[Question #7495] False Negative VDRL and Cushing syndrome

56 months ago

Dear Dr.

Thanks for your efforts and sorry for coming back,

I am referring back to you for with 3 questions:

-My VDRL Test Syphilis:

As I have got several Multiple sores on the head of the penis come and go but one of them is still current for about 04 months now, and recently a rash in the form of red boils on the back of my hands and my feets, I decided to test Syphilis VDRL yesterday which was 14 months after my exposure which come back negative but Unfortunately I had a common cold on the begging of the current month and I got Xithrone -Azithromycin- 500 mg once per day for six days while the last bill was 13 days before my test, I want also to draw your attention that on last March (05 moth after my exposure) I had got also a common cold and I got Augmentin 1000 twice per day for 08 days.

1- My first question is , is my test conclusive or should I repeat it once again?

HIV and Cushing syndrome and Normocytic and Normochromic anemia:

I was about to forget about HIV problem as my wife and my did the following tests:

my wife:

- HIV ABAG: 09 month from my exposure the normal intercourse between us.

- HIV ABAG: 13 month from my exposure the normal intercourse between us.

- CBC: 02.11.2020 for my wife A Normocytic Normochromic anemia with Hemoglobin 11.6 with mid lymphopenia 1673.

- CBC: on 14.12.2020: No anemia Hemoglobin 12.2 with relative lymphocytosis 3100, 57% and absolute lymphopenia 1600.

my self:

- HIV ABAG: 13 month from my exposure

- HIV antibody (Aids Test) - I don't know which generation-: 14 months from my exposure.

- 05 CBC during last year where my lymphocytes count in the average from 1300 up to 1745 with very low Eosinophils from 20- up to 30, but only at once CBC test of 02.11.2020 the Eosinophils was 114 but it came back again to 20 (relative 0.3% , absolute value 0.02) on the last two tests on 30.11.2020 and 20.12.2020.

so I have to more questions, if it is possible:

2- If Normocytic Normochromic anemia can appear within the first year of infecti

56 months ago

Sorry, I will continue .

2- does Normocytic Normochromic anemia can appear within the first year of hiv infection while haemoglobin can increase at the next cbc test even without getting treatment neither for anemia nor to hiv?

3- if I have Cushing's syndrome can my body produce antibodies for hiv2 with high cortisol level, I did 8 hiv ab test until 14 months after exposure?.

4- If I have coinfection between syphilis and HIV cases delay at producing HIV2 antibodies?

I am very much appreciated your help and waiting for you urgent answers.

Edward W. Hook M.D.

56 months ago

Welcome back to the Forum although I'm sorry you continue to worry unnecessarily. This is a repetitive post which indicates that you continue to worry without reason about the commercial sex worker exposure you had many months ago. Five months ago I closed our thread with the following statement - " Should you return with further posts on this topic, it is probably that the thread will be closed without a response and without refund of your posting fee." Given that five months have passed i have decided to answer these rather repetitive questions.

1. Syphilis would not cause recurring penile lesions of the sort you mention. Your VDRL provides definitive proof that you do not have syphilis. This is likely some other sort of dermatologic problem. Rather than worry about an STI that you do not have, I recommend you see a dermatologist.

2. As you have been told on multiple occasions the testing you have had has proven that you did not acquire HIV (including HIV-2)from your encounter. That answer is not going to change. Your wife's anemia does not suggest HIV, syphilis or nay other STI. The hemoglobin fluctuations you describe are not at all suggestive of HIV.

3. Your Cushing's disease would not change the accuracy of your tests. Believe the results.

4. No

Please, no further questions. You need to move forward without concern that you might have acquired HIV, HIV-2, or any other STI. EWH

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56 months ago

Dear Dr. Hook,

Thanks a lot for your response and I am really very appreciated your kind understanding to accept answer my question.

I need just a small clarification from you that my VDRL test result not affected by the antibiotic I took (Xithrone -Azithromycin- 500 mg once per day for six days ) which was completed only 13 days before I did my test as I read at many answers to you and Dr. Handsfeild here in your forum that antibiotics can interfere at VDRL test accuracy.

I think I started to feel better after your answer to me and I am waiting for your confirmation to open a new clean sheet for me life and move on.

Thanks again and Best Regards

Edward W. Hook M.D.

56 months ago

When antibiotics "interfere" with blood tests for syphilis, they do so because the cure the infection. This is problem occurs primarily when antibiotics are taken soon after exposure to an infectious person and when this happens the antibiotics act to prevent the development of syphilis. If you had acquired syphilis from your encounter over a year ago, the antibiotics you took would not change the result. The test would still show that you had syphilis. Believe your test results. EWH
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56 months ago

Dear Dr. Hook,

I am really appreciated all the vital advices given by you and Dr. Handsfeild at this Forum as I finally started to receive back again my peace of mind I lost for more than 01 year.

As final confirmation from you-I can imagine that it will be a repetitive question- I just want to be sure that neither my low number of lymphocytes which reach to 1300 only nor my Cushing's disease can stop producing HIV2 antibodies.

By your last reply to me, I have to repeat my appreciation to you and Dr. Handsfeild.

Thanks and Best Regards,

Edward W. Hook M.D.

56 months ago

Final reply. Your lymphocyte count is NOT dangerously low and would not prevent you from producing antibodies to HIV, including HIV-2. This thread is now complete.

Take care. Please do not worry. EWH

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