From:------- ny --uang-----
To: DR. Gian
Sent: Sunday, November 02, 2003 6:22 PM
Subject: Your answers and help are really appreciated
Dr. Gian:
Thanks for your time reading this message and appreciate your
explanation. I have learned your name from internet.
I am a 40 years old male, only have sex with female. Few weeks ago, I
had cramp on my left leg in one night, few days later after the cramp, I
had swollen joint on my left leg. I went to medical service. Dr gave
me X ray, X ray showed the joint of the bone was OK. Only the tissue was
swollen. Then the Dr. had drawn the fluid from the swollen tissue and
had "Culture test". At the same day, Dr. gave me penecillim and oral
medication.
A week after, the report showed "no bactria" on the "Culture test", then
I had blood test "FTA ABS", one week after the blood test, it
was reactive. I discussed the case with Dr. about the STD symptoms, I
had no recall anything irregular within this 10-20 years such as
"Chancre", or "yellow discharge". Then, I had "VDRL" test again, the
result showed 1:32 dilute. Now I am taking the medication and injection
of penicillim.
I was confused why "culture test" result was different from "blood
test"? By reading a lot of STD informations, it seems like that the
"Swollen knees" is gonorhea's symptoms. Can the the blood test of
positive of the FTA-ABS and VDRL be related to and affected by the
gonorhea due to the gonorhea entering into the blood stream?I was involved with multi sex partners before, but I always used
condoms. Within this one year, I had sex with only two
females , I already honestly told them to have medical check-up. This is
a big and expensive lesson for me.
Can you please explain to me why the "culture test" is nothing, but VDRL
and FTA-ABS is positive. I really appreciate your time and answers,
also, please advise the follow-up monitoring/treatment as well.
Best Regards,
J.
Hi J,
So let’s see if I can help clear up the situation. According to your
description the phenomena are two:
1) You have a positive test for Syphilis screening ( VDRL)
confirmed
with a positive FTA-ABS for Syphilis.
2). You had a swollen joint with a negative culture.
Your Doctor might have suspected a Gonorrhea infection associated with
your Syphilis infection and in particular what is called Disseminated Gonococcemia which follows the primary genital infection with
Gonorrhea by several days to 2 weeks. The infection spreads from the primary site
through the bloodstream and causes 90% of times an inflammation of a
single joint (Arthritis) which is why it is called Gonococcal Arthritis
Question. Did you have symptoms of Gonorrhea one-two weeks prior to the
swollen joint such as frequent urination, milky drainage, burning on
urination? Did you receive a test for Gonorrhea? It seems to me that
your Doctor made a presumptive diagnosis and treated you also for
Gonorrhea given the presence of a positive Syphilis test, the swollen
joint and your history of promiscuous sexual activity. This is fine and
appropriate. Don’t forget that there are almost 400,000 cases of
Gonorrhea reported to the CDC (Centers for Disease Control and
Prevention) each year in the United States. There are probably many
cases that are treated but not reported. The total number of cases is
thought to approach 1,000,000 and if unreported cases are included, some
estimates reach 2,000,000. A rate of 400,000 cases per year means that 1
out of every 687 Americans has gonorrhea. A rate of 2 million means that
1 in every 130 Americans are infected.
However J, you also need to know that there are many other explanations
for a swollen joint which are totally unrelated to the presence of a
Sexually Transmitted Disease. So to clear this matter you need to have
more info from your Doc who was looking for two separate but possibly
concomitant infections. The culture was done for Gonorrhea and the blood
test for Syphilis. They tests are unrelated and the presence of
Gonorrhea does not cause a positive test for Syphilis.
Now what about the positive Syphilis test? That’s not good news, isn’t
it? However if you caught in the first stage and you received the
recommended treatment the disease is curable. The Doctor did and will do
repetitive titers of the Syphilis test to see if the disease is still
active or not. Good for you for the changes you will be making in your
life as a consequence of this event. Learning often requires making and
acknowledging mistakes. And you did the right thing communicating the
situation to your partners.
Move on.
Dr. Gian
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From: BRENDA -------------
To: info@stdweb.com
Sent: Sunday, November 16, 2003 4:43 PM
Subject: Syphilis
Hello Doctor,
My father recently passed away with the diseas Syphilis. I am in total
shock, he was positive according to his doc and the blood test. I have a
serious ecezema problem and have had this for a number of years. Could
this have been passed on to me if my mom had of been pregnant at the
time?
Thanks
Brenda
Hi Brenda,
I doubt. The situation would have required your mother to be infected,
be seropositive and untreated for syphilis and you be the case of infant
with congenital syphilis. Since I assume you are seeing already a doctor
for your eczema ask him/her to do a serology test for
syphilis or do one
with STDWeB if you need confidentiality. Remember, action is the thing,
not worrying!
Be well.
Dr. Gian
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