[Question #11862] Latent Syphillis

11 months ago

If someone had latent syphillis +4 years or more would a rash re-emerge as a symptom or do they tend to be only early / secondary infection. And if someone is +4 years infected or so would a 2 week doxycycline be effective treatment. Finally, why is the EIA Pallidum antibody test not an effective test to determine an old infection as I have read there is a high false positive rate?

H. Hunter Handsfield, MD

11 months ago

Unless there is an unlikely coincidence in names, you have used a new account and username -- which is against forum rules -- to continue discussing an apparent obsession with syphilis despite the firm evidence you do not have syphilis and never did -- as discussed in thread 11843, closed 3 days ago. Brief replies this time, with no opportunity to continue the discussion after this response.

The rash of secondary syphilis never occurs more than 4 years after infection, and rarely beyond one year.

Doxycycline for 28 days is officially advised for syphilis more than a year in duration (when penicillin cannot be given), but two weeks probably is adequate.

Your last question shows you misunderstand the syphilis EIA test, which always is positive in people with syphilis and then remains positive for life. It often is used to diagnose long-standing or past syphilis. A negative result proves the patient does not have syphilis and never did. Because false positive results are possible, positive results require confirmation with additional tests to distinguish between no syphilis versus either current or past infection.

HHH, MD

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