Aa
extremely worried about neurosyphilis
Hi dr,
Now I feel really regretted for my carelessness. 2 years and 1 month ago, I had an exposure with a CSW(oral and vaginal sex). I just tested syphilis once(8 weeks post exposure) after that exposure. The test was serum test for RPR and TPPA, and both were neg-. I forgot if the dr said it was reliable or conclusive. I simply didn't keep it in mind because I didn't have typical symptoms of syphilis.
However, I have been suffering from many symptoms these days. Recently, I have stiff neck, limb pains, dry and itchy eyes, ulcers in mouth and some unconspicuous rashes on my neck. I read on the net that syphilis can be latent, and my symptoms are similar to those of neurosyphilis. I have no idea if I am in tertiary stage or neurosyphilis.
Here are my questions:
1. is it possible I still have syphilis in spite of my 8-week-post-exposure tests were neg- ?
2. If I had neurosyphilis or tertiary stage of syphilis, will my serum TPPA test absolutely show pos- at this time?(I read that in early or late infection stage the serum may show "false" neg- sometimes)
3.Need I go to have a lumbar puncture?
ps. since I live in a backward town lacking trained neurologist or dermatologist, I really need ur professional advice before I make decision to go very far to see a dr... So pleaseeeeeeee!
Now I feel really regretted for my carelessness. 2 years and 1 month ago, I had an exposure with a CSW(oral and vaginal sex). I just tested syphilis once(8 weeks post exposure) after that exposure. The test was serum test for RPR and TPPA, and both were neg-. I forgot if the dr said it was reliable or conclusive. I simply didn't keep it in mind because I didn't have typical symptoms of syphilis.
However, I have been suffering from many symptoms these days. Recently, I have stiff neck, limb pains, dry and itchy eyes, ulcers in mouth and some unconspicuous rashes on my neck. I read on the net that syphilis can be latent, and my symptoms are similar to those of neurosyphilis. I have no idea if I am in tertiary stage or neurosyphilis.
Here are my questions:
1. is it possible I still have syphilis in spite of my 8-week-post-exposure tests were neg- ?
2. If I had neurosyphilis or tertiary stage of syphilis, will my serum TPPA test absolutely show pos- at this time?(I read that in early or late infection stage the serum may show "false" neg- sometimes)
3.Need I go to have a lumbar puncture?
ps. since I live in a backward town lacking trained neurologist or dermatologist, I really need ur professional advice before I make decision to go very far to see a dr... So pleaseeeeeeee!
Your words are really relieving, sir.
I'm arranging a trip to get syphilis serum tests for RPR & specific TP this coming week. I'm gonna get tested in a renowned infectious disease hospital in south China. The problem is, since I'm not a Chinese and just know little of their language, I guess it's hard for me to get valuable information from the doctors I'll visit(most Chinese doctors can't speak English well). That is to say, I still have to educate myself about syphilis testing.
These are two websites that I found useful in Medhelp for my concern:
http://www.medhelp.org/posts/STDs/questions-about-syphilis/show/1101953
http://www.medhelp.org/posts/STDs/Neurosyphilis/show/1112870
What I get from the above posts is, that if I get a negative serum TREPONEMAL test(no matter if it's TPPA, TPHA or FTA-ABS) at this point(2 years and 1 month post exposure), then I'm not at all in any stage(including neurosyphilis, tertiary syphilis or late latent syphilis), and no matter what symptoms I have, they have nothing to do with syphilis.
Dear sir, is my deduction reasonable and rational?
I'm arranging a trip to get syphilis serum tests for RPR & specific TP this coming week. I'm gonna get tested in a renowned infectious disease hospital in south China. The problem is, since I'm not a Chinese and just know little of their language, I guess it's hard for me to get valuable information from the doctors I'll visit(most Chinese doctors can't speak English well). That is to say, I still have to educate myself about syphilis testing.
These are two websites that I found useful in Medhelp for my concern:
http://www.medhelp.org/posts/STDs/questions-about-syphilis/show/1101953
http://www.medhelp.org/posts/STDs/Neurosyphilis/show/1112870
What I get from the above posts is, that if I get a negative serum TREPONEMAL test(no matter if it's TPPA, TPHA or FTA-ABS) at this point(2 years and 1 month post exposure), then I'm not at all in any stage(including neurosyphilis, tertiary syphilis or late latent syphilis), and no matter what symptoms I have, they have nothing to do with syphilis.
Dear sir, is my deduction reasonable and rational?
I'm sorry, I can't answer those questions with any degree of certainty. Perhaps someone else here can.
Only a doctor can clear you of syphilis, of course. But from the outside, the only reason you think you have syphilis is a single possible exposure and some vaguely related symptoms. Believe me, I know that that's enough to make you worry, but my guess is that your symptoms are not at all related to syphilis. You had the test in the right window.
