VDRL testing

[tmac1421]

Hello Dr

About 6 years ago I had an unproctected 1 night stand with an unknown woman.

About a week later I developed a painless rubberish ulcer on the side of my penis and also one in my pubic area, along with some groin discomfort.  The sore went away in a week or so, and I had no other symptoms, although I may remember a lymph node swelling in my armpit.  I don't recall any secondary symptoms of syphillis such as a rash..I had work up done 6 months after and wanted them to test me for EVERYTHING because I was so nervous over what I had done...I cannot recall if they tested for syphillis.

Fast forward to now..after reading up on STD's I see what I may have had on my penis was a chancre....so I had a VDRL test about 6 months ago which was negative.

So....I guess what I am asking is given my symptoms 6 years ago...what are the chances my VDRL was negative due to chronic infection?  I live in Canada and I know the disease is rare...so my hope is that it was something else, please advise.

[Edward W Hook, MD]

Rest assured, you do not have syphilis.  Depite its rarity, syphilis testing is typically included in STD testing. More importantly, if you had been infected then (6 years ago) and remained untreated, your test would still be positive.  The tests are very good, believe the test.  This is not something for you to worry about.  EWH

[tmac1421]

Thank you very kindly!  And congrats on your award, keep up the excellent work!

[tmac1421]

Been racking my brain a bit about this lately, and on reading some material here at MedHelp, I have a couple of follow ups.

1) Is it true that even if syphylis is caught, only 33% move on to the second phase? ie The disease is killed by the immune system?  The ulcer on my penis was pretty big, this is why I am still concerned it may "reactivate"

2) Why does the material suggest the VDRL test can be falsely negative in the later stages of the disease?  I am sure I would be a candidate for a false negative seeing it was 6 years ago and the disease would be in the latent stages.

Thank you again for your time.

[tmac1421]

I saw you had a lot of questions yesterday to answer, still hoping you can get to this one and clear my mind, much appreciated!

[Edward W Hook, MD]

Sorry, missed your question.  Straight to answers:
1.  No, most infections casue secondary signs and symptoms.  the local immune response controls and heals the ulcer locally but there are still systemic manifestations

2. False negative VDRLs occur years after infection and are not present in peole with active disease.   If you had active syphilis which was of risk to you, your VDRL would be positive.

Please relax and believe the tests  EWH

[tmac1421]

Thank you for your invaluable advice....last follow up.

Can the disease lay dormant in me, causing the negative test 6 years post experience, but reactivate at a later time, say 2 years from now and cause health problems?

Once again, thank you and this is my final question.

[Edward W Hook, MD]

No. this post is over.  You are wandering into a hypothetical realm which is neither productive or healthy to worry about.  Once last time, believe the tests and move on.  EWH

[tmac1421]

Thank you.  Too much misinformation out there, keep up your valuable work.

[tmac1421]

I'm having a very hard time moving on...I'm an intelligent young man with a bright future and I do not want to be made seriously ill by a stupid mistake when I was 20 years old in what was my first sexual encounter.

I know what I saw on my penis and groin.  A painless, rubberish ulcer (2-3 cm across) in both areas, precisely the symptom of the first stage of syphillis.  I really do not know what else could have caused this one week after my sexual encounter and this is what makes it difficult to move on despite the negative test.  If you do not feel the need to answer this question I respect that, but I honestly don't know how to get closure when I can recall those symptoms.

[Edward W Hook, MD]

You assumption that the lesion you had was syphilis simply is not supported by reliable scientific tests.  If you cannot get past this, I would suggest you discuss this with a mental health professional for assistance.  I say this only out of concern for you.  To deny the facts, as indicated by your tests is not logical.  EWH

[tmac1421]

Ok, perhaps you are right Dr.  It is just difficult to read all the possible scenarios of false negatives.  People in here are going to beleive that they are the exception, they are the one that is going to have the false negative.  In my case, like you say, I just have to accept it and move on no matter how difficult it may be.

[tmac1421]

Close this thread if you have no further comments, thanks again for your time and considerate nature.