured. It could be folliculitis or something like that. You can try a triple antibiotic ointment like neosporin on a few of them to test it for several days and see if it makes those go away. Does it follow the follicles? It usually looks kind of irregular pattern. I had that on my hip and leg. They used two antibiotics as I had two bacteria. But I am allergic to neosporin and couldn't use it. The diarrhea may or may not be related. Did you ever get a stool culture? That is not a parasitic test to check for salmonella, shigella and other intestinal pathogens?
mkh9

[mkh9]

If the antibiotic ointment works then you can talk to the doctor about applying the ointment over such a large part of the body. It is what I read as the treatment for follicultiis. But I would make sure since I am a microbiologist not a doctor.
mkh9

[chris816]

I had a culture on my tongue, it came out negative for any dangerous bacteria

[mkh9]

The tongue wouldn't show a whole lot. Where do you live? Like which country and/or state if in the U.S? Just wondering what type of things you could have been exposed to.
regards,
mkh9

[chris816]

CA, USA, however,
I travel a lot, from Florida, Tennessee, Colorado, Washington, Nevada,  

[mkh9]

OK thanks. Do the rash spots look crusty? Are they rough and red/yellow kind of scaby? What do they look like?
mkh9

[chris816]

on the chest; they are very small, red, and a bunch next into each other
on the face, it comes and goes, one, red, with a yellow/white filling

[mkh9]

Chris816, it could be a staph infection by your description. So try the antibiotic  ointment. Then see if it starts to diminish the rash.
http://www.mayoclinic.org/diseases-conditions/folliculitis/basics/treatment/con-20025909

I would say it should look a lot better by one week. If it does then continue until it goes away. Wash your hands after touching the spots and change towels, sheets, clothes often. If it is a staph it spread easily. It could be a combination of staph and strep or fungus. Hard to know. In this case you would need a doctor to prescribe another topical like Erythromycin topical or a antifungal  topical.  Usually, they can tell by looking at it and feeling it.

But, it wouldn't be the first time a doctor didn't figure something like this out.

You can get a second opinion from a good family practice doctor instead of a specialist. If you plan on seeing him for the results of your tests you can ask if it looks like folliculitis.

mkh9

[chris816]

the rashes happening as a result of low wbc, doctor does not believe that they are the main issue

[mkh9]

Chris816
What does the doctor think?

I am wondering if you have a parasite? Or of course some other infectious thing like  a virus. Have you been out of the country before that? I know you mentioned some of your travel. Or been around someone that has been outside the country recently like SE asia or India? You might want to get a fecal test for parasites. Maybe do it once wait a week and repeat.

When hiking did you ever use a water pan or wash pan in water from a stream and wipe it clean? I am just trying to figure this out.

You have diarrhea that won't go away, and rashes. The white count isn't that low. But it is a CD4 count not a regular WBC count.

Did you have risky unprotected sex? You already tested for STD's and HIV.

There is also a co-infection of lyme. Ticks can also carry other things one is:

https://www.cdc.gov/ehrlichiosis/symptoms/

Ehrlichiosis has a lot of your symptoms.

I can look more into this if you are interested after reading the link.

The other co-infections of lyme are babesia, bartonella, anaplasma, RMSF, and Tularemia. RMSF and Tularemia are pretty rare and you would be even more sick so I don't think so.

mkh9

[mkh9]

The rash of Ehrilichia isn't quite right though. But the CDC doesn't always get it right believe it or not. I have a friend with lyme. I can ask her about it if  interested.
mkh9

[Elkayed]

Sent you a private message did you get it?
I am cured of ME/cfs on antiretrovirals.
Hiv negative too.