Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Are The Symptoms Of Syphilis?
Question: I had an experience where I went to a massage parlour. The massage lady sat naked on my lower back. She rubbed my shoulders and massage me. She sat and moved back and forth with her vagina. About 4 or 5 weeks later I got a small red spot on the skin and it gradually turned brownish/red. It did not ulcerate.It was flat with the skin. I went to the doctor a week after I noticed the spot and asked him what he thought. He did not seemed concerned about it. I told him my experience. He knew I have anxiety so he ordered a syphilis RPR blood test. This was done 7 weeks after my massage. The results came back non-reactive( negative) a week or so later I had another flat red spot show up and then a week later a brownish lesion flat with skin like 1/2 inch,, looked like a burn. It was not painful. I noticed these after I would cut grass for hours on the lawnmower. The original first red mark went away after a week,, maybe 8-9 days.. I picked at the other bigger lesion (spot on skin) and it came off and left a scar. I went to the urgent care with sinus type infection and they gave me a shot of rocephin 1 gram and also I got them to give me 2 weeks of doxycycline 2 times a day 100mg. I took all the medicine. I went back to the doctor for my physical 3 weeks later and told him I had some more spots show up.. he said to make me feel better he would do another syphilis test. This was done at 85 days or almost 3months after my massage, The test came back negative. Since then I have seemed to somehow be anxious about the whole situation from reading on the internet. I got a couple of water bumps on the roof of my mouth that I popped and they came back and I popped them.. Then I started feeling headache , stiff neck and occasionally tingling in my foot. Like it was alseep. Then I start worrying maybe I have syphilis and the test were not accurate . My doctor said even with the antibitocs I took that we would know for certain if it was Syphilis after this last test which was done at almost 3 months... could this be meningeal neurosyphilis or my anxiety. Please help
Brief Answer:
Syphilis unlikely; upload photo; more information
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query. After going through your query and test results, I am fairly sure that you don't have syphilis simply because this route of transmission is very uncommon.
Where are/were the spots located on your body? I would like to have a look at them. I would like you to upload a few photographs of the lesions/spots that you seems to have developed over the past few months, so as to ascertain whether do they look like a syphilitic rash or not.
Even if we suppose that the spots are a manifestation of syphilitic rash, the presence of a rash in syphilis is more common in "secondary syphilis" rather than neurosyphilis, though secondary syphilis this may also associated with neurological symptoms, like headache, stiff neck etc.
RPR is a non-specific test for syphilis. There may be situations where it may be false negative e.g Pro-zone phenonmena Or falsely positive.
You may undergo a specific test for syphilis e.g TPHA test, which would be more reliable in either confirming or ruling out a suspected syphilis.
Regards
Syphilis unlikely; upload photo; more information
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query. After going through your query and test results, I am fairly sure that you don't have syphilis simply because this route of transmission is very uncommon.
Where are/were the spots located on your body? I would like to have a look at them. I would like you to upload a few photographs of the lesions/spots that you seems to have developed over the past few months, so as to ascertain whether do they look like a syphilitic rash or not.
Even if we suppose that the spots are a manifestation of syphilitic rash, the presence of a rash in syphilis is more common in "secondary syphilis" rather than neurosyphilis, though secondary syphilis this may also associated with neurological symptoms, like headache, stiff neck etc.
RPR is a non-specific test for syphilis. There may be situations where it may be false negative e.g Pro-zone phenonmena Or falsely positive.
You may undergo a specific test for syphilis e.g TPHA test, which would be more reliable in either confirming or ruling out a suspected syphilis.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I will send some photos tomorrow. If by some chance it had been syphilis would the 1 gram shot of Rocephin and 2 weeks of doxycycline 100 grams 2 times a day.. would that have cured early syphilis less than 2 months?
I had 2 negative test one at 7 weeks after exposure. and the other 3 months after.
Can I put Syphilis out of my mind. ?
I never had a chancre anywhere. The spot on my back did not turn into an open sore or ulcerate...
I read this from Dr. Hunter Hansfield..
H. Hunter Handsfield, M.D.Blank
Apr 16, 2014
Welcome to the forum.
It is very atypical to test only with TPHA. That test normally is used only to confirm positive results on other tests like VDRL or RPR.
However, TPHA is positive in all persons with syphilis more than a few weeks in duration, and then remains positive for life. Your negative result proves you do not have syphilis and never did.
I hope these comments are helpful. Best regards-- HHH, MD
so I was tested with 2 RPR and they were negative,,, so it seems the other test is done to confirm a positive RPR???
could you please answer these last to post ? I will post photos tomorrow.
Could you answer these now??
the first spot was on my lower back , the second and third were also in the same area. none of the places were ever ulcerated.
I had 2 negative test one at 7 weeks after exposure. and the other 3 months after.
Can I put Syphilis out of my mind. ?
I never had a chancre anywhere. The spot on my back did not turn into an open sore or ulcerate...
I read this from Dr. Hunter Hansfield..