Move on. There are a ton of non-syphilis things that can cause the symptoms you mention.
Only a doctor can clear you of syphilis, of course. But from the outside, the only reason you think you have syphilis is a single possible exposure and some vaguely related symptoms. Believe me, I know that that's enough to make you worry, but my guess is that your symptoms are not at all related to syphilis. You had the test in the right window.
Move on. There are a ton of non-syphilis things that can cause the symptoms you mention.
Thank you so much, sir. I've read some your other posts and know your've taught yourself much more than I do.
1.What I read on the net tells me that tertiary stage can last for decades, and some of the tertiary cases don't always show positive results in serum RPR tests, especially in neurosyphilis, only through lumbar puncture can the patients get an accurate result. I'm very afraid of lumbar puncture and have no idea whether I should ask the dr for it....
2.Also, I read that in most cases, once a guy is infected and diagnosed with syphilis, his AntiTP will be positive for a lifetime, whether he is cured or not. According to this information, I guess even if I have progressed to neurosyphilis or tertiary(and without any treatment), the AntiTP in my serum would have no reason to disappear, right? In other words, if my serum test for AntiTP is still negative at this point, that means I'm not at any stage of syphilis, right?
1.What I read on the net tells me that tertiary stage can last for decades, and some of the tertiary cases don't always show positive results in serum RPR tests, especially in neurosyphilis, only through lumbar puncture can the patients get an accurate result. I'm very afraid of lumbar puncture and have no idea whether I should ask the dr for it....
2.Also, I read that in most cases, once a guy is infected and diagnosed with syphilis, his AntiTP will be positive for a lifetime, whether he is cured or not. According to this information, I guess even if I have progressed to neurosyphilis or tertiary(and without any treatment), the AntiTP in my serum would have no reason to disappear, right? In other words, if my serum test for AntiTP is still negative at this point, that means I'm not at any stage of syphilis, right?
Just to be clear, I don't think that your symptoms are STD-related (but internet-based diagnoses are of limited value). But I would let a doctor know about your symptoms. Could be a lot of things (including stress).
First of all, I'm not a doctor. Just an educated person who's suffered with syphilis and done obsessive research on the publically-available internet.
1) My guess is that the 8 week tests were conclusive. Depends on the lab in which they were done. The typically-cited window for antibody detection is 6 weeks, so you would have had antibodies at that time. Is it possible that the lab messed up your test? I can't answer that.
2) I believe that you would certainly have a significant amount of antibody in your blood if you were in tertiary. That said, your symptoms are not what I would expect from tertiary. You might see mouth ulcers and a rash (on trunk or on hands and feet) in secondary, which would come about a month or two after the exposure. I've not seen any indication on line that secondary symptoms can show up 2 years later. Tertiary syphilis would manifest with either neurological or cardiac symptoms (hearing/vision loss, for example) or a different sort of tumor-like rash. So I don't think that you're in tertiary syphilis (again, I'M NOT A DOCTOR). But who knows if the limb numbness is the sort of neurological symptom they'd look for.
3) Repeat: I'm not a doctor. But if possible, I'd go back for a blood test. My guess is that you do NOT have syphilis at all. But if I were you, I'd be worrying like crazy about syphilis, so if it weren't too much trouble, I'd get re-tested (you say that neurologist/dermatologist are far away... how difficult is it to get STD testing?) and then believe those results. If what you're saying is true, I'd bet 9999 to 1 that the test comes back negative.
1) My guess is that the 8 week tests were conclusive. Depends on the lab in which they were done. The typically-cited window for antibody detection is 6 weeks, so you would have had antibodies at that time. Is it possible that the lab messed up your test? I can't answer that.
2) I believe that you would certainly have a significant amount of antibody in your blood if you were in tertiary. That said, your symptoms are not what I would expect from tertiary. You might see mouth ulcers and a rash (on trunk or on hands and feet) in secondary, which would come about a month or two after the exposure. I've not seen any indication on line that secondary symptoms can show up 2 years later. Tertiary syphilis would manifest with either neurological or cardiac symptoms (hearing/vision loss, for example) or a different sort of tumor-like rash. So I don't think that you're in tertiary syphilis (again, I'M NOT A DOCTOR). But who knows if the limb numbness is the sort of neurological symptom they'd look for.
3) Repeat: I'm not a doctor. But if possible, I'd go back for a blood test. My guess is that you do NOT have syphilis at all. But if I were you, I'd be worrying like crazy about syphilis, so if it weren't too much trouble, I'd get re-tested (you say that neurologist/dermatologist are far away... how difficult is it to get STD testing?) and then believe those results. If what you're saying is true, I'd bet 9999 to 1 that the test comes back negative.
Have an Answer?
You are reading content posted in the STDs / STIs Community
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
