Late stage, testing, symptoms etc.

[hidding]

6 years ago, I had a large boil or pimple on my penis.  I was too young and stupid to do anything about it and it went away.  It did not look terribly like many of the syphilis chancres that you can see online.  Less that a year later, I met my wife.  She has never had any signs of syphilis, nor did I ever have any signs of secondary syphilis like the rashes etc.  I was and am in much better than average health since this incident.  My wife also tested negative for syphilis a few years ago when her doctor gave her a pre-natal battery (we ended up not having kids).  Recently, I became worried and took a RPR test that came back non-reactive.



I assume that I am all in the clear, but have read some places that the RPR can give off false negatives after people have been latent for a long time.



What would your advice be doc?

[general9]

A related discussion, hi was started.

[hidding]

I would like to know these question too By inactive, do you mean latent?   Or is latent syphilis still considered an active disease?   wondering . Thank doc.

[jgh]

By inactive, do you mean latent?   Or is latent syphilis still considered an active disease?   wondering

[H. Hunter Handsfield, M.D.]

Yes.  In that circumstance the negative RPR proves the person does not have syphilis.  Syphilis is not your problem.  You clearly are obsessing about a zero-chance risk, probably out of some sort of misplaced guilt or anxiety going back 6 years.  Sounds like you need counseling about it.

[hidding]

Doc, I have one more question, I promise this will be my last question. If a person has syphilis for 6 years without treatment when person took the RPR blood test for Syphilis would the RPR be able to show that the person its infected with syphilis?

[H. Hunter Handsfield, M.D.]

Chancres do not look like pimples, and pimples of the penis are quite common.  And syphilis is very rare in the US (and most industrialized countries) except in a few subpopulations, mainly gay men and poor minority populations in the southeast.  (Syphilis is totally absent in 80% of all US counties.)  And if you were infected, you can be sure you would have a positive blood test.  The RPR often becomes negative over time, but that's because the disease becomes inactive; it is very rare to have active syphlis with a negative RPR.

Bottom line:  there is no way you have syphilis.

Regards--  HHH, MD