Hello, I have a patient. New to me. Came back positive for RPR and positive trep confirmatory test. Current titer 1:8. He was treated in the 80’s trying to get his notes from his previous doc. He has no symptoms. I did a physical examination negative. He was negative for STDS, HIV, and HEP. Hx included MSM. No intimacy for the last two years including oral Any guidance helpful. Thanks
These ones are tricky. If he has had adequate treatment, then repeat the test in 3 months. If unsure about his previous treatment then retreat with full latent course of Ben Pen 2.4MU IM, once a week for three weeks (no allergies). Sometimes patients want to retreat just in case. Good luck.
great and informative. What is the interpretation of a test with an RPR test result of reactive, an RPR Titer of 1:1 and a Treponemal Pallidum AB test result of negative? Local NP insistent that it is a POSITIVE result
Sounds like a false positive if the TPPA or TPAB is negative as these tests are more specific for syphilis. The total antibody should also help, but this is a general test and can be turned positive by tropical infections like Yaws or Pinta. If you have a sexual history which is considered high risk, then in my clinic we would treat, just I'm case. I hope that is helpful. Take care.
Dr.. I wish to ask a question I’m 75 yrs.old my maternal grandmother was 15 in 1910 she and her (3) older sisters left their abusive fathers home and rented a house in Webb City ,Mo. …the girls lived near a mining field .the girls alleged they were taking in laundry for miners..however it is known the girls were b
@@DrBretPalmer Thanks Doc, its been a year now since I dont have any contact, now I am more cautious, I hope that theres a way to remove this Treponeme antibodies in my system
Hi doctor, I was treated for syphilis last year with six shots of benzathine Penicillin. I did the RpR test with titer last week and it says slightly reactive. Any possibility the treatment didn’t work? If so, will I start another treatment?
Hello Dr Palmer. I went to hospital to do a VDRL after treatment a month ago. And my lab results says REACTIVE 1:32 dilution. What does it mean? Is it going down?
What was the first result? The result you are reporting reacts slowly to syphilis treatment. What was your first results.... before Treatment? You'll need another blood test in 3 months and your sexual partners will need testing and treatment. Good luck Dr Bret Palmer
@@DrBretPalmer Before treatment it was REACTIVE 1:1. And after my treatment last October I went to check my blood again at November and it's REACTIVE 1:32.
Was the treatment 2.4MU of Ben pen, given as a split injection? If so this is more likely to be a delayed rise, and needs to be repeated. The health centre you went to should bring you in for repeat bloods. Hope this helps. Dr Bret Palmer
No, most likely a delayed reaction, unless your sexual history means it needs to be repeated.... e.g. sex with the same people as previous and they haven't been treated. Kind regards Dr Bret Palmer
If it has dropped substantially, then this could be your serofast level. You will need to repeat the blood test in 3 to 6 months time to ensure this is your level.. but looking good.
Good question. Unfortunately you can get false positives or false negatives in all tests but the TPPA is considered to be most reliable and give the lowest rates of false positive results.
Hello doctor i did an antibody test and that was non reactive tppa negetive rpr non reactive im just worried this isnt accurate after 15 years of testing
If your TPPA is negative then its negative. Nothing to worry about. If you have signs or symptoms then see a doctor for other medical diagnosis. If you've done the test multiple times, then it's probably a true negative 👍 Take care
@@DrBretPalmer im just worried about the time i was exposed to the time i have been tested im scared if i have no more antibodies or they have diminished. The last test i did was CMIA testing
Hello Doc.....my 1st test after treament was....RPR with dilution is /=1.80 + Does having history of syphilis will cause me unfit to work for having medical screening for working abroad? Hoping to hesr your advises and answer guys....stay safe.
