[Question #5092] RPR Confusion
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77 months ago
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Hello doctors, I’m hoping you can ease my mind here. On August 17, 2018 i went outside of my marriage. Encounter was with a partner from my past, she is a white female and i am male. Encounter was unprotected oral (i received) and protected vaginal. My guilt and anxiety over this has really done a number on me. I haven’t noticed any “classic symptoms” but i have the following test and results:
Chlamydia: NAAT negative at 7, 14, and 25 days
Gonorrhea: NAAT negative at 7 and 14 days
Trich: NAAT negative at 7, 25, and 39 days
RPR: non-reactive at 200 days
Oraquick gum swab negative at 3 months
Rapid HIV test negative at 202 days (INSTI)
I believe most of these are conclusive but the RPR scares me, I’m reading a lot about false negatives and am hoping you can help. Are these results reliable and can i trust my RPR? All test done at LabCorp
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77 months ago
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A bit more detail about my situation. This is the second time i had been with this women. The first time was February 5, 2018 and the exposure was the same. Receptive oral unprotected and protected vaginal. I had a 10-panel test done 5 weeks after that exposure which was all negative. She is a married, 40 year old, white female. Wasn’t sure if the past details would help or not
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Edward W. Hook M.D.
77 months ago
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Welcome to the Forum. For all of the reasons that I mention, you can be entirely confident that you did not acquire an STI from the exposure you describe. It is now time for you to put your concerns about STIs behind you and move forward without continuing concern. The reason I say this include:
1. Your partner was low risk. STIs as a generalization are uncommon as persons get beyond their late 20's.
2. Acquisition of STIs and syphilis in particularly form unprotected oral sex is quite rare.
3. Your tests are negative. All of your tests were taken at time when, if you had been infected, the tests would be positive.
4. You apparently do not have symptoms.
5. Statements about false negative syphilis tests are overblown. The RPR test is a good, reliable test. Believe the result.
Bottom line, you are in the clear. No further testing is needed. Please don't worry. EWH
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77 months ago
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Thank you doctor. This morning i took another rpr along with a TP-PA. Would you say i can be confident these results will be negative as well, and unnecessary? Is 200 days to long for secondary syphilis to begin showing symptoms? Would an apparent tender lymph node in the underarm be a sign of syphilis? No swelling that i noticed, just a bit sore near my left peck. Thanks again, sorry if this seems like paranoia.
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Edward W. Hook M.D.
77 months ago
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Sigh, yes, your results are really reliable at this time. You should be confident of the results (as I already told you). Additional testing is a waste of time and money. Another waste of energy is being misled by the inaccurate statements seen on the internet.
Secondary syphilis would have resulted in a positive test within 200 days. A single swollen lymph node is a non-specific finding. If you had a swollen node due to syphilis, you would have positive tests.
It is paranoia. You need not be concerned for all of the reasons I mentioned above. EWH
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77 months ago
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Thank you doctor, my final question is in regards to the prozone effect with an RPR. Is this phenomenon a common occurrence? I see it mentioned more and more frequently and that is what prompted my test this morning. I know this is my last follow up I’m allowed so I’ll say thanks to you your colleagues for this service, and hope for final negative results tomorrow.
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Edward W. Hook M.D.
77 months ago
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More sighs. The prozone is a very rare event whose existence only adds to the internet-fueled, totally unwarranted paranoia that people have about syphilis tests. Further, it does not effect the TPPA. When your results are negative, as I am sure they will be, please put your unwarranted fears about having contracts syphilis behind you.
End of thread. EWH
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