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href="https://www.sida-info-service.org/categorie/questions-frequentes/" class="taxonomy category"><span property="name">Questions fr茅quentes</span></a><meta property="position" content="2"></span> > <span property="itemListElement" typeof="ListItem"><a property="item" typeof="WebPage" title="Se rendre 脿 la cat茅gorie Questions fr茅quentes IST." href="https://www.sida-info-service.org/categorie/questions-frequentes/foire-aux-questions-ist/" class="taxonomy category"><span property="name">Questions fr茅quentes IST</span></a><meta property="position" content="3"></span> > <span property="itemListElement" typeof="ListItem"><span property="name">La syphilis, c’est quoi ?</span><meta property="position" content="4"></span> </div> <div class="col-md-8 col-sx-12"> <div class="content_global"> <article id="post-4117" class="post-4117 post type-post status-publish format-standard hentry category-les-infections-sexuellement-transmissibles-ist category-foire-aux-questions-ist tag-chancre tag-ist tag-syphilis tag-verole"> <header class="entry-header"> <div class="barre_action pull-right">  </div> <div class="entry-footer"> <div class="col-md-12 no-padding article-header"> <div class="col-md-4 col-sm-12 col-sx-12 text-left no-padding-left publish"><span>Publi茅 le : </span>22 mars 2017</div> <div class="col-md-4 col-sm-12 col-sx-12 text-left update-for"><span>Mise 脿 jour le : </span> 5 f茅vrier 2024 </div> <div class="col-md-4 col-sm-12 col-sx-12 text-right action_size no-padding-right"> <ul> <li> <a href="#" onclick="changeFontSize(1);return false;" title="Agrandir les caract猫res">A+</a> </li> <li> <a href="#" onclick="changeFontSize(-1);return false;" title="R茅tr茅cir les caract猫res">A-</a> </li> <li> <a href="#" onclick="resetFontSize(); return false;" title="Taille normale des caract猫res">A</a> </li> </ul> </div> </div> <div class="tagged text-center"> <a href="https://www.sida-info-service.org/tag/chancre/" rel="tag">chancre</a> <a href="https://www.sida-info-service.org/tag/ist/" rel="tag">IST</a> <a href="https://www.sida-info-service.org/tag/syphilis/" rel="tag">syphilis</a> <a href="https://www.sida-info-service.org/tag/verole/" rel="tag">v茅role</a> </div> </div> <h1 class="entry-title">La syphilis, c’est quoi ?</h1>  </header> <div class="entry-content"> <div class="picture_une"> </div> <div id="pl-4117" class="panel-layout" ><div id="pg-4117-0" class="panel-grid panel-no-style" ><div id="pgc-4117-0-0" class="panel-grid-cell" ><div id="panel-4117-0-0-0" class="so-panel widget widget_sow-editor panel-first-child" data-index="0" ><div class="so-widget-sow-editor so-widget-sow-editor-base" > <div class="siteorigin-widget-tinymce textwidget"> <p>Maladie v茅n茅rienne embl茅matique, la syphilis, ou 芦 v茅role 禄, est une infection bact茅rienne (<em>Treponema Pallidum</em> ou tr茅pon猫me p芒le) tr猫s ancienne, responsable de l茅sions de la peau et des muqueuses pouvant toucher de nombreux organes.</p> <p>Ramen茅e d鈥橝m茅rique du Sud par l鈥櫭﹒uipage de Christophe Colomb, la v茅role se r茅pand en Europe 脿 l鈥檕ccasion du si猫ge de Naples par Charles VIII (1494).</p> <p>Il ne faut pas confondre avec la "petite v茅role" qui d茅signait la variole.</p> </div> </div></div><div id="panel-4117-0-0-1" class="so-panel widget widget_ink-accordion" data-index="1" ><div class="so-widget-ink-accordion so-widget-ink-accordion-accordion-f6bc6cd48459-4117" > <div class="iw-so-accordion-plain iw-so-accordion iw-so-acc-singleExpand iw-so-acc-toggle"> <div class="iw-so-acc-item" id="toggle-1-1"> <a href="#" class="iw-so-acc-title iw-text-left"> Transmission de la syphilis <span class="iw-so-tgl-open"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> <span class="iw-so-tgl-close"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> </a> <div class="iw-so-acc-content"> <p>La transmission de la syphilis peut se faire par :</p> <ul> <li>Contact direct avec une muqueuse ou des l茅sions cutan茅es, le tr茅pon猫me ne survivant pas 脿 l鈥檃ir libre,</li> <li>Rapports sexuels non prot茅g茅s : p茅n茅tration vaginale, p茅n茅tration anale, rapports bouche-sexe,</li> <li>Risque de transmission 茅lev茅 de l鈥檕rdre de 30% sur un seul rapport. Le risque est maximal pendant la 1猫re ann茅e (p茅riode pr茅coce), les tr茅pon猫mes 茅tant pr茅sents d鈥檃bord sur le chancre, puis 脿 la surface des l茅sions de la peau et surtout des muqueuses.</li> </ul> <p>La transmission peut avoir lieu :</p> <ul> <li>Au cours de la syphilis primaire : chancre, ulc茅ration isol茅e ou plaie syphilitique, ou simple contact muqueux,</li> <li>Au moment des 茅ruptions de la syphilis secondaire : l茅sions cutan茅es et au niveau des muqueuses.</li> </ul> <p>La <strong>transmission m猫re-enfant</strong> constitue un risque majeur pour le f艙tus (mort <em>in utero</em>), ou gravissime chez le nouveau-n茅. C'est pourquoi le <strong>d茅pistage de la syphilis est obligatoire</strong> chez la femme enceinte.</p> </div> </div> </div> </div></div><div id="panel-4117-0-0-2" class="so-panel widget widget_ink-accordion" data-index="2" ><div class="so-widget-ink-accordion so-widget-ink-accordion-accordion-f6bc6cd48459-4117" > <div class="iw-so-accordion-plain iw-so-accordion iw-so-acc-singleExpand"> <div class="iw-so-acc-item" id="toggle-2-1"> <a href="#" class="iw-so-acc-title iw-text-left"> Sympt么mes de la syphilis <span class="iw-so-tgl-open"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> <span class="iw-so-tgl-close"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> </a> <div class="iw-so-acc-content"> <p>Les <strong>sympt么mes</strong> cliniques peuvent 锚tre tr猫s <strong>vari茅s</strong>, ce qui peut rendre le diagnostic difficile. L'incubation dure 21 jours en moyenne (de 10 脿 90 jours).</p> <p>La syphilis comporte plusieurs stades :</p> <ul> <li><strong>Primaire</strong> qui dure 6 脿 8 semaines. Un chancre et une ad茅nopathie peuvent appara卯tre sans pour autant 锚tre visibles. Le chancre peut appara卯tre 20 jours en moyenne (10 脿 100 jours) apr猫s le contact, au point d鈥檌noculation (d鈥檕霉 les formes extra-sexuelles). Il s'agit d'une ulc茅ration indolore, superficielle et bien limit茅e, d'un diam猫tre de 5 脿 15mm. Il 茅volue pendant une quinzaine de jours, puis dispara卯t. Le chancre grouille litt茅ralement de tr茅pon猫mes, d鈥檕霉 sa grande contagiosit茅.</li> </ul> <ul> <li><strong>Secondaire</strong> qui survient environ de 6 脿 16 semaines apr猫s la contamination et dure en moyenne 1 脿 2 ans. Le tableau clinique est tr猫s variable, les l茅sions pouvant rev锚tir toutes sortes d鈥檃spects et 锚tre en nombre variable (de quelques-unes 脿 plusieurs centaines).</li> </ul> <p>La syphilis <strong>latente</strong> (ou s茅rologique) pr茅coce est d茅couverte fortuitement, au cours d鈥檜n test s茅rologique, sur une syphilis d鈥櫭﹙olution inf茅rieure 脿 1 an. 30 % des syphilis sont diagnostiqu茅es 脿 ce stade.</p> <p>La syphilis <strong>tertiaire</strong> est devenue <strong>rarissime</strong>. Elle survient vers la 3<sup>猫me</sup> ann茅e (de 2 脿 plus de 10 ans). Elle peut provoquer des l茅sions neurologiques, cutan茅es, des troubles cardio-vasculaires. Elle est connue pour les troubles psychiatriques qui ont 茅t茅 beaucoup d茅crits dans la litt茅rature ancienne.</p> </div> </div> </div> </div></div><div id="panel-4117-0-0-3" class="so-panel widget widget_ink-accordion" data-index="3" ><div class="so-widget-ink-accordion so-widget-ink-accordion-accordion-f6bc6cd48459-4117" > <div class="iw-so-accordion-plain iw-so-accordion iw-so-acc-singleExpand"> <div class="iw-so-acc-item" id="toggle-3-1"> <a href="#" class="iw-so-acc-title iw-text-left"> D茅pistage de la syphilis <span class="iw-so-tgl-open"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> <span class="iw-so-tgl-close"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> </a> <div class="iw-so-acc-content"> <p>Le d茅lai pour le d茅pistage est d'environ 5 semaines. La s茅rologie (par prise de sang) peut se positiver au plus t么t 7 脿 10 jours apr猫s l鈥檃pparition du chancre. Avant 7 脿 10 jours, le diagnostic peut 锚tre pos茅 gr芒ce 脿 l鈥檈xamen direct en cas de l茅sion.</p> <p>Le d茅pistage se fait en 2 茅tapes :</p> <ol> <li>Tests tr茅pon茅miques (TT), en g茅n茅ral TPHA (<em>Treponema pallidum Hemagglutination Assay</em>). D茅tectent des anticorps dirig茅s contre des antig猫nes du tr茅pon猫me qui persistent m锚me apr猫s disparition du tr茅pon猫me. Ils restent le plus souvent positifs apr猫s traitement et se positivent entre 1 semaine et 10 jours apr猫s le d茅but du chancre. Si le r茅sultat est n茅gatif, le d茅pistage s鈥檃rr锚te l脿. S'il est positif, on passe 脿 l鈥櫭﹖ape 2,</li> <li>Tests non tr茅pon茅miques (TNT) soit VDRL (<em>Veneral Disease Research Laboratory</em>). Ils ont pour caract茅ristique de devenir n茅gatifs le plus souvent apr猫s traitement. Un r茅sultat quantitatif est utile pour faire la distinction entre une syphilis active et une cicatrice s茅rologique, et pour suivre l鈥檈fficacit茅 du traitement le cas 茅ch茅ant. Le VDRL se n茅gative en cas de gu茅rison, c鈥檈st donc un bon test de surveillance.</li> </ol> <p>Le suivi recommand茅 par la <a href="https://www.has-sante.fr/upload/docs/application/pdf/2017-03/dir3/argumentaire_syphilis.pdf" target="_blank" rel="noopener">Haute Autorit茅 de Sant茅 (HAS)</a> se fait selon le rythme suivant :</p> <ul> <li>En cas de syphilis pr茅coce, contr么le 脿 3, 6 et 12 mois, plus fr茅quemment chez les patients VIH positifs et la femme enceinte sans plus de pr茅cision,</li> <li>En cas de syphilis tardive, contr么le 脿 6, 12 et 24 mois.</li> </ul> </div> </div> </div> </div></div><div id="panel-4117-0-0-4" class="so-panel widget widget_ink-accordion panel-last-child" data-index="4" ><div class="so-widget-ink-accordion so-widget-ink-accordion-accordion-f6bc6cd48459-4117" > <div class="iw-so-accordion-plain iw-so-accordion iw-so-acc-singleExpand"> <div class="iw-so-acc-item" id="toggle-4-1"> <a href="#" class="iw-so-acc-title iw-text-left"> Traitement de la syphilis <span class="iw-so-tgl-open"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> <span class="iw-so-tgl-close"><span class="sow-icon-fontawesome sow-fas" data-sow-icon="" style="font-size: 2em; color: right" aria-hidden="true"></span></span> </a> <div class="iw-so-acc-content"> <p><strong>Syphilis pr茅coce</strong> : Benzathine benzylpenicilline, un antibiotique du groupe de la p茅nicilline : 1 injection IM (intra-musculaire) en dose unique.</p> <p>En cas d'allergie 脿 la p茅nicilline, le traitement se fera pas Doxycycline庐 100 mg 1cp 2x/jour pendant 14 jours au milieu des repas et au moins 1h avant de se coucher.</p> <p><strong>Syphilis tardive</strong> (plus d'un an) : le traitement reprend la Benzathine benzylpenicilline avec 1 injection IM par semaine pendant 3 semaines. En cas d'allergie et en l鈥檃bsence de neurosyphilis : Doxycycline庐 100 mg 1 cp 2x/jour pendant 21 jours au milieu des repas et au moins 1h avant de se coucher.</p> <p>La personne est consid茅r茅e comme gu茅rie, et donc non contaminante :</p> <ul> <li><strong>Syphilis pr茅coce</strong> : 7 jours apr猫s l鈥檌njection par Benzathine benzylpenicilline 脿 la fin des 14 jours de traitement par Doxycycline庐. Le pr茅servatif est toutefois recommand茅 pendant 7 ou 14 jours selon le traitement.</li> <li><strong>Syphilis tardive</strong> : 脿 la fin du traitement de 21 jours qu'il s'agisse de traitement par Benzathine benzylpenicilline ou par Doxycycline庐. 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</ul> </li> <li class="menu-item menu-item-type-taxonomy menu-item-object-category menu-item-has-children menu-item-6883"><a href="https://www.sida-info-service.org/categorie/questions-frequentes/droits/">Droits</a> <ul class="sub-menu"> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6887"><a href="https://www.sida-info-service.org/comment-obtenir-un-pret-malgre-la-maladie/">Assurance pr锚t immobilier et VIH</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-9830"><a href="https://www.sida-info-service.org/est-ce-qu-on-peut-refuser-de-m/">Peut-on refuser de m’embaucher si j’ai le VIH ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6890"><a href="https://www.sida-info-service.org/reveler-seropositivite-travail/">Dois-je r茅v茅ler mon VIH 脿 mon employeur ?