H. Hunter Handsfield, M.D.Blank
Apr 16, 2014
Welcome to the forum.
It is very atypical to test only with TPHA. That test normally is used only to confirm positive results on other tests like VDRL or RPR.
However, TPHA is positive in all persons with syphilis more than a few weeks in duration, and then remains positive for life. Your negative result proves you do not have syphilis and never did.
I hope these comments are helpful. Best regards-- HHH, MD
so I was tested with 2 RPR and they were negative,,, so it seems the other test is done to confirm a positive RPR???
could you please answer these last to post ? I will post photos tomorrow.
Could you answer these now??
the first spot was on my lower back , the second and third were also in the same area. none of the places were ever ulcerated.
Brief Answer:
Testing for syphilis; TPHA test
Detailed Answer:
Hi.
Yes, Doxycycline in the dosage mentioned would have been effective for early syphilis. However, ceftriaxone is given as a daily injection for 8-10 days, rather than a single dose.
Syphilis is unlikely diagnosis here, though you have been adequately treated for early syphilis with doxycycline.
TPHA is not routinely done for screening of syphilis.
RPR is for screening purpose. However, RPR may be falsely positive in a few patients (who never had syphilis) and here comes the need to do a TPHA test for confirming whether it was indeed positive.
A low titre RPR test e.g 1:2 or 1:4 is usually false negative or indicates latent syphilis. Here comes the need to perform a TPHA test to ascertain whether it is latent syphilis or false positive.
Whereas a RPR titre as high as 1:128 Or 1:256 is highly suggestive of syphilis.
In some instances, such as early syphilis, RPR may be falsely negative because of pro-zone phenonmena (very high titres of antibodies interfering with the test). However, if syphilis is strongly suspected by clinical features, TPHA is done to resolve the confusion.
Therefore although it is very unlikely that you have syphilis, the only reason to get a TPHA test (in spite of negative RPR test, twice) is to rule out pro-zone phenonmena(falsely negative RPR). However, I don't think you have a syphitic rash either, the spots are too far and few in between to be suggestive of a syphilitic rash.
Photographs would be confirmatory.
Regards
Testing for syphilis; TPHA test
Detailed Answer:
Hi.
Yes, Doxycycline in the dosage mentioned would have been effective for early syphilis. However, ceftriaxone is given as a daily injection for 8-10 days, rather than a single dose.
Syphilis is unlikely diagnosis here, though you have been adequately treated for early syphilis with doxycycline.
TPHA is not routinely done for screening of syphilis.
RPR is for screening purpose. However, RPR may be falsely positive in a few patients (who never had syphilis) and here comes the need to do a TPHA test for confirming whether it was indeed positive.
A low titre RPR test e.g 1:2 or 1:4 is usually false negative or indicates latent syphilis. Here comes the need to perform a TPHA test to ascertain whether it is latent syphilis or false positive.
Whereas a RPR titre as high as 1:128 Or 1:256 is highly suggestive of syphilis.
In some instances, such as early syphilis, RPR may be falsely negative because of pro-zone phenonmena (very high titres of antibodies interfering with the test). However, if syphilis is strongly suspected by clinical features, TPHA is done to resolve the confusion.
Therefore although it is very unlikely that you have syphilis, the only reason to get a TPHA test (in spite of negative RPR test, twice) is to rule out pro-zone phenonmena(falsely negative RPR). However, I don't think you have a syphitic rash either, the spots are too far and few in between to be suggestive of a syphilitic rash.
Photographs would be confirmatory.
Regards
Above answer was peer-reviewed by :
Dr. Raju A.T
here are some pictures of my lower back.. you can see the first spot started out red and over a week or so it gradually turned darker and eventually wrinkled and came off .. the larger spot started out like wrinkled skin,, I picked at it and it came off and left a scar.. the other 2 did not..
do you have an idea what these were?the pictures are of 2 different spots. the first several show how it started out reddish and gradually turned darker,, and then the other picture is of the bigger spot that was like wrinkled skin that I picked at and it came off and left a scar.
I had one more small spot show up similar to the first picture but i did not get photos of it.
I paid $29 for the unlimited specialist,, does that mean you can still look at the photos I sent and answer my questions. ? thanks
do you have an idea what these were?the pictures are of 2 different spots. the first several show how it started out reddish and gradually turned darker,, and then the other picture is of the bigger spot that was like wrinkled skin that I picked at and it came off and left a scar.
I had one more small spot show up similar to the first picture but i did not get photos of it.
I paid $29 for the unlimited specialist,, does that mean you can still look at the photos I sent and answer my questions. ? thanks
Brief Answer:
Most likely an Insect Bite hypersensitivity
Detailed Answer:
Hi.
I have carefully reviewed the photographs.
I apologize for the delay in my reply.
I must say this seems like a local irritant dermatitis to an Insect bite, nothing else.
In the early pictures, it is bright red and in later pictures it is brownish, wrinkled and partially healed.
This is no way related to syphilis.
