[Question #10226] Syphilis Query

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24 months ago
Hi there, after an unprotected incident I tested 9 weeks later for HIV, Syphilis, Chlamydia and Gonorrhea. All tests came back negative.  The HIV was a 4th gen test and the Syphilis was a blood sample from the finger sent to a lab. I am wondering how conclusive these tests are in this time frame? I had a sore throat for a few weeks and was diagnosed with strep throat. Once I started to take the antibiotics I got some lymph node swelling in my neck, chest and groin. I have now been off the antibiotics 2 weeks and I have a tickly cough, irritated throat and a burning sensation in the left side of my groin. I am wondering if this could be in relation to the Syphilis possibly? It has been 5 months since the incident and no sign of rash and no visible chancre.  I have had extreme health anxiety and high levels of stress and I am wondering if this could be contributing or if I should be worrying about re testing for any of the above. Thanks in advance.
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H. Hunter Handsfield, MD
24 months ago
Welcome to the forum. Thank you for your confidence in our services.

The tests you mention all are 100% conclusive when done 9 weeks after the last possible exposure. And negative test results overrule any and all symptoms. That is, no matter how typical the symptoms might seem to be for HIV, syphilis or other STDs the test results prove the symptoms have other causes. And your symptoms are not very typical for HIV, syphilis, or any other STD anyway.

You really should not be at all worried about these or any other STDs from your exposure five months ago. No further testing is needed. Of course you are free to be retested if my advice doesn't settle things for you. But truly I see no need and am not recommending it. You can be sure you're fine from an STD/HIV standpoint.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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24 months ago
Thank you for your quick response. I think the thing that concerns me is that some people advise the 12 week period for testing for Syphilis. Is it possible for people to slip the net if tested earlier? I also took a 7 day course of Doxycycline 72hours after the incident.. could this have effected the test results in any way? Thanks again 
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H. Hunter Handsfield, MD
24 months ago
There has been some uncertainty about time to conclusive testing for syphilis, and a conservative perspective is that it might take up to 3 months. But if so, that's rare; in my 40+ years in the STD business, I've never seen or heard of a case in which it took more than 6 weeks. But your doxycycline treatment is also crucial; you didn't previously reveal you had taken it so soon after the event. Doxy in that dose is 100% effective in preventing syphilis. Having taken it, there was zero possibility you were infected afterward; had you asked for expert advice at the time, you would have been told there was no point in testing for syphilis at all. There is no possibility you have it -- all is well.---
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24 months ago
Thank you for your very detailed answers I do appreciate it. I was hoping to have your response after reading some of your work. From your messages I am gathering that you are confident I do not have Syphilis which is reassuring.  I am wanting to not put my new partner at risk so being extra cautious and eliminating everything. At 5 months after an incident are there any particular symptoms or things I should keep an eye out for if I was one of the very rare people / unlucky enough to slip the net? Thanks again for your guidance 
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H. Hunter Handsfield, MD
24 months ago
With no symptoms at this time plus your negative test results, you can be confident you acquired no STD from the exposure you are concerned about. You needn't do anything, and no particular symptoms to be on the lookout for. Don't worry about it.

That completes the two follow-up exchanges included with each question and so ends this thread. I'm glad to hear the discussion has been helpful. Best wishes and stay safe.
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