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STDs (Expert Forum)
Trust in Syphilis test
Answered by
Edward W Hook, MD - HIV Prevention, stds
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.
Trust in Syphilis test
by Jurgen40, Aug 04, 2009 05:04AM
Dear Doctor!
I´m a man from Scandinavia who stupidly, outside my marriage, once gave a brief unprotected fellatio without ejaculation to an unknown man in an adult club. I asked before we did it and he said he was “clean” from STD:s. I still got tested for Chlamydia and Gonorrea 10 days after the event and I tested for HIV and Syphilis (VDRL) at 5 weeks after and again at 8 weeks ( 55 days). All tests came back negative. I haven´t noticed any chancre in my mouth and I have no “typical” symptoms of secondary Syphilis. However, knowing that there´s many exceptions from the typical symptoms of secondary stage I still worries about one single red spot on the side of my foot and some other pimple like rashes on my upper leg. I think the “pimples” were there before but I´m not 100 % sure of it. I have a little irritation in my throat as well but it has been there almost during the whole period so that might exclude syphilis.
My health care provider gives different message depending on who you ask regarding the need of further testing. Some says 12 weeks follow up and some 8. I trust 8 weeks regarding HIV but when it comes to Syphilis they seem less confident. Calling for a new appointment I got the information that it wasn´t necessary.
I read your answers to other worried people and you seem very confident that a test after 8 weeks like mine is conclusive without worries of false negative. Can you help me trust my result by answer the following;
- It´s said that a syphilis blood test always turns positive within 6 weeks follow the exposure but why is it so common with a recommendation of a 12 weeks follow up? Has there been any new knowledge the past few years changing previous recommendation?
- Is VDRL as reliable as RPR?
- Do you think the symptoms I describe give any reason to persist in getting a further test done or can I really leave the worries of Syphilis behind me?
Best regards and thanks!
I´m a man from Scandinavia who stupidly, outside my marriage, once gave a brief unprotected fellatio without ejaculation to an unknown man in an adult club. I asked before we did it and he said he was “clean” from STD:s. I still got tested for Chlamydia and Gonorrea 10 days after the event and I tested for HIV and Syphilis (VDRL) at 5 weeks after and again at 8 weeks ( 55 days). All tests came back negative. I haven´t noticed any chancre in my mouth and I have no “typical” symptoms of secondary Syphilis. However, knowing that there´s many exceptions from the typical symptoms of secondary stage I still worries about one single red spot on the side of my foot and some other pimple like rashes on my upper leg. I think the “pimples” were there before but I´m not 100 % sure of it. I have a little irritation in my throat as well but it has been there almost during the whole period so that might exclude syphilis.
My health care provider gives different message depending on who you ask regarding the need of further testing. Some says 12 weeks follow up and some 8. I trust 8 weeks regarding HIV but when it comes to Syphilis they seem less confident. Calling for a new appointment I got the information that it wasn´t necessary.
I read your answers to other worried people and you seem very confident that a test after 8 weeks like mine is conclusive without worries of false negative. Can you help me trust my result by answer the following;
- It´s said that a syphilis blood test always turns positive within 6 weeks follow the exposure but why is it so common with a recommendation of a 12 weeks follow up? Has there been any new knowledge the past few years changing previous recommendation?
- Is VDRL as reliable as RPR?
- Do you think the symptoms I describe give any reason to persist in getting a further test done or can I really leave the worries of Syphilis behind me?
Best regards and thanks!
Doctor's Answer
by Edward W Hook, MD, Aug 04, 2009 12:11PM
, Aug 04, 2009 12:11PM
The combination of the lack of lesions and two negative blood tests is solid, totally believable evidence that you do not have syphilis. For you to continue to be concerned about a disease for which you are at low risk because it is so very rare and for which the tests are so good is more a manifestation of your anxiety over the exposure you describe than a realistic possibility. Believe your results.
the RP{R is just as reliable as the VDRL.
You do not need further testing. EWH
the RP{R is just as reliable as the VDRL.
You do not need further testing. EWH
Since english is not my mother toung I might misunderstand the term "lesions". May I ask if you by "lack of lesions" mean that I didn´t have an obvious primary sore in my mouth?
Is the symptoms I described of suspected secondary stage not considered to be lesions?