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confused regarding testing for syphilis...

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February 17th, 2012
Dear Doctor,

Hope your doing well.I am kind of confused regarding testing for syphilis since i might have been infected 12 years back. I have swollen nodes in the neck region, and i have a canker like circular scar on the skin of my penis( could this be a mark left after the canker heals? ). Recently i even noticed a few blisters on the foreskin and I have 2 fibrous growth under the skin one on my inner thigh and another on my chest (< 1 cm diameter). I read sometimes tests for syphilis are not very accurate in late stage of the infection. I did a Treponema pallidum haemagglutination and a VDRL test which were negative. Now my confusion is, have i already progressed into a late stage like neurosyphilis and is a CSF test required? Is there a way i can conclude i am not infected with syphilis?

I will be happy if you can help me by sharing your view on my problem. I want to act quickly to avoid any further health complication.

Thanking you

Rahul


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replied February 18th, 2012
Sexually Transmitted Diseases Answer A31730
Hi, and thanks for your query on eHealth forum!

The Treponema pallidum particle agglutination assay (TPPA) and Fluorescent treponemal antibody absorption (FTA-ABS) test if positive are diagnostic of syphilis. Since TPPA is negative, FTA-ABS can be done to confirm diagnosis. Both the tests can be sued to diagnose any stage of syphilis except the first 3-4 weeks when they are negative as sufficient antibodies have not formed.

Penile ulcers may be due to infective or non-infective causes. Infective causes are sexually transmitted and include syphilis, gonorrhea, chancroid, genital herpes, LGV and granuloma inguinale. Hence all these should also be tested for. Since a confirmed diagnosis cannot be given on net please consult your urologis/venerologist to find the cause. Hope this helps. Take care!



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replied February 21st, 2012
Thank you Dr.Mathur. I'll do the FTA ABS test. I was little concerned because i wasn't sure if a spinal tap & CSF VDRL would be needed.

Best Regards
Rahul
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