[Question #1871] Congenital probability follow up question.
94 months ago
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Hello again Doctors,
sorry to bother you again but as my paediatrician is still worried about my kid “very mild right lobe enlargement” I’m not getting completely calm. I’m going to use my second opportunity to ask a further couple of questions before taking further action.
1) 1) Is there any kind of test that can effectively rule out past, treated syphilis infection? ( I’m afraid I already know the answer, but it would be nice to have confirmation one way or another )
2) 2) I was surprised about how confident Doctor Hook was about my case. I feel like I’m missing something out. So, to be more precise, would be such an unlikely event to be cured of syphilis accidentally by having one week of amoxicillin and then test negative on a treponemal test about few months to one year later?
Thanks for your time again.
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Edward W. Hook M.D.
94 months ago
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94 months ago
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Just a last question that I think would help me to see answered by you.
Most sources, even from very prestigious institutions, tell the readers that the treponemal tests remain positive for life.
But then there are quite a few papers, which are highly cited ( yes, I deal with science papers regularly in my work , thing that has been very detrimental for me in this situation ), who report significant rates of complete seroreversion of treponemal tests, sometimes even in patients in the early latent stage. Some of this papers even warn explicitly against believing that treponemal test once positive remain always positive. I wonder about this discrepancy. Is the everyday experience of expert physicians like you what contradicts this findings that have worried me so much?
Thank you so much for your time.
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Edward W. Hook M.D.
94 months ago
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94 months ago
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Sorry about that.
Again, thanks for your time and advice.
94 months ago
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The reasoning would be like that: The probability of all the following events happenning at the same time:
- not having symptoms myself,
- not having symptoms my wife,
- being cured incidentally by the amoxicillin,
- being in the minority of people who test negative with treponemal tests after being cured,
and
- my wife becoming negative in RPR in something more than a year after infection,
Is so low as to not worry a lot about it? Is that so?
Thank for your patience.
And let me apologize if I had been rude before. I'm having a pretty hard time. If it was me who can resolve this with a test I would be resolved by now. Besides, I'm hitting myself for not having done a syphilis test at the time. People of my generation don't event know what syphilis is; too scared of HIV.
Thanks again. You are being of great help in this difficult times.
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Edward W. Hook M.D.
94 months ago
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94 months ago
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Thanks so much