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Avatar universal

RPR didnt drop after treatment

I was treated for late syphillis(seems I contracted it 6 yrs ago) with 3 IM injections of Bicillin 6 mos ago, my initial titers were 1:16 and I just got tested and there was no drop in my titers.  I was told not to worry that every person is different and since my numbers didnt rise and that I should come back in 6mos. I'm still freaking out. should I see a different doctor? I was seen at a free STD clinic.

7 Responses
Avatar universal
Were you tested at all between treatment 6 months ago and the current test? If so, what were those results?  If your RPR titer dropped and now has risen again, that's a strong indication that your treatment failed. But even if it stayed the same the whole time, or if this is your only follow-up test, treatment failure definitely need to be considered.  You need ttat clinic's expertise an experience in syphilis, then consider your local health department clinic instead, or find an infectious diseaes specialist.

Whatever else, definitely follow up. If your previous treatment has failed, you are at high risk for potentially serious complications, especially involving the central nervous system -- things like blindness, stroke, and so on. Don't panic -- these things don't usually come on fast -- but don't let it drop. Please return with a follow-up comment to know the outcome.

Where are you, by the way (city, state)?
Avatar universal
Sorry for a deleted line in the first paragraph.  Corrected:

You need to return to the clinic where you were treated. Or if you aren't certain about that clinic's expertise an experience in syphilis, then consider your local health department clinic instead, or find an infectious diseaes specialist.
Avatar universal
Thank you for your response, It was county health dept and they only test every 6mo, this was my 1st follow up after treatment.
Avatar universal
That's an unusual policy. Most PH departments in the US follow CDC guidelines. But follow my advice above. (I'm still curious where you are.)
Avatar universal
Im in Los Angeles and I actually have a large medical group to go to, but I was embarrassed and did not want this on my medical records there. This infection was a result of my husband one night stand 6 yrs ago and I just found out when I donated blood at the Red Cross.  His titers were 1:246, we are waiting for his results. We had just celebrated 35yrs married. What a mess..
Avatar universal
At least you're in a medically sophisticated environment, which is good. I recommend that you bite the bullet in regard to your "large medical group". Your confidentiality won't be at risk; the federal penalties for inappropriate disclosure of health information are very large (minimum fine $5,000). And you're going to need sophisticated care -- among other things, probably a lumbar puncture (spinal tap). So get evaluated at a medical center and by doctors you trust.

And by the way, I hope you and your husband have been tested for HIV, which can be common in people with syphilis.
Avatar universal
We tested negative for HIV,  I will know next Wednesday about his Titers, in the meanwhile I took your advice and made an appt with my Provider, like you said  "bite the bullet" by the way I work with Neurology so I know the consequences of not treating this, thats why I was surpirsed that I wasnt tested after 3 mos and why is my titer still the same. PH said they test after 6mos if its latent syphilis.
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