[Question #8147] Syphilis rpr accuracy
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48 months ago
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Helo Drs. that is my inquire: How accurate is a RPR syphilis test at 4 weeks from the risk encounter and more than 10 days after chancre onset? It was done a western blot as well in the same moment, and both of them were non reactives for IgG and IgM.
The possible “chancre” ? Was present at least 10 days before blood test was done.
Tha is the story: in September 2019 y had a protected vaginal intercourse whit a masseuse that in the last moment offered protected vaginal. Several days after, (I don’t remember, how many, may be 10 or so) I notice a pimple on the skin, on the root of my dorsal penis, where the condom can cover or not. In two days it open like a little sore, not bigger than 2 or 3 mm. As a sanitary worker, I took on my own a 2,400 IU. Peniciline benzatine one week after it appears an it healed in 2 or 3 days. My test never became positives, may be because it was not syphilis or because the penicillin shot.
3 or 4 days before I realize the pimple, I had vaginal intercourse wit my wife, not anal, but perhaps the dorsal roo of my penis could touch accidentally her annus in “dogstile” position? ??
2 weeks after that, she had a little shore in her anus, that she notice for same itch and difficulty while defecation.
And now let’s go back to the beginning: She had a non reactive RPR and a non reactive Western blott 4 weeks after the event an 10 days after onset the possible chancre.
I thought it was ok, as she had not any symptoms of secundary syphilis except a little weight loose, but now , 2 years later, I am worried thinking she may have latent syphilis as a I have read that window period is up to 6 week.
I don’t know how to act, because this issue can greatly weaken our 30 years relationship. Do you think that there is a real risk and it’s necessary retest her?
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48 months ago
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I forgot to say that there was not visible pimple or sore on my penis the day I had vaginal sex with my wife, or at least it went unnoticed.
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H. Hunter Handsfield, MD
48 months ago
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You asked this exact question (with minor differences) in your third question on this forum, 5 months ago. Please go back and re-read my reply about RPR testing and its reliability. We also discussed that even if you had been exposed to syphilis and infected, the benzathine penicillin would have cured it and prevented a syphilis blood test from ever being positive. And now you also give strong evidence that your partner did not have syphilis anyway. Do your best to move on without worry. If you cannot, just have another syphilis blood test, to prove to yourself you do not have it and could not have infected your wife. But please stop asking about it on this forum. Repeated anxiety driven questions are not permitted and this will have to be your last question on the topics of your previous 4 questions. Thank you for your understanding.
HHH, MD
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48 months ago
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Sorry if I have been reiterative, but I certainly know that I have not syphilis, I trust in my tests and in your advise.
But ig you re-read, the question now is quite different, my wife could have been exposed days before I took penicillin and I am worried for her.
I just was asking you about the reliability of her test, that were different than mines in terms of timing and tipe of tests, and I had never asked about it before.
Sorry again and thank you.
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H. Hunter Handsfield, MD
48 months ago
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I was aware of the situation, and my reply about RPR was intended for your wife's test as well as your own. But your wife was not at risk anyway: syphilis cannot be transmitted until a chancre appears, and never sooner than 10=15 days after a newly acquired infection. Your treatment at 2 or 3 days assured your wife could not have been infected. She did not need to be tested.---
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48 months ago
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Sorry, but I think I haven’t explained the times well. I’ll try to do it:
Day 0: protected vaginal with masseuse.
Day 10: unprotected vaginal with my wife.
Day 12: I realize there was a pimple on the root of my penis, may be it have been there two days before… I don’t know.
Day 15: Pimple open in the middle, ike a little sore
Day 21: FTA-AB test, it was non reactive.
Day 21: I had penicillin injection. 2,400,000 and sore healed in 2 or 3 days.
Day 25: My wife realized she has a little sore in anus.
Day 37:my wife did a RPR and western blott bouth non reactive.
I am very sorry to insist on the subject, but I think I have not been able to explain it well.
Thank you very much for your patience.
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H. Hunter Handsfield, MD
48 months ago
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Thanks for clarifying the timing. It does not change my evaluation or advice. It is not possible that either you or your wife has syphilis. Please do your best to stop worrying about it.
And please no more questions about these events on this forum. The forum does not permit repeated questions on the same topic or exposure. Future new questions about this exposure, testing, and your fears about syphilis or HIV may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.
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