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RPR Negative - But Still Wondering
Middle-aged, heterosexual; was promiscuous from 19-21; diagnosed w/ genital herpes in 20's. Now, NO sex in 1+ yr. Last relationship, unprotected sex. Prior to that, 2 1/2 years w/o sex. Recently, sick w/ fever/fatigue after daughter had fever. I stayed sick for weeks. WBC normal - dr. said it was viral. A week later - still sick. Dr said wasn't necessary to run blood work - clearly bacterial infection developed - put me on Levaquin. Still sick. Put me on Keflex/Levaquin, combined-no labs-said he didn't want to run a big bill of lab testing (no insurance). 2nd day of Keflex/Levaquin, fever dropped, but severe shakes, incredibly sick. Went to ER b/c felt awful. Bloodwork normal. ER Dr. said shouldn't have been on antibiotics -stop. Stopped after 1 wk Levaquin & 2 days Keflex. My dr. started on a Medrol (no sense to me-hadn't done new labs) & sent me to infectious disease dr. Then, developed a wart-like, red bump in groin area. Few days later, completely gone-only faint scar. Wasn't herpes- I have herpes -know what looks like. Was like wart w/o fluid in it. Didn't worry about it-never mentioned to drs. Infectious specialist tested for RPR -came back normal. Tested positive for mononucleosis. Since then, I found 6 more red bumps on neck, back, stomach & thigh. Don't seem like pimples-more like flattened wart-like bumps. Don't hurt. If squeezed, some (not all) exude a clear, weepy fluid. Look like some pics of syphilis. Still fevers & fatigue, but do have mono. Read about Jarisch-Herxheimer reaction- sounds like shakes/chills of 2nd day of Keflex (before stopping). Read that RPR can be false-negative. So worried I can't sleep. Called infectious disease office- told nurse about bumps- she was irritated- said my RPR was negative- said take up w/ my regular dr. Regular dr. doesn't like to do blood work b/c no insurance. Doubt either dr. will run 2nd test to ease mind. Recommendations?
MEDICAL PROFESSIONAL
Welcome to the Forum. Syphilis is a rare disease and the description of your illness is not really suggestive of syphilis. Just to put things in perspective, this year there will be about 10,000 new cases of syphilis reported in our nation of 350,000,000 or 1 case for every 35,000 Americans. In addition, syphilis is more common among men who have sex with men (you are heterosexual) and African Americans (you did not state your race/ethnicity). Finally, very, very few people with syphilis have negative blood tests - the very small group who do are either those who are at the earliest stages of infection (i.e. those with a genital lesion within the 1rst 2-3 weeks of infection) or those with far advanced infection who have been infected and untreated for decades. you do not fall into either of these categories. If you have a negative blood test, you can be confident that you do not have syphilis.
The J-H reaction which follows syphilis treatment typically occurs in people with early stages of infection who have reactive syphilis blood tests. It can be associated with fever and feeling poorly but so can so many other things, including mononucleosis and other viral infections.
There really is little to suggest that you have syphilis. I applaud your doctor for being thorough and getting the test but now that it is negative, there is virtually no way that the symptoms you describe are due to syphilis.
I hope my reassurances are helpful to you. This is not syphilis. EWH
The J-H reaction which follows syphilis treatment typically occurs in people with early stages of infection who have reactive syphilis blood tests. It can be associated with fever and feeling poorly but so can so many other things, including mononucleosis and other viral infections.
There really is little to suggest that you have syphilis. I applaud your doctor for being thorough and getting the test but now that it is negative, there is virtually no way that the symptoms you describe are due to syphilis.
I hope my reassurances are helpful to you. This is not syphilis. EWH
MEDICAL PROFESSIONAL
1. No they would not change your results. If you took a prolonged course of keflex is might have cured syphilis had it been there but neither drug would change your test results.
2. No, there is no need for further testing
3. To seek precautionary treatment for syphilis is just not needed. If you asked me I would decline as this would be a waste of resources. For better or worse, you may be able to find someone to do this although I would not endorse it. the reasons we have tests is to guide therapy. I could show you similar kinds of skin lesions related to leukemia - I would not recommend therapy for leukemia either since there is no reason to think you have it. It sounds to me that you are worrying more than is appropriate and would suggest that you might benefit more from counseling regarding these concerns than from penicillin treatment.
I would add that this is not a platitudinous statement- it would have been easier just to say, sure, go get treated. I do not think this is in your best interest however.
Take care. EWH
2. No, there is no need for further testing
3. To seek precautionary treatment for syphilis is just not needed. If you asked me I would decline as this would be a waste of resources. For better or worse, you may be able to find someone to do this although I would not endorse it. the reasons we have tests is to guide therapy. I could show you similar kinds of skin lesions related to leukemia - I would not recommend therapy for leukemia either since there is no reason to think you have it. It sounds to me that you are worrying more than is appropriate and would suggest that you might benefit more from counseling regarding these concerns than from penicillin treatment.
I would add that this is not a platitudinous statement- it would have been easier just to say, sure, go get treated. I do not think this is in your best interest however.
Take care. EWH
Thank you, Dr. Hook. You have no idea how reassuring your post was to me. Hopefully, I will sleep tonight. I do have some additional questions that I couldn't fit in the first post, if it's okay...
1) Is it possible that the Keflex or Medrol would have altered RPR results? (I read that each of those meds can alter certain lab results, but I didn't know if RPR is one.)
2) Do you think I should be re-tested again, at a later date, to make sure Keflex/Medrol didn't alter the results?
3) Also, are there any concerns with me asking my doctor to treat me for syphilis, as a precautionary measure, to make sure there is no chance of undetected illness and subsequent irreversible neurological damage?
The reason I am so scared is because I am currently a graduate student, and it is quite scary to think of a disease that could irreversibly alter my brain at some point (after pouring so much work into education). If it weren't for how much these wart-looking bumps look exactly like some pics of syphilis (round, firm, reddish), if it weren't for the large one that was in my groin area and disappeared, and if it weren't for the correlation between a number of my symptoms and syphilis, I wouldn't be so concerned. I don't want to ignore signs of something that could damage my brain, but I also don't want to keep worrying myself, if needless.
I am impressed with your credentials in this area, and I am grateful for your speedy response. I was concerned with whether you might be offering reassuring platitudes - but then, I read a synopsis of your impressive experience in this field. I am grateful to have your expertise for this. You just don't know how helpful it is to me.
1) Is it possible that the Keflex or Medrol would have altered RPR results? (I read that each of those meds can alter certain lab results, but I didn't know if RPR is one.)
2) Do you think I should be re-tested again, at a later date, to make sure Keflex/Medrol didn't alter the results?
3) Also, are there any concerns with me asking my doctor to treat me for syphilis, as a precautionary measure, to make sure there is no chance of undetected illness and subsequent irreversible neurological damage?
The reason I am so scared is because I am currently a graduate student, and it is quite scary to think of a disease that could irreversibly alter my brain at some point (after pouring so much work into education). If it weren't for how much these wart-looking bumps look exactly like some pics of syphilis (round, firm, reddish), if it weren't for the large one that was in my groin area and disappeared, and if it weren't for the correlation between a number of my symptoms and syphilis, I wouldn't be so concerned. I don't want to ignore signs of something that could damage my brain, but I also don't want to keep worrying myself, if needless.
I am impressed with your credentials in this area, and I am grateful for your speedy response. I was concerned with whether you might be offering reassuring platitudes - but then, I read a synopsis of your impressive experience in this field. I am grateful to have your expertise for this. You just don't know how helpful it is to me.
You are reading content posted in the STDs Forum
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.
