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What Are The Symptoms Of Syphilis Infection?
Question: I am a married man. This summer I stepped out of my relationship this summer - I received oral sex around July 15th August 13th-I visit clinic. I was tested for Gonorrhea, Chlamydia, Syphilis, and HIV all results return negative (even though I was early for the syphilis window). I was also treated with Rocephin 250, 1g Azthromycin, and of course 2.4 MU BPG. On August 15,16th I had sex with my wife where we conceived. I was confident that i was fully covered from STD even though I had not cleared the window. I had read a post from Dr. Handsfield on medhelp saying that you are non infectious 24 hours after the shot of BPG (http://www.medhelp.org/posts/STDs/How-long-are-you-contagious-after-treatment-for-syphilis/show/0000) On 9/17 (4 weeks after last exposure) My wife has all her normal tests done with OB/GYN. To both of our suprise the RPR turns up positive (1:1) and the confirmatory done by chemiluminescence (which I though was weird) was negative. I freak out, tell her about the indsicretion She is tested for syphilis via RPR and EIA again 2 weeks later just over 6 weeks from our last sex(Which I have read on medhelp a number of times is conclusive via Dr. Handsfield). The doctor was satisfied but I had read the Trep-Sure test they used, would not be the best test during Primary syphilis.
Are these test sufficient for my wife?
Could I have passed syphilis to her even being treated about 48 hours before our sex
Are these test sufficient for my wife?
Could I have passed syphilis to her even being treated about 48 hours before our sex
Brief Answer:
Your wife free from syphilis, needs no more testing for syphilis
Detailed Answer:
Hi,
Welcome once again to HCM.
Yes, you are correct. That in very early stage of primary syphilis, (till 4 weeks after the possible infection), RPR, would likely be nonreactive even in presence of syphilis. But there might be symptoms for primary syphilis,by this time (4 weeks) like ulcer genitals, or inguinal lymph node enlargement etc. or oral ulcers following oral sex.
Moreover syphilis due to oral sex is unusual. So the reactivity of syphilis in low titre for your wife is due biological false positive only and evidenced by a non-reactive Chemiluminescence test and your wife needs no more test for syphilis.
Dr S.Murugan
Your wife free from syphilis, needs no more testing for syphilis
Detailed Answer:
Hi,
Welcome once again to HCM.
Yes, you are correct. That in very early stage of primary syphilis, (till 4 weeks after the possible infection), RPR, would likely be nonreactive even in presence of syphilis. But there might be symptoms for primary syphilis,by this time (4 weeks) like ulcer genitals, or inguinal lymph node enlargement etc. or oral ulcers following oral sex.
Moreover syphilis due to oral sex is unusual. So the reactivity of syphilis in low titre for your wife is due biological false positive only and evidenced by a non-reactive Chemiluminescence test and your wife needs no more test for syphilis.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I know you answered this question before, and I appreciate your patience. I am just having such a tough time believing that nothing is wrong and have been seeing a psychologist over the issue. Have you seen a case where a rpr was positive like that and then two weeks later negative? If she had syphilis the titer would stay the same or go up, not go non reactive....I guess Im just looking for assurance.
Brief Answer:
RPR not become nonreactive without specific treatment, in case of syphilis
Detailed Answer:
Hi,
Welcome once again.
I had few cases similar to that of your wife's case in which RPR came reactive and became non-reactive after 1 month when it was repeated without any anti-syphilitic treatment in acute Biological false positive ( following vaccinations and high fevers).
If there was Syphilis with an individual, the RPR would take not less than 3 months to become non-reactive following the correct treatment.
In case of Syphilis, it would remain static or shoot up and never became non- reactive without appropriate treatment.
Dr S XXXXXXX
RPR not become nonreactive without specific treatment, in case of syphilis
Detailed Answer:
Hi,
Welcome once again.
I had few cases similar to that of your wife's case in which RPR came reactive and became non-reactive after 1 month when it was repeated without any anti-syphilitic treatment in acute Biological false positive ( following vaccinations and high fevers).
If there was Syphilis with an individual, the RPR would take not less than 3 months to become non-reactive following the correct treatment.
In case of Syphilis, it would remain static or shoot up and never became non- reactive without appropriate treatment.
Dr S XXXXXXX
Above answer was peer-reviewed by :
Dr. Raju A.T
She had no vaccination or high fever and the follow up rpr ( after the reactive one) was only taken 2.5 weeks after the original, does that change your assessment....If someone was infected the titer would shoot up in 2.5 weeks time?
Brief Answer:
RPR titre possibly raised to next titre by 2 weeks, if syphilis present.
Detailed Answer:
Hi,
Welcome once again.
If there is no history of fever and vaccination, look for some other reason. Seek the help of a physician.
As you rightly pointed out, if she had infected the titre could have raised two fold by another two weeks time.
Dr S.Murugan
RPR titre possibly raised to next titre by 2 weeks, if syphilis present.
Detailed Answer:
Hi,
Welcome once again.
If there is no history of fever and vaccination, look for some other reason. Seek the help of a physician.
As you rightly pointed out, if she had infected the titre could have raised two fold by another two weeks time.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Raju A.T
in primary syphilis it is not normal for the titre to stay they same but rather go up...correct? I've read that pregnancy alone could be a reason for a false positive, is this true?
Brief Answer:
Many reasons for acute Biological False Positive results.
Detailed Answer:
Hi,
Welcome back.
Antibody titre started appearing during Primary Syphilis and it reaches the maximum during the secondary stage of Syphilis. So naturally in the course of an untreated Syphilis, the titre would be increasing during the primary after the appearance of antibodies.
Acute BFP results can occur in conditions like pregnancy, high fevers, measles, chicken pox,Hepatitis, immunization, even in presence of other STDs, bacterial and viral pneumonia, Leptospirosis etc.It can happen even with narcotic drug addiction etc.
You need not analysis all these. Trust that your wife is free fro Syphilis. Dr S.Murugan
Many reasons for acute Biological False Positive results.
Detailed Answer:
Hi,
Welcome back.
Antibody titre started appearing during Primary Syphilis and it reaches the maximum during the secondary stage of Syphilis. So naturally in the course of an untreated Syphilis, the titre would be increasing during the primary after the appearance of antibodies.
Acute BFP results can occur in conditions like pregnancy, high fevers, measles, chicken pox,Hepatitis, immunization, even in presence of other STDs, bacterial and viral pneumonia, Leptospirosis etc.It can happen even with narcotic drug addiction etc.
You need not analysis all these. Trust that your wife is free fro Syphilis. Dr S.Murugan
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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