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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Cold With Fever And Swollen Neck Lymph Nodes?

Hi. 23 yrs old Male. Went to a strip clup about 21 times in the last two years. Last time was on July 6 ,2014. No intercourse or high risk exposure of any kind whatsoever. Last time though , there was some petting , and the stripper spat on my penis. Was worried.Got a complete STD panel done yesterday. Everything came back negative (HSV,HIV,Chlamydia,gonorrhea,hep a,b,c) , EXCEPT RPR . It says RPR was reactive , for RPR titer 1:2. There have been no clinical presentations of syphilis on my body. No chancres or rashes. For the past 2 days iv had a mild cold with fever , slightly swollen lymph nodes on neck and little fatigue (have gotten very little sleep and not eating properly due to work .might be due to this.) . Wanted to confirm about RPR titer. Should I test further (specific tests)? , wait for more symptoms ? , anything else that can cause a false positive(that im likely to have and should test for) ? .Thank you for your time. Needless to say , my strip club days are over. Not worth it for a hypochondriac like me.
Fri, 12 Dec 2014
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General & Family Physician 's  Response
Hello
Not going in detail I will just discuss about RPR .
In your case it is 1:2 ,while a serum rapid plasma reagin titer of 1;32 seems to be the best cutoff point to decide whether or not to perform lumbar puncture for CSF examination.
Now about specific test because RPR is reactive so I advise you get in these tests for confirmation.
Nontreponemal:VDRL/RPR ;more sensitive , less specific , as you had got this (RPR).
Treponemal test :MHA-TP TPPA , EIA.
These tests are more specific than RPR and mainly used FOR CONFIRMATION , so get in any if these specific test.
Hope this will help you.
RPR as I mentioned in detail so for confirmation get as mentioned above tests.
Good luck.
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What Causes Cold With Fever And Swollen Neck Lymph Nodes?

Hello Not going in detail I will just discuss about RPR . In your case it is 1:2 ,while a serum rapid plasma reagin titer of 1;32 seems to be the best cutoff point to decide whether or not to perform lumbar puncture for CSF examination. Now about specific test because RPR is reactive so I advise you get in these tests for confirmation. Nontreponemal:VDRL/RPR ;more sensitive , less specific , as you had got this (RPR). Treponemal test :MHA-TP TPPA , EIA. These tests are more specific than RPR and mainly used FOR CONFIRMATION , so get in any if these specific test. Hope this will help you. RPR as I mentioned in detail so for confirmation get as mentioned above tests. Good luck.