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Syphilis: RPR reactive, but negative for treponema pallidum antibodies?
Last week, I went to get a battery of STD tests. Everything came back negative, except for the RPR, which reported a value of 1:2 reactive. The following line item shows treponema pallidum antibodies: negative.

I'm wondering if this means that the RPR is a false positive. In terms of recent medical history, I had cold symptoms (sinus congestion) about four weeks ago, and a persistent cough which lasted about 3 weeks. I had a flu shot a week before getting tested (so it overlapped somewhat with the cough).

In terms of sexual history, I'm a straight man, 30 years old. In the past year, I've had protected intercourse with two women (most recently five weeks ago), unprotected oral with the same two women, and have kissed several others. I never noticed any symptoms resembling a chancre.

Past medical history: nothing remarkable, except that I was a sickly child. Pneumonia three times, whooping cough twice, bronchitis multiple times.

1. What is the probability of an RPR false positive here? If the treponema pallidum antibodies show negative, is that a definitive verdict of "no syphilis"?

2. How long after initial exposure does it take to develop TP antibodies?

3. I'd like to get re-tested. How long does it make sense to wait before doing so?

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2 Answers
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300980 tn?1194933000
Welcome to our Forum. I'll be pleased to explain. there is little question about what is going on in this situation- You do not have syphilis, you have a false positive RPR test. Such false positives are present in about 1% of the population and that your RPR has no major negative implications for you or your health.

When person have syphilis, they develop positive treponema pallidum antibody tests BEFORE they develop a positive RPR.

False positive RPR tests may be transient an thus could be related to your recent cold or they can be lifelong.  Either way, other than knowing that you have had this false positive test, there is little else to do or worry about.  If you choose, for your own peace of mind to get re-tested, I would wait a month or so to do so. If your FP test is transient, it will have most likely resolved by then.  EWH
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18512654 tn?1465482470
A related discussion, T. Pallidum - Do I have Syphilis? was started.
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239123 tn?1267651214
University of Washington
Seattle, WA
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