[Question #510] time lapse for a rpr test

42 months ago
I had a rpr test taken 7 years ago after waiting 6 months from a low risk encounter.It was non reactive.Now 7 years later I started having some muscle soreness and some leg,knee pain.Had my primary take another rpr plus some other tests.Test was again non reactive,but I had a hypothyroid.Could my rpr test be wrong twice and is 7 years too long to take another test.
I am always worried.That's my nature.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Welcome to our Forum.  If you had acquired syphilis through the exposure that you describe, your RPR would have been positive 6 months following the encounter and, if untreated and still active, 7 years later as well.  Further, the symptoms you describe, muscle soreness and knee pain, are not symptoms which would be suggestive of syphilis.  I would not worry further and I see no need for further syphilis testing related to the exposure you have described.

I hope this comment is helpful to you.  eWH

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42 months ago
What you are saying is that 7 years a rpr test should still show positive if you have syphilis.I keep reading about false negatives as it comes to latent syphilis.What is latent syphilis.I just get nervous thinking my 2 tests could be false negatives.I went to a homeopathic doc and he said my nerve score was a little high.He used some strange acupuncture reading device and told me it was stress.Anytime someone mentions the brian or nerves it brings me back to syphilis....I know it sounds crazy.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
The amount of misunderstanding about syphilis and syphilis testing is staggering.  I repeat, if you had active untreated syphilis, your test would remain positive despite the passage of 7 or even more years.  No change in my assessment or recommendation.  EWH
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42 months ago
One more question for my 25 bucks.I have read where the Mayo and Cleveland clinics are not using the rpr as the 1st screening test.Is it because of false positives.It does seem that most hospitals still use the rpr as the 1st blood test for sysphilis.Like you said there is a lot of confusion in regards to syphilis and the testing for it.I know most of the questions you get from the public probably sound paranoid,but there are  scared people out there and I hope you understand that  most of us need that x-tra assurance to go on with our daily lives.Thank you very much for your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
I don't see a question here.  I will comment on your statement.  Some labs, perhaps including the ones you mention now use a testing approach in which the order of the two tests used for syphilis testing is reversed (that is, instead of doing the RPR test first, then a treponemal test if the RPR is positive as is the more traditional approach, they do the treponemal test first, then the RPR if the treponemal test is positive).  This gets nearly everyone to the same place and if either approach creates more false positives, it probably is the newer approach in which the treponemal test is done first.  The reason for the switch had little to do with false positives.  The labs make more money because doing the treponemal test first because with this approach the majority of persons tested for syphilis as tested with the cheaper, easier to do test before the RPR (the RPR is only performed in persons with positive treponemal tests).  EWH
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41 months ago
Would the rpr test be sensitive if a person had neurosyphilis.Ringing in ear at times plus floaters and sometimes I have had an eye flash in corner of eye over the last 2 years.I have also been a little dizzy the last few days and wanting to throw up at times.
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
As stated clearly in the Forum guidelines participants can have up to three replies to questions asked as part of a question.  This is your 4th question.  The short answer however is that if you had acquired syphilis, including Neurosyphilis from your exposure 7 years ago and still had untreated Neurosyphilis, your RPR would be reactive.  This thread will be closed later today.  If you have further questions ( I recommend you just believe your tests results) you'll need to open a new question.  EWH
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