Syphilis: 2 day old exposure, treatment and testing (for positive result)

I work in the adult industry. We're tested every 4 weeks for Gonorrhea, Chlamydia & HIV & every 6 months for syphilis. HPV/HSV testing is optional, (but requested to be every 6 too). The girl who I worked with was brand new to the industry & was tested by the central non-profit clinic, AIM, (aim-med.org) It is, apparently, not required that a negative syphilis test be back or on hand, in order to work, (I am checking into this).
Regardless, my exposure was 3/23. I have stopped working with other people, (they were notified by AIM as well). My questions are, how soon can an accurate positive/negative result be tested? And, since I have a skin rash that develops with Penicillin treatment, are there treatment options that are just as effective, or can/do I qualify for a desensitization procedure, (how long would that take?). Once on antibiotics when will I be able to have sex again?
I have, in remission, guttate Psoriasis.

[Edward W Hook, MD]

I would not suggest you question her diagnosis or its timing but rather suggest that you assume that you have probably been exposed to syphilis.  That being the case and given how recently you have been exposed, antibiotic therapy will prevent (as opposed to treat) syphilis.  The recommended therapy for prevention of syphilis in penicillin allergic persons is doxycycline, 100 mg by mouth, twice daily for 2 weeks.  To verify that you did not get syphilis you should have a blood test for syphilis both as you start therapy and upon completion.  If the 1rst test is negative, the second one will be as well.  At the end of therapy you can assume that you have prevented you infection and return to work.

Lesions can be subtle in women and might be missed.  

Hope these comments help. Take care.  EWH
  

[gybek83]

I "inspect" the girls prior.. And I didn't notice any sores on or around her vaginal area.. Does this tremendously decrease the chances of getting it, if she was, apparently asymptomatic?

[gybek83]

If I begin antibiotic treatment tomorrow, 3/26 will I show no symptoms, or will a sore still develop?

[gybek83]

What is the time it takes to get test results back? And can I get an accurate negative/positive so soon after exposure?

[Edward W Hook, MD]

At my clinic we can get test results back in a day or two.  I anticipate that your inital test reulsts will be negative and have complete confidence that if you take the doxycycline as I suggest, you will not develop syphilis.  The reason for repeat testing is simply to "close the loop".  It's almost overkill but, in your profession, I presume you would like to be able to "prove" that you did not get infection.  EWH

[gybek83]

So, if my 1st test is negitive and I start treatment, will I be able to safely return to work in a week?

[Edward W Hook, MD]

Yes.   EWH

[gybek83]

Is it standard for two weeks, or is it safe or possible to rather double the dose daily to 1 4x a day, and have the treatment be a week?