hello! I have recently received a reactive result for syphilis, and was given the one shot of penicillin treatment. I work on a cruise ship, and so regular testing is not available sadly, and the doctor said I won’t be retested for another 3 months…
this is driving me mad as my symptoms have calmed a little bit but are definitely still present, and I don’t understand how I am supposed to know if the treatment even worked.. can I get retested sooner and see if it is working?
Can anyone tell me their experience with symptoms after treatment, and when they got retested and what happened with your titre readings? Any advice is GREATLY appreciated, I have never had an STI before so the anxiety is real.thanks guys
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Lostatsea04
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My initial symptoms were a faint, non itchy rash covering my torso / back / arms / legs, which I was put on steroids for. I then developed tongue sores / white patchy tongue (which I assumed was a fungal infection).
Now after my shot, the rash is fainter but comes and goes with severity, and my tongue sores / “fungal infection” hasn’t healed at all. I also have slight sores one in each nostril which is very strange.
Everything seemed to calm down a few days after my shot, but now seems to be slightly worse / returning
The rash sounds likely to have been secondary syphilis and should face completely post treatment. I am presuming after treatment you avoided sex for 2 weeks and also have not had further sexual contact, or sex with an untreated partner ?
yes that is correct - I’ve avoided any sexual contact whatsoever since the initial encounter that I think caused this.
That’s why I’m slightly worried the treatment may have failed? As the rash seems to be present still as well as the tongue problem? Is this possible do you think? Or is it common for symptoms to come and go post treatment ?
If you had tested negative for syphilis within the last 2 years of testing positive, then a single benzathine should be sufficient and curative. If you have other symptoms, then need to look at other causes / sti's - I presume you did a full check. in the eventuality you are concerned and cant retest easily , you could take 2 weeks of doxycycline 100mgs twice daily - being careful with sun exposure - which is the alternate treatment in those who are penicillin allergic.
yes my last cruise ship medical was less than two years ago and that was negative for all STIs.
Yes my test covered everything including HIV which all came back negative 5 weeks after the sexual encounter in question so I assume they are all accurate…
But my rash is definitely still present. Fainter than before but still there which is worrying.
Before they tested me for STIs they had me on a very high dose of steroids for a prolonged period of time so maybe that could be the cause of the oral problems?
I am going to ask medical onboard if I can be retested at the 6 week mark - if this is possible do you know what my titre reading should be if the treatment worked from the original of 1:32?
Sorry for all the questions but like I say it’s hard to get good advice onboard! I appreciate your help!
Hmm it is possible the steroids may have caused a separate issue. Testing in 6 weeks may give a confusing result - usually the blood is checked 3 and 6 months post treatment - and a successful fall is a 4 fold drop in titre - so from 1:32 it should be 1:8 after 6 months .
There may not be an answer easily accessible on the ship and the easiest option may be to take the two weeks doxy and see if all resvoles. If yes , then it was possibly syphilis . if not - then you need to consider other causes.
thank you for all your help - I will see what medical say when I go and hopefully they will consider further treatment.. they also rarely like to give out medication too so that may be a struggle.
I had the rash for a while before treatment too so there is also a chance I’m being paranoid and it is just taking longer to go away than normal - my shot was only two weeks ago
Or the rash may be a completely separate issue like pityriasis versicolor ... Perhaps give it time. I presume you were given the correct single dose penicillin , ie 2.4 mega units IM of benzathine pencillin ?
after googling that it does look extremely similar - accept it comes and goes in severity day by day it’s really quite strange so yes I suppose maybe giving it time is the best thing I can do..
like I say getting the treatment / time / diagnosis onboard is just nowhere near as efficient as on land so worse case scenario is I wait until I’m home and see my doctor there.
The oral infection is causing me more grief with the bad taste and horrible appearance - I’ve had two rounds of medication for oral thrush and neither have worked.
Yes I think thats what they told me they were giving me! One injection in the buttock.
update: after another visit to the dermatologist, he believes all my symptoms point to a failure of treatment due to the steroids causing my immune system to falter. They’re giving me another 2 shots of penicilin G at weekly intervals and hoping this clears things up. I’ll also be retested for syphilis and HIV in three weeks time.
Hmmm not completely sure about that , as when we are treating for neurosyphilis, there is a steroid lead in for 3 days to prevent a paradoxical reaction - and this doesnt cause treatment failure.
Regardless, a retreatment is reasonable. Lets see if it works. keep us updated
also yes I remember you saying - I mean maybe he just wants to see if there has been any change whatsoever I’m not sure. To be honest I’m more concerned about getting retested for HIV to really rule that out because with so many symptoms I can’t help but be anxious that that is what it is
P.P.S - even after two rounds of treatment (currently on my third) I still have persistent oral thrush / tongue sores. Another complication that scares me about HIV / treatment failure
honestly at this point I have absolutely no idea haha the symptoms seem to be not improving / multiplying in different areas with no explanation so I’m willing to try anything even though the injection HURTS. Haha. I also developed a papule on my scrotum and lesions on my penis shaft.. just to top it all off. It seems never ending
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