Syphilis EIA IgM/IgG Screen 6 weeks after lesion on penis foreskin and 82 days after potential exposure.

[lt2929]

Hello

I had protected sex, but I know at one point the condom rolled up my shaft. Status of female is unknown, but considered a high risk group.

At 5 weeks and 6 days after, I had a small open sore on my foreskin, an area possibly not covered, about 5mm oval. It wasn't hard or indurated, it was flat, and healed to fresh pink skin after 5 days or so. A Dr at the GUM clinic swabbed it, it was negative and said it didn't look like Syphilis. It healed fully to a small scar within 9 days. They said it looked like skin trauma, the day it appeared my foreskin was burning in the shower, it wasnt there at that point.

I have had multiple trepenomal EIA tests in the 6 weeks since this lesion appeared all negative, with the latest being a self collection kit that does a screen for Syphilis Total Antibodies. This was 82 days after exposure.

I also had a blood draw from vein at 5 weeks 2 days post exposure, test performed by The Doctors Laboratory for Syphilis IgM/IgG by EIA. Only issue here, the sample was delayed by 5 days albeit refridgerated, assured this wasnt an issue but cant shake idea that antibodies might have disolved. And I was pinning a lot on this test as it was from vein and was from TDL.

My question is, can I consider my blood test results conclusive given I have repeated screening up to 6 weeks past the onset of the lesion and 82 days post exposure.

Surely, by now I should have at least IgM antibodies detectable, I am an otherwise healthy male.

The Bashh guidlines and British Medical Journel recommend repeat screening 2-4 weeks following suspected lesion. Only issue here is I did test at 2 weeks and 4 weeks, not inbetween/within

The anxiety is too much, should I test at 13 weeks, 15 weeks, 6 months. Because I know I need to stop testing at some point and move on.

Should I do another test with blood from vein vs self collection screening test.

Most places say that even the less sensitive vdlr/rpr only take up to 4 weeks to turn positive after possible chancre onset, so surely these EIA screens should be conclusive by now either from vein or from finger collection kit.

What is the max timeframe from a suspected chancre onset to EIA trepenomal bloodtest positivity in otherwise healthy individuals.

Could I have slowed antibody formation by not eating, sleeping, anxiety in the first two weeks as I was having extreme stress, panic attacks etc.

For argument sake, assuming that this was a highest risk exposure, even in that event, is 6 weeks post onset of a suspected chancre and 82 days post exposure enough to rule out Syphilis with my tests

Please help

Thanks

[Prxncexsss]

just get check one last time

[Galen70]

To me the major issue here appears to be your anxiety around syphilis , which is a totally cureable infection, rather than the likelihood of the infection itself. If your sexual contact was within the UK , where the prevalence of syphilis in heterosexuals is very low , and also if you used a.condom , the chance of you even being exposed to syphilis is very very small. Current BASHH guidelines are four weeks and sometimes 3 months if antibiotics might have muddled the picture. So your negative tests so far should.reassure you , you should do a final test around 12 weeks , and then put this behind you.

[lt2929 in reply to Galen70]

Hi Galen,

Thanks for your reply.

I have not had any antibiotics.

Are you saying 4 weeks and 12 weeks after exposure. In which case my test at 82 days is almost 12 weeks. I have just done another today, which would be 7 weeks 1 day after the onset of the lesion.

Or are you saying 4 weeks and 12 weeks following the onset of the chancre. In which case for me, I would need a test 18 weeks after exposure. 5 weeks from now, which I hope is not the case.

Where in the guidlines do you see that?

Thanks

[Galen70 in reply to lt2929]

I'm sorry you didn't have a chancre. You had a skin change on your genitals. No test has proven it is syphilis. And you havent mentioned where the contact was , and therefore the risk . Even heterosexual sex workers in the UK have a low prevalence of syphilis .

[Galen70 in reply to Galen70]

The 2015 guidance says 4 and 12 weeks from the possible exposure risk .

[Galen70 in reply to Galen70]

Remember many people who acquire syphilis have no symptoms at all. So screening must be from the time of the exposure risk .