Potential exposure: July 12, 2024 (handjob with heavy saliva exposure; no oral sex). Abx were coincidental for sinus/congestion. 

Timeline:

• Aug 6: Amox-clav x7 days
• Sept 4: Negative CIA
• Sept 18-Oct 6: Painless oral sores
• Oct 2: Negative RPR, slight elevated ast/alt
• Oct 14: Azithromycin
• Nov 19: Azithromycin
• Nov 22: Wife (pregnant) negative CIA
• Nov 24: Wife cefdinir
• Dec 12: Wife amox-clav
• Dec 18: My negative RPR, slightly enlarged liver with gallbladder sludge. 
• Jan 10, 2025: Wife negative RPR at delivery
• Jan 2025: Doxycycline for me
• May 19, 2026: My negative CIA

Other findings after exposure: white groin/ankle patches resembling leukoderma/vitiligo, slight patchy hair thinning, foot rash, and hand rash(top of hand) on me.  My son dropped from ~44th percentile birth weight to ~3rd-5th percentile by 6 months and had a transient rash in infancy.

Main concern: Could antibiotic use have partially treated syphilis and delayed/prevented serologic positivity?

Questions:

1. How likely is antibiotic interference in this scenario?
2. How reliable is a negative CIA nearly 2 years later?
3. How realistic is congenital syphilis given my wife's negative CIA during pregnancy and negative RPR at delivery given antibiotic use?

I was hoping dr. Hook would take a look as i read about studies he did