Strong syphilis suspicion

[needanswers10]

Dear Dr.,

Hope you can help me out. I've been very worried about syphilis for a long time.

I had a series of homosexsual encounters about 4 years ago in Germany - some of them unprotected. After these, several weeks later I noticed my penis very sore and a slight discharge - went away after some weeks on its own. Afterwards, I had several blisters/bumps/warts...don't know how to describe them, inside my butocks. They were fairly big, about a thumb each. At some point they opened and poured some kind of liquid. A scab took over and they seemed to heal, but they came back again.  

I was young, stupid and unaware of all STDs so I didn't seek medical advice until about 6 months after exposure, when I went to my GP due to the butocks rash and got a 3 day course antibiotic. I didn't mention my sexual encounters and he didn't ask either - they didn't run any tests. After I took the meds the rash disapeared like magic.

After this I noticed several different rashes in my body and a lot of hear loss, some in round patches in my head. This also stopped after a year. During that year I had a lot of flu-like episodes sore throat continuosly.

Now I'm older/not much wiser but more concerned about my health. I've done very thorough reading and I have the impression that all these symptoms match a syphilis infection way too well. Therefore went and got tested with the RPR and WS and FTA-ABS tests. All came back negative but this was about almost 4 years after the possible infection.

My worry is a possible late latent infection not picked up by these tests, as I've read non-treponemal tests would be negative most likely after all this time, and the non 100% accuracy of the FTA-ABS test in the late latent stage.

What would you recommend? Are these tests results reliable or due to my high risk exposure+sympthoms should get treated anyway? Is there the slightest chance of it being dormant and coming back with very bad health consecuences later in my life?

[needanswers10]

Dear Dr.,

Hope you are well and haven't missed my last post. As you suggested I got tested again, I couldn't though discuss in detail my past experiences with my doctor, it's too embarrasing for me. That's why I would very much like your advice on what to do now.

I am very good at the moment, no more rashes or any other symptoms. I just want to know if I can take syphilis out of my mind forever.

After all the reading I've done I got to the conclusion that FTA-ABS tests and alike are only about 98% accurate in lthe ate latent stage. Is this true? Could you please explain me a bit more about this? Is this after many many years and patients with HIV infections? Or could I potentially have a false negative?

I just need a good expert's advise to either continue invesgating or close this down forever, my mind is always on this and that's not healthy for me.

Hope you could kindly answer this post.

[needanswers10]

Dear Dr. Cummings,

Thank you very much for your answer, really appreciated.

Following your advice I have been re-tested for several STDs, including HIV,Hep and Syphilis. All came back negative again.

Regarding syphilis, that is what's been worrying me these past years, I've had the following tests done:

- WS & RPR about 2 years after possible infection
- EIA IgG & IgM about 2.5 years after possible infection
- FTA-ABS about 3 years after exposure
- Syphilis antibodies and antilipoids screen test (don't know the specifics of these) and TPHA about 3.5 years after exposure

moreover, I've been so scared that I've contacted my sexual partner back then and he got tested as well for current or past infection, and claims he doesn't have anything.

Do you think this is enough to close this? With the symptoms and risk I've had I have read too much info about this disease and it seems to me that several false negatives happen with several tests at different stages of the disease.... Could you please advice me on what to do? Are these results 100% proof that I'm not going to have any problems related to this disease in the future?

Thank you very much in advance for your kind advice

[Dr Sean Cummings]

Hello

You are correct to be concerned about finding out the answers etc. I agree that syphilis on the face of it is a relatively strong contender for the symptoms and signs you were displaying. That said, the tests you have had are reassuring.

I would suggest that you visit a doctor you feel able to discuss your past with and then have a whole range of tests run on you including a repeat syphilis screen and also HIV. Your doctor, if informed etc will be able to guide you very well.

Best wishes, Sean