[Question #132] Syphilis Rpr test

37 months ago
6years ago I had a rash on my shoulders,neck that was a little painful and burning feeling.might have got this from a cream my doc gave me for brown spots on back and shoulder.i freaked out because I had a sensual massage sex 6 months earlier no sex involved had to take every test under the sun.my Rpr was non reactive.i was happy.6 years later started to have some muscle twitching.could have had them before but never paid any mind.could my Rpr test from 6 years ago be wrong.i am very paranoid and compulsive.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to Ask the Expert. Thanks for your question.

First, the rash you describe is not at all typical for syphilis. Rashes from syphilis don't itch or burn, and would not be limited to your shoulders and neck. The rash typically is body wide. Second, the RPR test is very accurate in ruling out active syphilis. If your rash were due to syphilis (despite its atypical nature), the RPR would have been positive.

So no worries -- all is well. I hope these comments have been helpful. Best wishes and stay safe--

HHH, MD



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37 months ago
I was just thinking can the Rpr test still pick up syphilis years after infection.i would like to do a follow up to clear my mind.plus,I am scared about my leg feet twitching.isthis a sign of late stage infection.i am driving myself and my family crazy.my family doc told me to let it go.my labs were good for potassium and calcium and magnesium is not working .
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Such a symptom doesn't even hint at syphilis. However, the answer is yes: the RPR always picks up active late stage syphilis. Your family and family doctor are correct. Syphilis is not a realistic concern or a rational one. Time for you to move on and stop obsessing about it. If you cannot, professional counseling is the next step. I suggest it from compassion, not criticism. Good luck with it.---
37 months ago
thank you.i was just worried because of the muscle twitching and some pain.may I ask what are symptoms of late stage syphilis infection.From what I have read except for the blindness and brain problems it seems kinda vague.I have never seen this question asked and it would seem to help a lot of people who are worried.I had a doctor tel me my bilateral thumb pain could be tertiary infection.His remark seemed tongue and cheek.It just seemed in the last few months I have had odd  stuf happen like facial acne,thumb pain and the stupid twitches.Great site by the way..have a good one.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Thanks for the thanks about the forum and our service. I appreciate it.

The old terminology for late neurosyphilis (more than a few years after initial infection) was "general paresis of the insane", or GPI. That tells the main problems: dementia and paralysis (paresis). Abnormalities in gait, confusion, disorientation, various kinds of visual difficulties, and hearing loss are the most common early symptoms. Although it is conceivable that your symptoms could be part of the picture, they would never be the only symptoms. And you have the negative RPR. If your symptoms were due to late syphilis (neuro or otherwise), the RPR would be positive.

So truly, you needn't worry. Forget it and move on. If you cannot, re-read the last part of my previous comment. Good luck.
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