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STDs (Expert Forum)
Is an RPR or FTA-ABS re-test necessary?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Is an RPR or FTA-ABS re-test necessary?
by slartibartfast, Jan 13, 2007 12:00AM
Hello,
I am a male and just over seven months ago I had a sexual encounter with a female escort on a trip to Germany (this is NOT a common occurance - happened only once before in my life, and after all the obsessing related to this encounter I don't see it happening again!). A condom was used for intercourse, but not for receptive oral sex (or, obviously, for kissing). I did not perform oral sex during the encounter. When the encounter occurred I was half way through a 3 week course of Ciproflaxin for a completely unrelated case of prostatis (so I had a week and a half of antibiotics after the encounter). About a week after I returned from Germany I had a canker sore inside my mouth just at the base of my gums (so right at the border between hard and soft tissue). This is not unusual after coming back from a sleep deprived international trip (I get them about 25% of the time when I come back from a long haul trip). This looked just like a standard canker (white, flat, and with a red inflammed border), hurt just like one, and was gone in the same amount of time. I had no sores anywhere else on my genitals or lips (and I did look thoroughly and frequently). Still, it spooked me a bit even though it looked no different (and felt no different) than any canker sore I had in the past. None the less, six months after the encounter I got an RPR and HIV test. Both came back negative. Now, about a week after the test I started to get small, raised, red dots on my knuckles and at the base of several of my fingers - some were clustered; they were no where else on my body and there was no other "rash". I should add that this followed a several week period of long runs during which I wore fleece gloves that left my hands damp itchy and ended up creating exema (eczema)-like cracked knuckles and skin that persisted until I stopped wearing the gloves. Obviously, these red dots spooked me again and made me think of secondary syphilis. My question has three parts:
1.) Could the fact that I was on antibiotics have interrupted the course of syphilis and prevented a chancre or impacted the RPR results 5 1/2 months after I finished the antibiotics? How accurate would the result be 6 months later assuming a normal progression?
2.) Would you recommend a re-test for the RPR and an additional test (FTA-ABS) as well to be sure?
3.) If I had a flu-shot a month ago and just got over an upper respitory cold, how long should I wait to get re-tested (if I need to) in order to avoid a false positive result?
Thank you for your reply.
I am a male and just over seven months ago I had a sexual encounter with a female escort on a trip to Germany (this is NOT a common occurance - happened only once before in my life, and after all the obsessing related to this encounter I don't see it happening again!). A condom was used for intercourse, but not for receptive oral sex (or, obviously, for kissing). I did not perform oral sex during the encounter. When the encounter occurred I was half way through a 3 week course of Ciproflaxin for a completely unrelated case of prostatis (so I had a week and a half of antibiotics after the encounter). About a week after I returned from Germany I had a canker sore inside my mouth just at the base of my gums (so right at the border between hard and soft tissue). This is not unusual after coming back from a sleep deprived international trip (I get them about 25% of the time when I come back from a long haul trip). This looked just like a standard canker (white, flat, and with a red inflammed border), hurt just like one, and was gone in the same amount of time. I had no sores anywhere else on my genitals or lips (and I did look thoroughly and frequently). Still, it spooked me a bit even though it looked no different (and felt no different) than any canker sore I had in the past. None the less, six months after the encounter I got an RPR and HIV test. Both came back negative. Now, about a week after the test I started to get small, raised, red dots on my knuckles and at the base of several of my fingers - some were clustered; they were no where else on my body and there was no other "rash". I should add that this followed a several week period of long runs during which I wore fleece gloves that left my hands damp itchy and ended up creating exema (eczema)-like cracked knuckles and skin that persisted until I stopped wearing the gloves. Obviously, these red dots spooked me again and made me think of secondary syphilis. My question has three parts:
1.) Could the fact that I was on antibiotics have interrupted the course of syphilis and prevented a chancre or impacted the RPR results 5 1/2 months after I finished the antibiotics? How accurate would the result be 6 months later assuming a normal progression?
2.) Would you recommend a re-test for the RPR and an additional test (FTA-ABS) as well to be sure?
3.) If I had a flu-shot a month ago and just got over an upper respitory cold, how long should I wait to get re-tested (if I need to) in order to avoid a false positive result?
Thank you for your reply.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 13, 2007 12:00AM
, Jan 13, 2007 12:00AM
Syphilis is rare in this situation; a typical canker sore (painful) is unlikely to be a syphilitic chancre (painless); and the negative RPR 6 months after the event is proof you don't have syphilis. Cipro is totally inactive against syphilis and could not have affected the test result, and neither can a flu shot. I don't know the cause of the "red dots" on your knuckles, but it isn't syphilis. You don't need further testing.
Forget syphilis. See a health care provider if you remain concerned about the red spots.
Good luck-- HHH, MD
Forget syphilis. See a health care provider if you remain concerned about the red spots.
Good luck-- HHH, MD
Thanks for the rapid and very helpful answer. Off to my dermatologist to get the red dots figured out.
Very much appreciated the assistance.