Positive syphilis on initial screen. Could it be false positive?

[Castroy24]

Hello,
Need some advice (I am a male).  I recently tested positive on initial screening for Syphilis.  Specifically on CLIA test.  I was told that the RPR and TPPA were also done and were negative.  I was advised to go for another test to confirm as it could possibly be false-positive.  My exposures were unprotected oral sex and protected vaginal sex with csw in May 2018 and another recent one 10 days ago (same exposure).
What are the odds that it was indeed a false-positive (which I hope is the case).  I am unable and very scared.  I just found out and will be going for second test tomorrow.

[auntiejessi]

Which test did you have done first?

If you had the CLIA done first, and then had the RPR and TPPA to confirm the CLIA, and those were negative, then the CLIA was a false positive for the 2018 exposure. That's conclusive.

HOWEVER, as you know, it is too soon to know for sure for the recent exposure.

So -

1 - Yes, that's conclusive for the 2018 test. Focus now on the recent exposure.

2 - Syphilis sores can appear anywhere from 10-90 days, but the average is 21 days.

3 - Maybe? It's not the preferred treatment for syphilis, but might help prevent it. I wouldn't count on it, though, and definitely test if you are concerned. Oral sex is lower risk than vaginal, and you had protected vaginal sex, which lowers the risk a lot.

With the discomfort, did they test you for NGU? This is an infection in the urethra, and can be caused by normal mouth bacteria entering the urethra. They'd look for white blood cells in your urethra. The azithromycin would cure it.

[Castroy24]

I had white blood cells on the swab gram test.  I would assume thet discomfort was NGU and cleared with azythromicin.   I'll just wait and retest for syphilis at 3 weeks and 6 month post exposure to be completely sure.  Thank you so much for your response.

[ianthurstan]

6 week mark and 3 month mark would be better.

[auntiejessi]

I agree - 6 weeks and 3 months is all you need for syphilis.

[Castroy24]

Thank you for your response.  I forgot to mention, the reason I went in for testing is because I was feeling urethral discomfort.  Doctor game me zithromycin as precaution.  I tested negative for Chlamydia and Gonorrhea.

Follow-up questions:

1.  Would I have definitively tested positive for syphilis by now on the 2018 exposure?  Or should I just focus on the recent exposure?
2.   As I wait to get retested at 6 week mark, should I be looking out for chancre sore and how soon would it appear if infected?  It has been 12 days post exposure as of today.
3.  Would the zitrhomycin I took as precaution have any affect on possible early syphilis infection?

Thanks again for you help.

[ianthurstan]

In many cases when a patient has an infection such as chickenpox, Lyme disease or certain types of pneumonia or an autoimmune disease such as lupus the body tends to produce antibodies which can fool the syphilis test. So, it is better for you to do another test to calm your mind. But, as I read through your text I found, it is too early to confirm syphilis. You should re take the test on 6-week mark and 3 month mark after exposure.