[Question #11165] Syphilis scare testing
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16 months ago
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Hello doctors,
I have a question regarding my syphilis testing.
I had a exposure with a very promiscuous woman. I performed cunnilingus, analingus, and the condom fell off.
After the exposure at 42 days I received testing for all major STIs
All tests were negative. But lets just talk about syphilis for now as its the one im worrying about.
I received a RPR (DX) with reflex to titer and Confirmatory testing from Quest. It was Non-Reactive.
At around 90 days I received more testing for all STI all negative. I received another Syphilis RPR at this time. Non-Reactive.
Im a bit scared because I just remembered I may have taken amoxicillin Clavulnate around or after my 42 day test I kind of forget. I took it due to a lymph node in my neck. (I still have the swelling but an ENT said im fine) Im afraid the amoxicillin made my RPR test from 42 days and my test from 90 days false negative and I have to get tested again. I also received more STI testing 9 months post exposure. The RPR I had at this time was a bit different. It was an RPR but it said
RPR (Monitor) W/Refl Titer also from Quest Also Non-Reactive. Was this not a good test? It doesnt have confirmatory testing in its name would it not have picked ups syphilis if it was there? would I need another RPR? Can I move on from this? I also had an HIV test around these times all negative. Would antibiotics mess up the HIV test?
I have a question regarding my syphilis testing.
I had a exposure with a very promiscuous woman. I performed cunnilingus, analingus, and the condom fell off.
After the exposure at 42 days I received testing for all major STIs
All tests were negative. But lets just talk about syphilis for now as its the one im worrying about.
I received a RPR (DX) with reflex to titer and Confirmatory testing from Quest. It was Non-Reactive.
At around 90 days I received more testing for all STI all negative. I received another Syphilis RPR at this time. Non-Reactive.
Im a bit scared because I just remembered I may have taken amoxicillin Clavulnate around or after my 42 day test I kind of forget. I took it due to a lymph node in my neck. (I still have the swelling but an ENT said im fine) Im afraid the amoxicillin made my RPR test from 42 days and my test from 90 days false negative and I have to get tested again. I also received more STI testing 9 months post exposure. The RPR I had at this time was a bit different. It was an RPR but it said
RPR (Monitor) W/Refl Titer also from Quest Also Non-Reactive. Was this not a good test? It doesnt have confirmatory testing in its name would it not have picked ups syphilis if it was there? would I need another RPR? Can I move on from this? I also had an HIV test around these times all negative. Would antibiotics mess up the HIV test?
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16 months ago
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Also, What brought me to the scare was I read on this forum from Dr Handsfield in question #8625 that Amoxicillin can suppress a test result?
"As discussed previously, the chance of syphilis from this exposures was
very low, although not zero. Amoxicillin in that dosage probably would
abort incubating syphilis, preventing it from ever becoming active.
However, it might only suppress the infection, delaying symptoms (which
might show up as long as 3-4 weeks after completing amoxicillin) and
also delay a positive test result. Assuming no symptoms, you could have a
syphilis blood test 3 months after completing amoxicillin -- a negative
result at that time would be conclusive."
Kind of scared me
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Edward W. Hook M.D.
16 months ago
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Welcome to the Forum and thanks for your questions. I'll be glad to comment. Let me start by reminding you that syphilis is a relatively uncommon STI, particularly among women, even women with many partners. In addition, most single exposures to infected partners do not lead to infection. Finally transmission of syphilis requires direct lesion contact and I presume that you did not see any lesions on your partner. Putting these facts together, even without testing there is a substantially less than 1% chance that you were even exposed to syphilis. Further, while some claim that it may take longer to develop a sore or a positive test, syphilis lesions typically appear within 3 weeks (21 days) of exposure and blood tests are positive within a month; most experts consider 6 week/42 day test results conclusive.
Syphilis testing is done in a two step process. Persons who have an initial test (the RPR) which is negative do not need further tests- persons who have a positive/reactive RPR test however have a "reflex" test in which a 2nd test is performed to make sure that the RPR test in not falsely positive. Your test results are both definitive- you do not have syphilis and no further testing is needed
Your HIV tests are also conclusive and do not need to be repeated. Antibiotics do not invalidate or interfere with the accuracy of tests for HIV.
I urge you to believe your test results and move forward without concern. I see no need for further testing. EWH
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16 months ago
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So antibiotics couldnt of affected the tests? and the RPR monitor test I had was a good test? Also if I was taking a multivitamin with biotin in it could it affect the tests?
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Edward W. Hook M.D.
16 months ago
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At the time you were tested, antibiotics would have no effect on the accuracy of your tests.
The RPR test you had was a good one.
You would have to be taking massive doses of biotin to effect your tests.
I think you are worrying unnecessarily. I suggest you stay off the internet. It will only mislead you. EWH
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16 months ago
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Thank you doctor.
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16 months ago
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Sorry,
I saw I had one more question so just wanted to clarify. Even though the RPR (monitor) with reflex to titer test I took at 9 months post exposure doesn’t have the confirmatory testing it would have been positive if I had syphilis right? And because it’s negative I do not have it? Sorry I’ve been overthinking this
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Edward W. Hook M.D.
16 months ago
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Confirmatory testing is only needed if the initial RPR result was positive. With negative RPR, no reflex testing is warranted. You can be completely confident that you do not have syphilis
This will complete this thread. Take care. Please don't worry. EWH
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16 months ago
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Hello Doctors,
I submitted a new question. But it got closed with no response? the question was #11196
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Edward W. Hook M.D.
16 months ago
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You are wasting your time and mine. Antibiotics would not change the accuracy of the test. Antibiotics can cure us, but there is no reason to even consider the possibility that you had syphilis that needed curing.
I am not sure why you are having so much trouble moving forward. There is no event that you had Syphilis or were even at risk for the infection. EWH.
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16 months ago
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Im sorry, I was just wondering why the other question was closed without an answer? You can go ahead and close this one
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16 months ago
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It was
[Question #11196]
[Question #11196]
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Edward W. Hook M.D.
16 months ago
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Please accept that you do notI have Syphilis. Further “what if…” or “‘could it be…” questions Serve no useful purpose. You did not have syphilis. You need to move on and stop worrying.
This will complete this thread. There should be no need to return. EWH.
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