Hi Dr Sean / Jose. Thanks very much for this great forum. I was wondering if you could impart you wisdom on my little dilemma below relating to syphilis.
Male 40s. Hetrosexual
Contact and Symptoms
In mid July 2010 I had sex with a sex worker in the UK (although she was from Milan Italy). We gave and received unprotected oral sex and at one point rubbed the head of my penis against her open vagina (for about 10 secs or so).
About 1 week later I began feeling very fatigued and poorly. The lymph nodes in my armpits flared up and, strangely, I had pains in the palms of my hands and soles of my feet . I had no noticeable lesions but did have a slight ache in the left of the head of my penis. No discharge, no pain when urinating.
After a couple of weeks these symptoms went away and for about a week I was my usual self. I then (Aug 2010) started to get little ‘electrical’ scratching sensations over my body and itching around my neck (no rash). This turned in to a full burning sensation all over my back for about a month (again no rash). It was similar to a shingles pain I had back in my 20s but that time a rash accompanied it. It was very painful.
By the end of Sept 2010 these symptoms too had passed but they were replaced by burning tongue sensations (for about 3 weeks) and clusters of mouth ulcers that would come and go over the period of a couple of months (one ulcer in particular was very nasty on the side of my tongue – approx 100 days after sexual contact). My GP saw these and said they were ulcers.
Over Oct 2010 I had a very bad facial rash (red and stinging hot, very red !) and noticed the palms of my hands were very red all the time too. (no spots just red all over). I did see a dermatologist who examined me after the rash had all but gone he said it was possibly rosacia – but I’ve had rosacia and it certainly didn’t affect my palms and certainly didn’t have the horrendous burning sensation that was on my face. The dermatologist have me 40mg doxy 1pd for 2 months. I only managed 3 weeks (as it upset my stomach).
No sooner had I finished the doxy (Dec 2010) I started to get vertigo and dizzy sensations and to cut a long story short for the past two months I have suffered appauling labarynthitis. I’ve also had the most chronic fatigue I’ve ever had in my life. My ENT specialist has run audiograms and I have lost hearing, I have tinnitus and he says my cranial nerve has been damaged by ‘something’.
Before all of this I have been 100% fit and healthy.
My key concern is syphilis as so many of the symptoms I have had can be attributed to the condition and they seem to match primary and secondary ?
Tests.
I’ve had full sex health check at 5 weeks 3 days after contact (please dont mention other clinics by name - they get very upset) HIV, Syph igm igg, Hep, Gon, Clam etc etc. A repeat at 5 months at (please dont mention other clinics by name - they get very upset) and a full NHS sex health screen and 6 months. All of my test have been NEGATIVE. I’ve also had numerous FBC, ESR, Auto immune antibody, Liver, Kidney, Blood Chemistry, Fasting Glucose, Serum C Reactive Protein, Serum Folate, B12, Infectious mononucleosis test done over the last six months. All fine.
Questions.
Given the contact, symptoms and test results do you think there is a likelihood I have syphilis ? My NHS GUM and private doctor have great faith in the test results ( 3 negative syph) and think I’ve just had a run of bad luck with my health.
Could anything have inhibited production of syphilis antibodies or masked them in the tests ? if so what is the likelihood ? should I get a repeat ?
If not syphilis is there anything else that can be picked up through sexual contact that could cause these symptoms that’s not covered in a standard screen ?
Can I get on with my life and have sex without worry ?
Most unlikley you have syphilis but obviously if you are still concerned the only option is to treat again.
Syphilis is rare in heterosexuals and you have had a great accurate test which was negative.
You asked:-
Quote:
Given the contact, symptoms and test results do you think there is a likelihood I have syphilis ? noMy NHS GUM and private doctor have great faith in the test results ( 3 negative syph) I entirely agreeand think I’ve just had a run of bad luck with my health.again, agreed
Could anything have inhibited production of syphilis antibodies or masked them in the tests ? if so what is the likelihood ? should I get a repeat ?I don't believe they were masked and I do not believe you have syphilis - however as I said at the outset if you think you need a further test then you should do that
If not syphilis is there anything else that can be picked up through sexual contact that could cause these symptoms that’s not covered in a standard screen ?I cannot think of anything and as you say all tests are negative - so I'm not terribkly helpful on that I'm afraid
Can I get on with my life and have sex without worry ?certainly I would encourage you to - all the tests you have had done are negative and you have had many.
