[Question #9802] Ongoing syphilis concern
28 months ago
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I felt more honest context was needed. A few years ago, I had a brief encounter with a man. He licked, put mouth around my scrotum for about a minute, until I ended it. I can't recall when this occurred.
Around this time, wife got pregnant & miscarried. Shortly after, we conceived.
Wife tested negative for VDRL. Our now 3-year old appears healthy. Congenital worries me. Wife and I tested ECLIA (finger prick), Syphilis TP (I think CMIA), and I had FTA-ABS. Non-reactive. You've said once infected, positive for life. CDC claims 15-25% of those treated early will sero revert to non-reactive. Need to get closure.
Wife tested negative for VDRL. Our now 3-year old appears healthy. Congenital worries me. Wife and I tested ECLIA (finger prick), Syphilis TP (I think CMIA), and I had FTA-ABS. Non-reactive. You've said once infected, positive for life. CDC claims 15-25% of those treated early will sero revert to non-reactive. Need to get closure.
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H. Hunter Handsfield, MD
28 months ago
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Welcome back, but sorry you found it necessary. I'm also sorry to learn you've spent so many years apparently obsessed with this issue. In preparing to respond, I reviewed our discussion 10 months ago. That discussion has the answers you need; your apparent obsession has led you to unnecessary search for reasons that advice might have been wrong. And you have indeed misinterpreted what you found.
Seroreversion of T. pallidum specific antibody tests -- mostly studied for FTA-ABS, but not for other confirmatory tests -- does indeed occur, but primarily (and I believe ONLY) when early syphilis is treated within a few weeks of onset. Once syphilis has been present several weeks or longer, those tests remain positive for life. Second, when the tests do revert to negative, it is ONLY after syphilis has been effectively treated. This never happens in the natural course of untreated syphilis. Therefore, in someone who never was diagnosed with syphilis and is tested months or years later, the tests are conclusive proof that tested person does not have syphilis and never did.
And by the way, when someone is treated sufficiently early, typically within a month or two of catching it, and if their TP specific confirmatory test later becomes negative, that person is at zero risk for having ongoing syphilis or for the infection to recur and cause problems. They are free of syphilis until and unless they have a new exposure and a new infection.
From the information provided in your previous thread, it is and remains 100% certain that neither you, your wife, nor your child has syphilis and never did. All is well. Do your best to stop worrying about it.
HHH, MD
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28 months ago
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Thank you. Two quick follow ups: I was worried if one or both of us inadvertently 'cured' the syphilis by taking an antibiotic around that time (my wife took an antibiotic with her D&C). And I can't be sure I didn't have antibiotics for any respiratory illness. Lastly, would you classify my "encounter" as low risk, since it was only mouth-to-my scrotum? That's it. I'll put it behind me. Thank you again.
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H. Hunter Handsfield, MD
28 months ago
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If you or your wife happened to take an antibiotic effective against syphilis, and if it aborted an incubating infection, it would have prevented both the standard screening blood tests (RPR, VDRL, etc) and the confirmatory tests (FTA-ABS, TPHA, EIA tests, etc) from ever being positive. Negative test results thereafter prove you never had active syphilis, do not have it now, and cannot possibly infect anyone else, including a baby in utero.
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And yes, I'll bet nobody in the world in the past 30 years has acquired syphilis by oral contact with intact skin anywhere on the body, including the scrotum. I didn't closely re-read your previous thread, but if that was the exposure on your mind and the time, none of your concerns about syphilis testing had any basis at all.
The nature of your questions strongly suggests a rather abnormal obsession with syphilis, and maybe reflecting psychological conflicts over sex in general -- e.g. your sexual experiences before marriage. If I'm wrong, that's great -- no worries. But if I'm right, and you frequently dwell on such thoughts, you might consider professional counseling. I suggest it from compassion, not criticism.
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28 months ago
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Yeah, I think you're probably onto something with my anxiety. I will move past this (and probably into counseling). Thank you for the swift, honest response, and the work of this forum in general.
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H. Hunter Handsfield, MD
28 months ago
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Thanks for the thanks. I'm glad to have helped.---