STDs Expert Forum
Sypilis concern
About This Forum:

The STD Forum 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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Sypilis concern

2 years and three months ago I(male) received oral sex from another unknown male. I got extremely nervous and began to check myself meticulously for the next two years.  
Day 3 post exposure I began 500mg of Amoxicillin 3X a day for 10 days
Day 10 post exposure I took 2g of Azithromycin at once
Day 14 post exposure I developed an acne like rash on my forehead that consisted of small zit like bumps with tiny whiteheads, they would ooz when popped.   I developed horrible headaches, sore lymph nodes under my jaw, armpits and a little in the groin, sore throat, swollen tonsils. Day 33 post possible exposure I tested for everything including HIV and Syphilis (RPR) and results were negative for all. I continued to have these symptoms on and off but they would come on a flare I have been test now 7 times for HIV out through 2 years post possible exposure and were negative every time.  
I tested again for Syphilis with a RPR at 7.5 MONTHS and was negative again as well.  
I continue to get flares of symptoms to this very day of all of the above plus mouth sores, body itch, and extreme joint pain.  I have been to my doctor many times and have been tested for just about everything under the sun many of which are non STD related.  My CBC shows completely normal.
MY concern is Syphilis, but I have never saw a chancre of any sort (Trust me as I have checked), nor did I develop a foot or palm rash; 1)Is my negative RPR accurate at 7.5 months?  I am worried about the timing and the chances it would not be accurate that far out as well as the prozone effect?
2) Would the 2 antibiotics have cured syphilis since they were taken so early after my possible exposure?
3)Is there ANY chance this is syphilis given the atypical symptoms and reoccurring flares?
BTW I do not live in the areas that have been known for azithromycin resistance
300980_tn?1194933000

Welcome to the Forum.  I'll be happy to work through your question but, before I do, I want to let you know that before reading your question I've reviewed your other 40 posts on our Community sites made over the past couple of years and let you know that without reading today's question, it appears to me that you do have a tendency to worry (guilt?) over some of your sexual interactions and that you appear to get a lot of information from the internet.  While the internet is a great place for general information, it is a terrible place to try to sort out the details of one's health because much of the information there, while placed with good intentions, tends to provide information out of context and to make rare events sound common.  Mis-information tends to be the rule rather than the exception. thus the internet may not be the best place for you to be seeking information.

Now that I have read your question, let's address your concerns.  

1)Is my negative RPR accurate at 7.5 months?  I am worried about the timing and the chances it would not be accurate that far out as well as the prozone effect?
Syphilis was referred to as the "great imitator" because it can present in a variety of ways however, the disease is rare, the tests for the infection are quite reliable, and most importantly the infection is exquisitely sensitive to antibiotics.  Both the amoxicillin and probably the azithromycin that you took would have cured your infection.  Your 7.5 month tests are reliable and should be believed. the prozone effect should not worry you (internet effect??   The prozone occurs in less than1% of persons with untreated syphilis).

2) Would the 2 antibiotics have cured syphilis since they were taken so early after my possible exposure?
Yes, they would have been curative.

3)Is there ANY chance this is syphilis given the atypical symptoms and reoccurring flares?
No, I am quite confident this is not syphilis.

I hope my answers are helpful to you- you need to work on moving forward from your exposure of concern.  You did not get infected through it.  EWH
4 Comments
Blank
Avatar_m_tn
Doctor,
Thank you for your prompt response to my concern about syphilis a while back.I would like to ask you a follow up question although it has been a while since I posted my original question to you.

I continue to have symptoms of some mystery illness that is still undiagnosed.  I have not been back to my doctor since my battery of bloodwork, he has pretty much said he does not know what is wrong.

I respect your medical advice which is the reason I reached out ot this community in the first place but I would like if possible a more descriptive explaination of the effect of the meds I took at the 3 and 10 day post encounter mark.  How would 500mg 3x aday for 10 days of Amox do against syphilis when started on day 3?  And Azithromycin 2g at day 10?  


I tested early on at day 33 but I had been taking those meds listed about so I believe they would have an effect on the results, but I am more concerned with the accuracy of the test at 7.5 months.  

At the 7.5 month mark put me at risk for the Prozone effect?  My test was an RPR w/reflex and apparently confirmed with a Trep. if it was reactive, but only if the inital RPR was reactive, which they say it wasn't.  How accurate was that test?  
I know you are going to say move on, but its hard to when this all started post encounter, I am still sick without a diagnosis.  
What symptoms would I be experiencing this late in the game if I indeed had caught it 2.5 yrs ago?
Blank
300980_tn?1194933000
Your worries are not warranted. The 10 days of amoxicllin starting 3 days after an exposure would have completely prevented the development of syphilis, as, probably, would the azithro.    Following such therapy it is unrealitic to continue to worry about syphilis.  Further, you you point out,syphilis would not still be causing symptoms at 2.5 years.

Time for you to try another doctor.  This is not syphilis. EWH
Blank
Avatar_m_tn
Thank youfor your reply
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank