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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