[Question #2512] Test results despite symptoms?

44 months ago
Good morning doctors. I am returning with a few questions because of all the symptoms I still have. Briefly, my episodes were years ago and I had many rpr/syphilis /hiv tests after six weeks.  ALL the tests were negative(rpr,tp eia, fta-abs, and tppa) from after six weeks of exposure, and with many of the same tests out to six years after exposure.  Then from what you and my dr have said that was FOR SURE, a false positive FTA. To this day though, I have LOTS OF SYMPTOMS. These include BAD FLOATERS, lots of muscle twitching, some white tongue as well as some bloody noses.  A few questions
1)Can I be ABSOLUTELY CERTAIN that I have not missed HIV with all the testing?
2)is it at all possible to get(after 3 months), to get negative rpr,tppa,fta,tp eia, but still SOMEHOW, have the disease?
3)I know syphilis is the great intimidator, but is it a tricky one to diagnose as well?  Are the tests that good that no matter what stage of syphilis, a clinician would be able to diagnose it/pick it up?
4) I guess really, is there ANY WAY that either of these two diseases can evade detection with all the 3rd/4th generation hiv tests, rna,DNA, western blot, along with all of the syphilis testing that has been done?

I may have a follow up or two questions, but I hope you can clear up. 
Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
I must say, I am disappointed to see you back on our site with this series of repetitive questions.  Syphilis and HIV both have a large number of manifestations which can mimic other diseases and vis versa.  It is for that reason that syphilis tests and their interpretation have been carefully studied and as an expert on STIs, including HIV and especially syphilis, I can tell you with great confidence that you do not have either of these diseases as a result of your dalliances about a decade ago.  As I said in our earlier interaction -"The nature of your question suggests that you continue to be guilty about you're missteps many years ago. You need to get over it. You do not need more testing. If you cannot stop worrying, you need to speak with a counselor who can help you work through your guilt and anxiety."  That is still the case.  In my opinion, you need professional help on why you are unable to accept your test results and the input of multiple trained professionals that you do not have syphilis.  To do otherwise will potentially be harmful to your health as your perseveration on syphilis may keep you from finding out why you really are having the symptoms you describe. 

Since your questions are repetitive, my responses will be brief:
1)Can I be ABSOLUTELY CERTAIN that I have not missed HIV with all the testing?
YES!!!

2)is it at all possible to get(after 3 months), to get negative rpr,tppa,fta,tp eia, but still SOMEHOW, have the disease?
NO, not without treatment.

3)I know syphilis is the great intimidator, but is it a tricky one to diagnose as well?  Are the tests that good that no matter what stage of syphilis, a clinician would be able to diagnose it/pick it up?
Yes, the tests, particularly when repeated are "that good".

4) I guess really, is there ANY WAY that either of these two diseases can evade detection with all the 3rd/4th generation hiv tests, rna,DNA, western blot, along with all of the syphilis testing that has been done?
No!!

Einstein said (to paraphrase) "...One definition of insanity its to do the same thing over and over again and expect different results."  Consider this, accept your results, and get the real help you need.  EWH
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44 months ago
Thank you for your response. I honestly do know  and understand how it looks with all the negative tests. I actually am over the guilt thing, but something in my body is going on and for some reason I go back to syphilis. I guess I think that maybe somehow the tests could be wrong for whatever reason in my case. I definitely have something happening and really need to figure it out. 
1)as I said before, I have taken antibiotics for various infections over the years. Would an individual have to have a specific regimen of antibiotics to cure syphilis?  Could for some reason it just be cured after taken for some other illness and not know it?(actually have to get pcn injections)?
2)in regards to testing, in whatever stage of syphilis, and specifically latent, can the rpr,fta, tppa, as well as tp Eia miss it, even if done repeatedly?(meaning get false negatives)
3)what is the most absolute window period for syphilis testing with trep and non trep testing and does the duration of infection affect that timeframe?
4) i have read that you Essentially will always have a positive trep type test if you've had the disease, is that correct?
5) if number 4 yes, then does it always mean that without treatment I've never had it?
6)with all my negative tests (except one false positive fta(ARE YOU CONFIDENT IT WAS FALSE POSITIVE??),,,can I be ABSOLUTELY CERTAIN I don't or haven't ever had syphilis?
Thanks so much. I know it seems quite repetitive and neurotic, but something is going on and I want to be absolutely certain I've done all I can to rule it out. 
Again, than you


Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
With all due respect, while guilt may or may not be at the root of  root of your concerns, you are not thinking about this clearly and your inability to let go of your fixation on syphilis concerns me about your mental health.  Were you a patient in my practice I would require you to see a mental health professional for his/her guidance in  how to help you move forward.  I am not denying your symptoms but I am completely confident that they are not due to syphilis and I worry the your inability to accept this is keeping you from investigation possible true causes of your symptoms.  This is not a matter of how this "looks", there is absolutely NO EVIDENCE that you have or have ever had syphilis.

Brief answers to your repetitive, questions, all of which have been addresses (in some occasions more than once) before:
1)as I said before, I have taken antibiotics for various infections over the years. Would an individual have to have a specific regimen of antibiotics to cure syphilis?  Could for some reason it just be cured after taken for some other illness and not know it?(actually have to get pcn injections)?
Yes, other antibiotics may have incidentally have cured syphilis if you had it HOWEVER, if this were the case you would no longer have symptoms AND your blood tests would still be positive.

2)in regards to testing, in whatever stage of syphilis, and specifically latent, can the rpr,fta, tppa, as well as tp Eia miss it, even if done repeatedly?(meaning get false negatives)
NO, no the combination of tests you describe, particularly when performed repeatedly.

3)what is the most absolute window period for syphilis testing with trep and non trep testing and does the duration of infection affect that timeframe?
If you had established syphilis, at least the treponemal tests would have been positive.  Your test results are incompatible with active syphilis.

4) i have read that you Essentially will always have a positive trep type test if you've had the disease, is that correct?
Correct

5) if number 4 yes, then does it always mean that without treatment I've never had it?
There is no evidence you have ever had syphilis!

6)with all my negative tests (except one false positive fta(ARE YOU CONFIDENT IT WAS FALSE POSITIVE??),,,can I be ABSOLUTELY CERTAIN I don't or haven't ever had syphilis?
Yes, you can be absolutely confident that you do not have syphilis.

EWH
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44 months ago
Thank you very much for your input again...Going to put this behind me once and for all.  
1)If in fact someone had syphilis for years, wouldn't their RPR be positive if it was active disease?--Any prozone possibility?
2)Can you actually  have true active syphilis with a Positive TREP specific test, but negative RPR?
I know this is how its monitored if a person has been previously infected.
3)If the disease is infact treated adequately, can it reactivate without another exposure?(meaning, on its own)?
4)As far as my false positive FTA is concerned, if it was truly a positive test, the RPR would have been positive?
5)If you as a doctor are indeed looking for syphilis, and you test the patient 2-3 years after the exposure with the FTA, RPR, EIA, TPPA, and they are NEGATIVE, would you as a physician be 100% certain they don't have that disease and never test for it again unless there was a true exposure?
6)LASTLY, despite any symptoms that might be happening with the patient, you would know you had ABSOLUTELY ruled it out?
I just have to know that I have done all I can to make sure this isn't a possibility so my doctor and I can look for what is REALLY going on.
Thanks so much for helping all of us worried and stressed
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
1.  Correct.  Proponents is. It a consideration for you.
2.  Not unless there is a proponent which, as I said is not a concern for you.
3.  No.
4..  Correct.  Further, your subsequent treponemal tests would have been positive.
5.  Yes, I would be completely confident that such a patient did not have syphilis, as I have told you earlier.
6.  Repeating your questions does not change the answer.  Syphilis has been ruled out.


You have now had three answers.  The thread will be closed and, given the repetitive nature of your questions, further mquestions from you on this topic will be deleted without comment.  Continuing to be concerned about syphilis is illogical and needs to cease.  I wish you the best.  EWH
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44 months ago
Can you clear up what you mean by proponents?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
It was an autospell error.  Should have read "pro zone".  End of thread.  EWH---