Hi there Red Sparrow. Usually not. How ever it depends on your work and where you work. When you go for a screen the syphilis result will always be positive but if the RPR is neat (as in this case) or even negative then all is good. If it rises a fair bit then you would need to be retreated but this would only occur if you get re-infected. I don't know many places that test for syphilis as part of an occupational health screen. However all countries operate differently and if they test they probably just want to make sure you've been treated. Best of luck with any applications
@@DrBretPalmer Me i had been discriminate of getting work due to having history of treated syphilis, once is bound to Cyprus and bound to KSA, they dont accepting with history of syphilis
No. If you've been treated most countries will accept this, you'd have to see which countries have syphilis on their visa application, most countries don't.
@@DrBretPalmer Doc it was the reality, there’s still stigma when it comes to STI, they don’t acknowledge that you had been treated already, do you have email address? I’ll show you my medical result that they declared me Unfit to work because of guideline not because I’m medically unfit
Doctor, I have a question in relations to epididymo orchitis. If my blood and urine tests results were clean for STDs and bacterial/viral infection, but I had a fever, does that mean i can rule out infection as the cause of epididymo orchitis? I am confused because my tests came back clean, yet I still had a fever.. any thoughts?
Many things can cause a fever. Are your testicles painful? If do wear something supportive and rest. If testicles still getting worse then see a sexual health doctor. Sometimes can be an infection that's not sexual transmitted. E.g. bacteria from the mouth that has got into the wrong place.
Hi there. An RPR of 117 is high but also an odd figure. Due to the way RPR is calculated, RPRs should be even. RPRs always double. E.G.: Neat, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, 1:124 etc If youce never been treated for syphilis then you need to be treated.... if this us your first test then you'll need the extended course. Take care. Dr Bret Palmer
@@DrBretPalmer Hello doctor, I checked a few months ago and got the result 1.2. RPR, I took 3 doses of penicillin and took an oral antibiotic for a month of examination, and the result came out 117.0000
@@DrBretPalmer And now I have a rash on my back shoulders and I have sores on the human back and inside the palate on both sides above the teeth and the pain in the legs
my test report shows non-treponemal non reactive250.0 or 0.025 i cant understand which one is it but can you help me interpret that report please doctor .. 😄
Hi there. If you are testing for syphilis then usually would have an antibody test, which is positive and negative. A treponemal test.... which appears to be positive. Then an RPR level, usually a ratio, this isn't included. Do you have this result? Also which country are you in?
unfortunately .i didnt get to see my report the doctor said not to worry now and gave me a paper where there were only 2 things which i mentioned above and i live in south korea..and also i was diagnosed by syphilis 6 months ago
sorry i forgot to mention yeah i got penicillin 2 at once for 3 times in week intervals ..yes both got treated ..and this was the report from after 6 months of the treatment i told the doctor about past syphilis and treatment but i dont know which test i went through... i dont even know what the report means i just wanted to confirm if i have to get another test?
In the UK, you'll get retested in another 6 months. You may have to ask your doctor what the RPR level was (usually given as a ratio or if you are lucky will say 'Neat' or 'Negative'.
You'll need to watch the full syphilis video. In short this could be a new infection or an old infection. Either way need an extensive sexual history. If unsure then will need to be treated. Hopefully helpful Kind regards Bret
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thanks D.R Bret Palmer, you did explain everything about Syphilis very well
Thank you
Hello, I have a patient. New to me. Came back positive for RPR and positive trep confirmatory test. Current titer 1:8. He was treated in the 80’s trying to get his notes from his previous doc.
He has no symptoms. I did a physical examination negative. He was negative for STDS, HIV, and HEP. Hx included MSM. No intimacy for the last two years including oral
Any guidance helpful. Thanks
These ones are tricky.
If he has had adequate treatment, then repeat the test in 3 months.
If unsure about his previous treatment then retreat with full latent course of Ben Pen 2.4MU IM, once a week for three weeks (no allergies).
Sometimes patients want to retreat just in case.
Good luck.
thank you@@DrBretPalmer
great and informative. What is the interpretation of a test with an RPR test result of reactive, an RPR Titer of 1:1 and a Treponemal Pallidum AB test result of negative? Local NP insistent that it is a POSITIVE result
Sounds like a false positive if the TPPA or TPAB is negative as these tests are more specific for syphilis.
The total antibody should also help, but this is a general test and can be turned positive by tropical infections like Yaws or Pinta. If you have a sexual history which is considered high risk, then in my clinic we would treat, just I'm case.
I hope that is helpful.
Take care.
Dr.. I wish to ask a question I’m 75 yrs.old my maternal grandmother was 15 in 1910 she and her (3) older sisters left their abusive fathers home and rented a house in Webb City ,Mo. …the girls lived near a mining field .the girls alleged they were taking in laundry for miners..however it is known the girls were b
Doctor why my Rpr turns non reactive while my Vdrl test still reactive
VDRL is life long, RPR is reactivity, depends on age and other illnesses.
Sounds like you've had successful syphilis treatment.
@@DrBretPalmer oh thanks i got 3 times shot weekly interval of 2.4million units of Pen G but also my TPHA test remains reactive ,
@revz27 it will do, usuallyfor life, but you've got the right treatment. And RPR is negative which is good 👍
@@DrBretPalmer Thanks Doc, its been a year now since I dont have any contact, now I am more cautious, I hope that theres a way to remove this Treponeme antibodies in my system
@revz27 no they stay. But sounds like you've cleared the infection
Hi doctor, I was treated for syphilis last year with six shots of benzathine Penicillin. I did the RpR test with titer last week and it says slightly reactive. Any possibility the treatment didn’t work? If so, will I start another treatment?
Hello Dr Palmer. I went to hospital to do a VDRL after treatment a month ago. And my lab results says REACTIVE 1:32 dilution. What does it mean? Is it going down?
What was the first result?
The result you are reporting reacts slowly to syphilis treatment.
What was your first results.... before Treatment?
You'll need another blood test in 3 months and your sexual partners will need testing and treatment.
Good luck
Dr Bret Palmer
@@DrBretPalmer Before treatment it was REACTIVE 1:1. And after my treatment last October I went to check my blood again at November and it's REACTIVE 1:32.
@@DrBretPalmer Do I need to have penicillin shots again sir?
Was the treatment 2.4MU of Ben pen, given as a split injection?
If so this is more likely to be a delayed rise, and needs to be repeated. The health centre you went to should bring you in for repeat bloods.
Hope this helps.
Dr Bret Palmer
No, most likely a delayed reaction, unless your sexual history means it needs to be repeated.... e.g. sex with the same people as previous and they haven't been treated.
Kind regards
Dr Bret Palmer
Sir i had tested yesterday result is 1:4 what it mean
Is it normal??
If it has dropped substantially, then this could be your serofast level. You will need to repeat the blood test in 3 to 6 months time to ensure this is your level.. but looking good.
Sir is it curable ??
How many weeks it takes to increase from 1:4 to 1:8
Is it possible to be negative for FTA-ABS even if you are positive for TPHA?
Good question.
Unfortunately you can get false positives or false negatives in all tests but the TPPA is considered to be most reliable and give the lowest rates of false positive results.
@@DrBretPalmer thank you Doc. For answering my questions 😇
Hello doctor i did an antibody test and that was non reactive tppa negetive rpr non reactive im just worried this isnt accurate after 15 years of testing
If your TPPA is negative then its negative. Nothing to worry about.
If you have signs or symptoms then see a doctor for other medical diagnosis.
If you've done the test multiple times, then it's probably a true negative 👍
Take care
@@DrBretPalmer im just worried about the time i was exposed to the time i have been tested im scared if i have no more antibodies or they have diminished. The last test i did was CMIA testing
What does this result mean?Rapid Plasma Reagin (RPR/VDRL), Serum 117.0000
Hello Doc.....my 1st test after treament was....RPR with dilution is /=1.80 +
Does having history of syphilis will cause me unfit to work for having medical screening for working abroad?
Hoping to hesr your advises and answer guys....stay safe.
Hi there Red Sparrow.
Usually not. How ever it depends on your work and where you work.