If I was the treating doctor I would have asked you to apply a topical steroid+antibiotic combination cream Or simply a topical plain steroid cream e.g (betamethasone valerate), twice daily for a few days.
That should appropriately take care of it.
These are prescription drugs and you may contact with your physician for a prescription of one of these.
Regards
Most likely an Insect Bite hypersensitivity
Detailed Answer:
Hi.
I have carefully reviewed the photographs.
I apologize for the delay in my reply.
I must say this seems like a local irritant dermatitis to an Insect bite, nothing else.
In the early pictures, it is bright red and in later pictures it is brownish, wrinkled and partially healed.
This is no way related to syphilis.
If I was the treating doctor I would have asked you to apply a topical steroid+antibiotic combination cream Or simply a topical plain steroid cream e.g (betamethasone valerate), twice daily for a few days.
That should appropriately take care of it.
These are prescription drugs and you may contact with your physician for a prescription of one of these.
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thank you for your help.. These spots are gone now, The larger one left a scar. do you have any reason why they would have came at different times?
It is good to hear that it is not syphilis related.
the spots have been gone over a month. It seemed to have started after I was cutting grass a lot in the late summer early fall.. I cut grass for hours,, that is where the bottom of the lawnmower seat comes to on me,,
so I can forget about Syphilis?
It is good to hear that it is not syphilis related.
the spots have been gone over a month. It seemed to have started after I was cutting grass a lot in the late summer early fall.. I cut grass for hours,, that is where the bottom of the lawnmower seat comes to on me,,
so I can forget about Syphilis?
Brief Answer:
Need not worry about syphilis
Detailed Answer:
Hi.
Yes, you should absolutely forget about syphilis.
These spots are surely related to your outdoor activities since you noticed these at about the same when you were engaged a lot in outdoor gardening activities.
Even though they came in at different times but that is not unusual for insect bites.
Regards
Need not worry about syphilis
Detailed Answer:
Hi.
Yes, you should absolutely forget about syphilis.
These spots are surely related to your outdoor activities since you noticed these at about the same when you were engaged a lot in outdoor gardening activities.
Even though they came in at different times but that is not unusual for insect bites.
Regards
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
last question..
would there be any other STD that would cause this? there was no sexual activity , just as I described above, massage lady sat on my back, no underwear.
did you see the last photo? it was a bigger spot above the red one.. lighter color.. it is the one that scarred..
do I have anything else to worry about?
or can I forget all this and move on
would there be any other STD that would cause this? there was no sexual activity , just as I described above, massage lady sat on my back, no underwear.
did you see the last photo? it was a bigger spot above the red one.. lighter color.. it is the one that scarred..
do I have anything else to worry about?
or can I forget all this and move on
Brief Answer:
Nothing like an STD
Detailed Answer:
Hi.
Yes, I have reviewed all the photographs that you posted.
This is unlike any STD. Moreover, the type of contact you mentioned is uncommon for an STD.
No history of any ulcer or sore or erosions suggestive of an STD.
Syphilis is the only organism that can penetrate intact skin but then the lesions don't resemble syphilis at all and the tests also does'nt seen to suggest that. Most other STD's don't even penetrate intact skin.
Herpes can be acquired by rubbing of genital mucosa against the skin if it is aggressive enough to be taken up by skin. Just touching intact skin won't transmit herpes. However having said that, there is no history of any sore or erosions which are classically seen in herpes.
Initially I was thinking that probably you got herpes Zoster (though it is not an STD) but after looking at the pictures even ruled that out because there was no fluid filled lesions or history of fluid filled lesions.
I think you can just forget about this episode and move on with other important things in your life!
Regards
take care
Nothing like an STD
Detailed Answer:
Hi.
Yes, I have reviewed all the photographs that you posted.
This is unlike any STD. Moreover, the type of contact you mentioned is uncommon for an STD.
No history of any ulcer or sore or erosions suggestive of an STD.
Syphilis is the only organism that can penetrate intact skin but then the lesions don't resemble syphilis at all and the tests also does'nt seen to suggest that. Most other STD's don't even penetrate intact skin.
Herpes can be acquired by rubbing of genital mucosa against the skin if it is aggressive enough to be taken up by skin. Just touching intact skin won't transmit herpes. However having said that, there is no history of any sore or erosions which are classically seen in herpes.
Initially I was thinking that probably you got herpes Zoster (though it is not an STD) but after looking at the pictures even ruled that out because there was no fluid filled lesions or history of fluid filled lesions.
I think you can just forget about this episode and move on with other important things in your life!
Regards
take care
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
thank you so much
Brief Answer:
You are welcome
Detailed Answer:
Hi
Thanks for writing to us at healthcaremagic
You do have a button on your screen that ends the discussion. Click on it
Do not forget to rate my answer.
Thank you.
Regards
You are welcome
Detailed Answer:
Hi
Thanks for writing to us at healthcaremagic
You do have a button on your screen that ends the discussion. Click on it
Do not forget to rate my answer.
Thank you.
Regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
