Relapsing Syphilis Following Good ResponseTreatment

[frenky58]

Please Help Me out with this rare case of syphilis occurence.

I was diagnosed syphilis in Des 2016. I also tested other STIs like HIV,Gonnorea,Chlamydia, and Hep,but all were negative. No sexual intercouse since Feb 16 (time when I got syphilis through oral sex). I got treatment for early syphilis (single dose penicillin 2,4 MU intramuscular). My syphilistic titer history since then :

Des 16 : 1/128
Mar 17 : 1/16
Jul 17 : 1/4
Oct 17 : 1/4
Nov 17 : 1/2 --> Quite sure, I was cured
Feb 18 : 1/8 --> I was so panic. I'd tested in 2 different clinics with the same methods (VDRL) and came with the same result 1/8. The next day I got HIV tested to make sure it was not due to HIV and it came to negative result. I had consulted to a doctor and she said it's ok because it's occured in low titer so she thought it was due to "quantitiative error/variance test".
Mar 18 : 1/16 --> Quite sure, the syphilis was relapsing.

I had searched on internet (journal, articles, and so on) but found no same case. I just found relapsing symthomatic secondary syphilis in HIV positive but in my case I got no clinical symthom at all, only increasing in titer and no HIV. Is this due to asymthomatic neurosyphilis ? But I read if I were infected neurosyphilis, I won't get a fourfold decreasing change in titer. (My history titer showed a good respond to treatment).

Can anybody tell me what happened to me ? Am I alone with this case? I came accros with article on internet telling that there is "persister bacteria" which means a tiny colony one which can not eradicated by antibiotic because of their characteristic and cause relapsing to their host. Is that I got persister syphilistic bacteria inside my body ? Or Is this because of my asymthomatic syphilis? Please somebody help me out with my case. I am so panic and exhausted :(

[frenky58]

A ≥4-fold increase of VDRL titer after treatment indicates reinfection or relapse. Reinfection is impossible because I never did sexual intercourse with anybody since my treatment. Hence, it indicates relapse. But the odd things are :

1) Since the initial treatment, I got very good respond (titer 1:128 --> 1:2 in almost 1 year) but spontaneously it's rising back to 1:16 without any clinical sympthom. I don't find such the case on internet (journal,articles,etc)
2) It might be occured in hiv positive but with clinical sympthom (based on journal) but my case, I am not HIV positive and I didn't suffer from any kind of clinical sympthom during my seroligical relapse
3) If it was neurosyphilis then my previous syphilitic titer would not decreased that well.

The doctor I met might give wrong diagnose since my case is rare and I got tested in multiple clinics but showed the same result so the error is unlikely.

[DragonPulse]

Hello

I think you are overthinking until the point of being unable to carry on with your life.

You tested positive for syphilis and you received a treatment (syphilis is easy to treat). If you only had oral sex it was not necessary to test for HIV as it's nos spread that way.

Your test were indicating that the infection was disappearing. As your doctor said, it's a error that comes with each test, that's the reason why sometimes numbers are difficult to understand.

If you had syphilis in the 4th stage, believe me, your tests wouldn't be negative and you would have realized.

It's time to move on. If you see you are not able to do it, ask for therapy.

All the best.