[Question #7840] Syphilis - still concerned
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51 months ago
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Hello, unfortunately I'm still very concerned about syphilis despite all my testing. Here is my timeline once again:
12/28 and 1/06 - unprotected sex w/ female
2/21 - tested for hiv 4th gen, rpr, gono/chlamydia - all negative
2/22 - started 14 days of doxy due to discharge/leaky/crawling feeling
3/01 - tested again all of the above four, all negative
3/04 - 10 std panel @ quest + hiv rna, all negative-discharge went away briefly when i started the doxy, but then returned. i started penicillin 10-day around 3/10 as I had an E. faecalis infection. the discharge feeling went away then returned on 3/18 weirdly after smoking marijuana.
3/30 - started another penicillin 10-day course.
3/31 - another full panel @ labcorp, all negative
4/16 - hiv 4th gen + pcr rna returned negative
4/28 - syphilis rpr, t. pallidum AB and hep c rna all negative.
5/04 - had a Mycoplasma Genetalium test at labcorp. I'm wondering if that was causing my discharge symptoms, however they went away in the middle of the penicillin course and haven't returned.
I'm sorry for the repeat question here, I'm just incredibly concerned. I never showed any syphilis symptoms like a rash or chancre, but I'm afraid that my taking of the antibiotics before 90 days may have killed the bacteria but not enough and that it may return at some point. I'm just afraid that it may return and cause me neurological issues as the CDC says they can be caused at any stage in the infection. I want to think i can't be treated for something I don't have but I'm just very worried it'll return and that it's still there, just at a level that can't be detected by any of the tests. The T. Pallidum AB test from 4/28 came back negative so there were no antibodies to the infection, yes? I just keep thinking what-if the bacteria is still somehow in my body and is not being detected by the tests and that antibodies weren't produced. Anyway thank you for any input, I'm just having a hard time calming down about it.
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Edward W. Hook M.D.
51 months ago
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Welcome back to the Forum although, like Dr. Handsfield’s last responses, I’m sorry you felt the need. Dr. Handsfield clearly stated that your test results were absolutely conclusively negative for Syphilis. The antibiotics you have taken since your exposure do not in anyway change the fact that there is no evidence whatsoever that you have ever acquired Syphilis and had you been infected by your exposures four months ago, your tests would have been positive by now. Further, persons with neurological Syphilis would absolutely have a positive blood test at the time there symptoms were present. Repeating your questions will not change the answers.
I urge you to believe your test results. There is no need for further testing. The results will not change. EWH
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51 months ago
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Thank you Dr. I'm truly hoping my results don't change in a couple months or something. Just a follow up q regarding mycoplasma genitalium:
- As I recounted to Dr Handsfield, I was having NGU symptoms and discovered I had an E. faecalis infection after my primary doc took a swab. Now it seems like my symptoms were due to Mgen, but strangely enough they went away in the middle of the penicillin course I took at the beginning of April and haven't returned. I have recently been having precum after having an erection, it's clear and sticky and has the same consistency. My scrotum has also been tingly often the past couple days. If I truly had Mgen, my symptoms would not have disappeared / would have gotten worse while taking the penicillin, right? It seems penicillin is not a treatment for Mgen so I can't help but be perplexed that they symptoms went away. I also didn't feel any discharge symptoms until 2/22 and they were always weirdly intermittent. Do you think my results for Mgen will come back negative? Thank you again.
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Edward W. Hook M.D.
51 months ago
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Sigh. I suspect you are being paranoid and perhaps challenged by guilt of some sort. Your syphilis results will not change! Further testing is a waste of time and money.
As Dr. Handsfield has already told you, E. Faecalis is NOT an agent of STI and is a NORMAL part of the urogenital microbiome.
You do not mention the results of a M. genitalium test. I anticipate that your test results will be negative. Penicillin is not active against M. genitalium and would have not effect your test results. The characteristics of your genital secretions you describe are normal. I suspect that your "symptoms" went away because your genitally focused anxiety caused you to notice normal findings which come and go.
Please do not use your final reply until you have your M. genitalium tests. I really think that you are overthinking this and need to determine a way to accept that you were not infected by the encounter that you now regret. Please note that in that this is our third reply to questions in less than three weeks and that your questions are becoming repetitive, following my next reply to complete this thread, further repetitive, anxiety-driven questions may be deleted without a reply and without return of your posting fee. This is done purely out of concern for you, nothing more. Repeating the same questions and persevering in the face of multiple negative tests serves no purpose for you. EWH
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51 months ago
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Yes Dr, unfortunately this was an encounter I regret and it has been tremendously traumatic as the person in question is not really a good person. I believe the syphilis result at this point. My M. Genitalium result came back negative today. I got it done on tuesday. I had gone to bed at around 5am and woke up at 11:45 pm, and had the specimen collected around 1pm. I didn't eat or drink anything before the collection. It was my first void and the first part of the stream. I filled up the cup very decently and I'm hoping that wouldn't dilute the sample and make the bacteria undetectable. I read that this is very difficult to diagnose as the bacteria is extremely small so that puts me really on-edge. Is there a need for me to get tested again in a few weeks or get tested for ureaplasama urealyticum or mycoplasma hominis?
Anyway thank you Dr. I really appreciate the advice. I'm aware this is my last reply.
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Edward W. Hook M.D.
51 months ago
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I would urge you to believe your test for mycoplasma genitalium. Your specimen was collected under optimal circumstances. The size of mycoplasma genitalium does not make testing less affective. Currently available nucleic acid amplification tests are very sensitive and very accurate for mycoplasma genitalium diagnosis. I see no reason for further testing for this organism.
Please do not test for Ureaplasma or mycoplasma hominid. Both of these organisms are normal constituents of the genital track microbiome. A positive test for these organisms would only prove that you have normal bacteria present in your genitals tract.
I appreciate the fact that you have acknowledged your anxiety over the encounter that you now regret. Please remember however that even high risk partners are usually not infected, and that most exposures to infected partners do not result in transmission of infection. You have tested on numerous occasions. It is time to except that you were not infected and move forward without concern. Declared that all is well and put this behind you. Take care.
As you know, this will complete this thread. EWH
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