old incident haunts in my mind

[Peteb77]

Hi!

I used 2 times a sex worker's services when I was single 12 years ago in 2001. Both times I used condom, but other time it started slipping away, so I put it back better (I don't remember anymore did we change a new condom or not).
Anyway now I have been over 10 years in a single relationship, 7 years married. Sometimes I have been thinking this incident later, even though I have never had any symptoms from any STD. I even went to test for hepatite and HIV many years later, and they both were negative.

Now then I read from internet that also syphilis could be symptomless and cause heart and brain damage even decades later.

I went to test for syphilis too, but for some reason this sex councellor wasnt very good at taking blood samples (and I have small veins), but she said I have nothing to worry about since I and my wife haven't got any symptoms like chancre etc. So, I did not reserve another time for testing.

However, I read from internet from very reliable looking site, that only 1/3 of infected gets the chancre and a doctor in a net site had said that "only" 75% gets the rash as second stage symptom. So what I understand, that there is theoretically chance that syphilis could be symptomless, or did I understand wrong? Now I'm feeling that I am getting contradicting information. On the other hand a professional had said that it causes always symptoms and another professional in the net had said it doesn't (if I understood right). So who should I believe?

I had told about my wife about what I had done when I was single, before her, but I haven't want to worry about her about these things I think about in my head about possible STDs. So, do I have nothing to worry about? Who should I trust?

[Edward W Hook, MD]

A syphilis blood test would not clear without therapy over 10 years.  If you had active syphilis, the test would be positve.

While I agree with the counselor that your risk for syphilis is very, very low, in some instnaces, such as yours, the reassurance provided by testing makes it worth doing.  You were worried enought to seek testing and to ask me about it, Thus I presume you would still benefit from testing, not to prove you have syphilis but to prove that you do not so that you can stop your worrying.  EWH

[Peteb77]

Thanks for the answer. The thing is I already went for testing, but the person wasnt very skilled in taking blood samples, and could not get one. Because she said, I was not in risk, I did not book another time. So, basicly what I understand, I should book another test time, and hope for better blood sample taker?

Somewhere in medhelps forums I found a mention, that these things could clear out on it's own like in 10 years, if you had no symptoms. However this seems not to be the case with syphilis, did I understood right?

Or do those people who develop tertiary stage (heart and brain damage, etc) always had symptoms before? Me and my wife don't have children.

[Edward W Hook, MD]

Welcome to the Forum.  I will try to help.  The information you have received is not totally contradictory.  Nearly everyone who gets syphilis does get lesions (symptoms of infection) but these symptoms can be missed because the lesions of syphilis are typically painless and may be either attributed to other causes or missed because they are in a location where they go unnoticed.  Thus the diagnosis can be missed and without a doubt, the very best way to rule out the possibility of syphilis is with a blood test.  It seems as though you are worried about syphilis long after any possible exposures and therefore, in this situation, my advice would be for you to seek a blood test.  

At the same time however, I also feel that it is most unlikely that you have syphilis or that you could have given it to your wife.  Statistically, syphilis is a rare infection and this, along with the absence of symptoms that you noticed make it unlikely.

As for your wife,  I do not see where you are living but if you and your wife had had children, in most countries she would have had blood tests for syphilis as part of routine evaluation that is recommended for all pregnant women.  If her tests were negative (she may not know that she was tested- unfortunately sometimes doctors do not tell their patients they are testing), then she did not get syphilis from you.

My sense is that you really have very, very little to worry about but if the possibility remains on your mind, testing is relatively easy and highly reliable.  Get a test, then believe the results which I anticipate will be negative.  I hope my comments are helpful. EWH