Thanks very much for your very rapid and insightful reply to my little dilemma. I’ll sleep more soundly tonight !
If possible, could I just ask a few more questions on the subject of syphilis before closing the thread, I hope they may help clarify a few things and may help me and other users of the forum ?
You made the following comments on some other syphilis related forum entries ..
“..some people remain seronegative whilst they have the hallmark symptoms and signs of syphilis. I have known a few of these and they do present a challenge”
“I have had several patients with obvious syphilis on clinical examination but they have taken a long time to become positive on testing.”
Q1 Can you clarify ? Are you saying there are people with syphilis who never go seropositive or are you saying they just take longer than usual ? If they never go seropositive, why would this be and how common is it ? If they just take time what is the longest duration you have witnessed ?
Q2 I have heard of the ‘Prozone Phenomenon’ which can provide false negative results in second stage syphilis. Is the Prozone Phenomenon possible in UK NHS / Private Igm Igg testing ? If so why does it occur and how common is it ? Should I be worried given my symptoms and blood results ?
Q3 I took a very low dosage of Doxy for 3 weeks 40mg 1pd (about 3.5 months after contact). Could this in any way have stopped / slowed down production of syphilis antibodies ?
Q4 I mentioned my burning red face rash (so bad I had the air con blasting on my face every morning going to work for about a month) and my burning back. This burning sensation is never mentioned in any syphilis symptoms I’ve come across on the web. Is it fair to say that facial and back burning sensation is not a symptom of syphilis ?
Q5 Have you ever come across a person with syphilis in the secondary stage who has presented with 8th cranial nerve damage (hearing loss ? tinnitus ? labyrinthitis ?).
If possible, could I just ask a few more questions on the subject of syphilis before closing the thread, I hope they may help clarify a few things and may help me and other users of the forum ?
You made the following comments on some other syphilis related forum entries ..
“..some people remain seronegative whilst they have the hallmark symptoms and signs of syphilis. I have known a few of these and they do present a challenge”
“I have had several patients with obvious syphilis on clinical examination but they have taken a long time to become positive on testing.”
Q1 Can you clarify ? Are you saying there are people with syphilis who never go seropositive or are you saying they just take longer than usual ? If they never go seropositive, why would this be and how common is it ? If they just take time what is the longest duration you have witnessed ?I did clarify in the responses you have picked up and indeed you have quoted that clarification - I said that they took longer to become seropositive with HALLMARK symptoms of syphilis. You do not have hallmark symptoms - you think you do but you don't. You're worrying about something you have added 2 and 2 together to form 9 about.
Q2 I have heard of the ‘Prozone Phenomenon’ which can provide false negative results in second stage syphilis. Is the Prozone Phenomenon possible in UK NHS / Private Igm Igg testing ? If so why does it occur and how common is it ? Should I be worried given my symptoms and blood results ? Yes prozone may occur - but for the reasons already given I do not believe you have had syphilis and I have already told you that you should not be worried about your "symptoms"
Q3 I took a very low dosage of Doxy for 3 weeks 40mg 1pd (about 3.5 months after contact). Could this in any way have stopped / slowed down production of syphilis antibodies ?no
Q4 I mentioned my burning red face rash (so bad I had the air con blasting on my face every morning going to work for about a month) and my burning back. This burning sensation is never mentioned in any syphilis symptoms I’ve come across on the web. Is it fair to say that facial and back burning sensation is not a symptom of syphilis ?yes
Q5 Have you ever come across a person with syphilis in the secondary stage who has presented with 8th cranial nerve damage (hearing loss ? tinnitus ? labyrinthitis ?).no
Syphils Symptoms but Neg Results
Syphilis symptoms but negative results
Syphilis symptoms but negative results
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