[Question #2802] Accuracy of Syphillys Testing

42 months ago
Greetings,

Approximately 2.5 years ago I had a small outbreak of genital warts.  I also had a small white sore (maybe 1/4") develop on my scrotum.  The white part went away and it turned into an open sore, and completely vanished in about 7-10 days.  Both of these incidents occurred about 3.5 months after I had protected sex with a sex worker.   At this time I did a full STD Panel test and everything came back negative except Herpes Type I - though I have never had a cold sore - before or since the testing.  (I also did 2 more oral and one more HIV blood test - all negative.) During this time I also felt ill at times, and during a physical a year later I had  lower than normal white blood count, but they did return to normal, and all blood tests since then have been fine.  About 6 months ago I had another RPR test and that was negative as well.  I have never experienced a rash break out either.  In actuality, I would have not even been concerned with or thought about Syphilis if it were not for that sore that I had.  I can still feel a small lump of hard skin and there is a small scar where the sore was, so that is still a mystery to me.

My question is - how accurate are the RPR tests in the time frames given above, and should I have some type of other test done to rule it out completely?  If it isn't Syphilis, any idea what that sore could have been caused by?

Thank you for your time.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum.  I'll be glad to comment.  The two Syphilis blood tests that you have had, one about 3 months after your condom protected, low risk exposure and the second more recently, effectively and reliably rule out the possibility of syphilis.  Based both on the description of the lesion and your tests results you can be completely confident that you did not acquire syphilis.  No need for continuing concern, no need for additional testing.

The lesion you describe on your scrotum is most consistent with either a benign scrotal cyst or folliculitis.  Neither is an STI and despite your residual scar there is no reason for concern or intervention of any sort.  I hope this comment is helpful to you.  EWH
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