Very worried...

[maku18]

I've had some problems for a while now-muscle fatigue, generally being very tired, frequent headaches etc. I had 4 of my lymph nodes very swollen so I went to see the doctor. He said I get tested for HIV if I think that is a possibility. I went down to a local STD clinic, did the rapid HIV test-non reactive and gave a urine/blood sample for all the other tests.

Yesterday they called me back and said none of the other test results have come yet but I had a false positive for syphilis. I went down to talk to a doctor there. He said my RPR test from the blood came back with a 1:8 titer (reactive) but the second part of the test the TPPA came up as nonreactive. He told me that there are 2 possibilities. a.I recently got syphilis and it isn't showing up on the TPPA test yet or b.I have something else showing up on the RPR and I shouldn't worry at all about it at all since the TPPA is 100% accurate..

I started worrying about everything then. I remembered a  constant, very clear fluid I’ve always had on the tip of my penis through random parts of the day on most days. I’ve had skin colored bumps all over my penis since as far as I can remember, most tiny but some very slightly bigger and not grouped with the rest. I’ve had solid, white circular pimples appear on my penis/scrotum at times (spewed puss when I tried to pop it once) that usually pop and leave scabs and disappear.

Is it really plausible that Ive had something for nearly 3 years without ever knowing it? Do you suggest I go get tested for things like Hep C, Herpes, HPV, warts, etc. as well, more importantly are there any real tests that are accurate even when you don't have an outbreak (I couldn't find the info online)? Are the other tests 100% accurate if they say neg? What do you think the RPR means, should I get checked for non STDs?

Thanks for any help.

[maku18]

Thanks doc. Wouldn't you know it though, the day after writing that I wake up and notice there is a fairly big reddish pink, painful watery growth on my inner thigh and my dermatologist is out of the country for a week. Your advice gave me confidence that it isn't important though, thanks.

[H. Hunter Handsfield, M.D.]

Herpes is not a possible explanation for the penile "bumps".  I already commented that they might be normal anatomic variants.  Anything that "does not show up reliably" enough to show a doctor almost certainly is not abnormal.  Still, that is what you should do:  if a doc examines your penile skin and sees nothing abnormal, then no abnormality is present, and any variations in appearance from time to time are meaningless.

Do not get tested for herpes.  Given your sexual history, there simply is no possibility; there is a greater risk of a confusing (false positive) blood test result than there is that a test would accurately show herpes.

[maku18]

Thanks doc. What do you think about the bumps though? After looking online at a bunch of herpes pictures I can't really tell if that's what I have or not and they never show up reliably for me to get to a doctor. To be more descriptive, they are mostly either light reddish or pure white in color and hurt a lot when I touch them. It feels like theres stuff watery and jiggling around when I touch them and the one time I've tried to pop them twice, once pure white puss came out followed by a little blood and the second time it was just a very thin clearish/red liquid (blood?). They have appeared on my inner thighs, scrotum and shaft. Do these sound like herpes to you? Do you think I should get a herpes test or just forget about it? Thanks very much.

[H. Hunter Handsfield, M.D.]

You don't have syphilis.  Your doc has it backwards in regard to the test results:  in early syphilis, the TPPA turns positive before the RPR, not after.  It is possible to have early syphilis with positive TPPA and negative RPR, but not vice versa.  And your risk for syphilis was effectuvely zero, based on your sexual history.

Your symptoms do not hint at syphilis or any other STD.  I cannot comment on distant past symptoms like a "constant clear discarhge", but syphilis doesn't cause such a symptom; and the penile bumps you describe sound entirely normal.

You have a biological false positive syphilis blood test, nothing more.  Once in a while, a BFP is a sign of an underlying health problem, but in outwardly healthy people like you, it generally is meaningless.  If in doubt, return to your doc to discuss it.  But you can put syphilis and other STDs out of your mind.

Best wishes--  HHH, MD

[maku18]

Also, I forgot to say I've never injected anything in me besides for shots/blood drawn at a doctor and have had sex twice only with a condom (finger/kissing on mouth/anal/vaginal/no oral) a little over 3 years ago, but with a girl that was very likely not healthy.