</a></li> </ul> </li> <li class="menu-item menu-item-type-taxonomy menu-item-object-category menu-item-has-children menu-item-6237"><a href="https://www.sida-info-service.org/categorie/dossiers/">Dossiers VIH/Sida</a> <ul class="sub-menu"> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-88168"><a href="https://www.sida-info-service.org/dossier-tout-savoir-sur-le-tasp/">Le TasP, c’est quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6245"><a href="https://www.sida-info-service.org/kit-d-information-sur-l-infection/">Tout savoir sur le Sida</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-5738"><a href="https://www.sida-info-service.org/preservatifs/">Tout savoir sur les pr茅servatifs</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6268"><a href="https://www.sida-info-service.org/autotest-le-depistage-en-video/">Tout savoir sur l’autotest</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6247"><a 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menu-item-object-category current-post-ancestor current-menu-ancestor current-menu-parent current-post-parent menu-item-has-children menu-item-6917"><a href="https://www.sida-info-service.org/categorie/les-infections-sexuellement-transmissibles-ist/">IST</a> <ul class="sub-menu"> <li class="menu-item menu-item-type-post_type menu-item-object-post current-menu-ancestor current-menu-parent menu-item-has-children menu-item-7321"><a href="https://www.sida-info-service.org/definition-ist/">Une IST, c’est quoi ?</a> <ul class="sub-menu"> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-5903"><a href="https://www.sida-info-service.org/blennorragie-gonococcie-chaude/">La gonococcie, c鈥檈st quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-5967"><a href="https://www.sida-info-service.org/chlamydia-chlamidiose-chlamydiae/">Les chlamydiae, c鈥檈st quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post current-menu-item menu-item-6031"><a href="https://www.sida-info-service.org/la-syphilis-cest-quoi/" aria-current="page">La syphilis, c鈥檈st quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-5905"><a href="https://www.sida-info-service.org/hpv-papilloma-virus-humain/">Le HPV, c’est quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6030"><a href="https://www.sida-info-service.org/gardnerella/">Une vaginose 脿 Gardnerella, c鈥檈st quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6008"><a href="https://www.sida-info-service.org/herpes-genital-hsv-2/">L鈥檋erp猫s g茅nital, c鈥檈st quoi ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-5904"><a href="https://www.sida-info-service.org/mycose-candidose/">La mycose, c鈥檈st quoi ?</a></li> </ul> </li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-11508"><a href="https://www.sida-info-service.org/les-hepatites-sont-elles-des-ist/">Les h茅patites sont-elles des IST ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-8362"><a href="https://www.sida-info-service.org/une-ist-ca-peut-etre-grave-2/">Une IST, 莽a peut 锚tre grave ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6788"><a href="https://www.sida-info-service.org/les-ist-ne-sont-pas-a-negliger/">Se prot茅ger des IST ?</a></li> <li class="menu-item menu-item-type-post_type menu-item-object-post menu-item-6434"><a href="https://www.sida-info-service.org/comment-savoir-si-on-a-une-ist/">Comment diagnostiquer une IST ?</a></li> <li class="menu-item menu-item-type-taxonomy menu-item-object-category current-post-ancestor current-menu-parent current-post-parent menu-item-7330"><a 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