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Syphilis Reinfection RPR Rise — SCE Infectious Diseases MCQ

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HardSTIsSyphilis Reinfection RPR RiseSCE Infectious Diseases

After successful treatment of early syphilis, a patient had a stable RPR titre of 1:2. It is now 1:8 after a new sexual exposure. What does this change indicate?

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Correct answer: A — A fourfold RPR rise indicating reinfection or treatment failure

The best answer is “A fourfold RPR rise indicating reinfection or treatment failure”. A two-dilution, fourfold RPR increase is clinically significant and triggers exposure review, examination, HIV testing as appropriate and stage-directed retreatment. A sustained fourfold rise in non-treponemal titre after prior treatment supports reinfection or treatment failure and requires clinical reassessment and retreatment.

Reference: BASHH syphilis guideline: https://www.bashh.org/resources/25/syphilis_2024/