Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Treponema pallidum — Syphilis

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 30 October 2026 · Methodology

Treponemataceae · Spirochaete

"The great imitator" — recrudescence majeure en France depuis 2010 (Santé Publique France). Stades : primaire (chancre indolore auto-résolutif), secondaire (roséole syphilitique + alopécie + plaques muqueuses), tertiaire (gommes, syphilis cardiovasculaire, tabès, paralysie générale) ; l'atteinte du SNC peut survenir à tout stade. Sérologie : TPHA/VDRL ou TPPA/RPR — tests tréponémiques + non-tréponémiques. ATB : benzathine-pénicilline G IM dose unique (primaire/secondaire), 3 injections (duration not verified) (latente tardive), pénicilline G cristalline IV (duration not verified) (neurosyphilis, syphilis oculaire) — see cited source. Maladie à DO (déclaration aux autorités sanitaires).

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Treponema pallidum are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Skin — Chancre + roséole	High tropism	Evidence C	1	direct
Central nervous system — Neuro-syphilis	High tropism	Evidence C	1	hematogenous
Eye — Syphilis oculaire	Moderate tropism	Evidence B	2	hematogenous
Aorta — Syphilis cardiovasculaire	Moderate tropism	Evidence C	1	hematogenous
Bones / Joints — Ostéite syphilitique	Rare tropism	Evidence C	1	not recorded

Described portals of entry

• Skin

Spread routes recorded: 4 of 5 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Sources

• Ghanem KG, Ram S & Rice PA — The modern epidemic of syphilis (2020) — doi:10.1056/NEJMra1901593
• Workowski KA et al. — CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep) (2021) — doi:10.15585/mmwr.rr7004a1

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