When you go for a screen the syphilis result will always be positive but if the RPR is neat (as in this case) or even negative then all is good. If it rises a fair bit then you would need to be retreated but this would only occur if you get re-infected.
I don't know many places that test for syphilis as part of an occupational health screen.
However all countries operate differently and if they test they probably just want to make sure you've been treated.
Best of luck with any applications
@@DrBretPalmer Me i had been discriminate of getting work due to having history of treated syphilis, once is bound to Cyprus and bound to KSA, they dont accepting with history of syphilis
No. If you've been treated most countries will accept this, you'd have to see which countries have syphilis on their visa application, most countries don't.
@@DrBretPalmer Doc it was the reality, there’s still stigma when it comes to STI, they don’t acknowledge that you had been treated already, do you have email address? I’ll show you my medical result that they declared me Unfit to work because of guideline not because I’m medically unfit
@revz27 that's terrible. What country do you live in?
Doctor, I have a question in relations to epididymo orchitis. If my blood and urine tests results were clean for STDs and bacterial/viral infection, but I had a fever, does that mean i can rule out infection as the cause of epididymo orchitis? I am confused because my tests came back clean, yet I still had a fever.. any thoughts?
Many things can cause a fever.
Are your testicles painful? If do wear something supportive and rest. If testicles still getting worse then see a sexual health doctor.
Sometimes can be an infection that's not sexual transmitted. E.g. bacteria from the mouth that has got into the wrong place.
Rapid Plasma Reagin (RPR/VDRL), Serum 117.0000
Hi there.
An RPR of 117 is high but also an odd figure. Due to the way RPR is calculated, RPRs should be even.
RPRs always double. E.G.:
Neat, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, 1:124 etc
If youce never been treated for syphilis then you need to be treated.... if this us your first test then you'll need the extended course.
Take care.
Dr Bret Palmer
@@DrBretPalmer Hello doctor, I checked a few months ago and got the result 1.2. RPR, I took 3 doses of penicillin and took an oral antibiotic for a month of examination, and the result came out 117.0000
@@DrBretPalmer And now I have a rash on my back shoulders and I have sores on the human back and inside the palate on both sides above the teeth and the pain in the legs
Hummm are you sure that's not an antibody level?
@@DrBretPalmer Test Result Units Reference Range
Rapid Plasma Reagin (RPR/VDRL), Serum 117.0000 Negative
METHODOLOGY: Flocculation
my test report shows
non-treponemal non reactive250.0 or 0.025 i cant understand which one is it
but can you help me interpret that report please doctor .. 😄
Hi there.
If you are testing for syphilis then usually would have an antibody test, which is positive and negative. A treponemal test.... which appears to be positive. Then an RPR level, usually a ratio, this isn't included.
Do you have this result? Also which country are you in?
unfortunately .i didnt get to see my report the doctor said not to worry now and gave me a paper where there were only 2 things which i mentioned above and i live in south korea..and also i was diagnosed by syphilis 6 months ago
I assume you was treated?
Injection or tablet?
Was your partner treated as well?
sorry i forgot to mention yeah i got penicillin 2 at once for 3 times in week intervals ..yes both got treated ..and this was the report from after 6 months of the treatment i told the doctor about past syphilis and treatment but i dont know which test i went through... i dont even know what the report means i just wanted to confirm if i have to get another test?
In the UK, you'll get retested in another 6 months.
You may have to ask your doctor what the RPR level was (usually given as a ratio or if you are lucky will say 'Neat' or 'Negative'.
Tpha positif =80ui/ml
Vdrl negativ = 00
???? Thx doc
You'll need to watch the full syphilis video.
In short this could be a new infection or an old infection.
Either way need an extensive sexual history. If unsure then will need to be treated.
Hopefully helpful
Kind regards
Bret
2
helo doc.how about in VDRL lab.results for pregnant are reactive syphilis it means that positive?
Yeap
Is there a posiblility for both RPR and VDRL to turm negative after 3 shots of Penicillin benzate?
Yes it is possible. They both can turn negative if left long enough or if treated super early.