<s>[INST] Hello doc why is it that i have no pain or symptoms of syphillis but when i go for a medical my vdrl/tpha are reactive but this sickness was already treated ive done injectible by penicillin in 4 times once every wk in 1 mnth after this treatment my vdrl/tpha was non reactive my question why is it this sickness after a mnths it is reactive again? [/INST] you have got the wright medicaton  Penicillin is the treatment of choice for all stages of syphilis, with the type of penicillin and dosing based on clinical staging of the disease.Latent syphilis (ie, without symptoms) is detected by serological testing and is divided into early latent syphilis (acquired within the preceding year) and late latent syphilis or latent syphilis of unknown origin.Nontreponemal (RPR/VDRL) titers can be used to monitor treatment response. Successful treatment is associated with a 4-fold or two-tube decline in titer (ie, from 1:32 to 1:8) 6 months after therapy for primary or secondary syphilis and 1 year after therapy for latent syphilis. RPR and VDRL titers are not interchangeable or convertible, so it is important to use consistent testing with a single method to monitor disease activity. The treponemal (FTA-ABS/TP-PA) tests remain positive for the life of the patient regardless of therapy </s>