Treponematosis, also known as treponemiasis, refers to a group of nonvenereal diseases caused by Treponema species that are both morphologically and serologically similar. These include Treponema pallidum subspecies pallidum, which causes veneral syphilis. These diseases are transmitted through direct contact among children in warm arid climates, subtropical, or tropical climates. The pathogenic treponemes affecting humans are Treponema pallidum pallidum causing syphilis, Treponema pallidum endemicum causing endemic syphilis or bejel, Treponema carateum causing pinta, and Treponema pallidum pertenue causing yaws.
Epidemiology
Infection with Treponema pallidum subspecies pallidum mainly affects children, and children of endemic areas often become infected before reaching puberty. The US Centers for Disease Control and Prevention recommend that all refugee children coming from these countries be screened using a nontreponemal test at the time of initial health screening. According to a World Health Organization estimate in 1997, 460,000 new cases of endemic treponematosis occurred annually worldwide, with over 2.5 million persons currently infected. The disease predominantly affects children and is found in countries of the Middle East and the southern Sahara Desert. In Europe, the infection has been reported in immigrating children from endemic regions. Pinta, endemic to the Caribbean, Central America, and South America, is more frequently seen among young adults; yaws, a disease of the equatorial regions, requires high humidity and rainfall. The WHO estimated that endemic treponematoses, especially yaws, cause widespread disfigurement, disability, and economic hardship in poor countries. Successful pilot project in Haiti and the Dominican Republic related complete eradication of the disease because of mass use of penicillin. Because of the decrease in the focus on public health, it reappeared in the 1970s and 1980s. Treatment with either penicillin or azithromycin can achieve a cure rate of 95 to 97%. Treponematosis does not disclose any racial or sexual predilection.
Anatomy
Pathophysiology
Bejel and Yaws are transmitted among children through direct skin-to-skin contact with infectious lesions. Bejel can also spread through mouth-to-mouth contact or by sharing utensils for eating. Pinta is more frequently seen in older teenagers and children. Treponemes penetrate mucosal surfaces or damaged skin potentially presenting as ulcers or papules after a few weeks. The bacteria can spread both topically and through the blood stream and may heal on their own. In the secondary stage, after the treponemes have disseminated the disease may resolve spontaneously, persist or recur. Long-term effects can include multiple skin lesions and damage to cartilage or bone. The disease may enter a latent stage, but in some cases, it can progress to a tertiary stage characterized by severe deep tissue destruction.
Etiology
Treponematoses can be spread through direct contact with contaminated objects or lesions, especially in cases of endemic syphilis. Indirect transmission can occur through mouth-to-mouth contact or by sharing utensils for used for eating and drinking cups. Yaws are transmitted through direct contact with skin lesions that shed treponemes whereas endemic syphilis may spread indirectly via contaminated objects.
Genetics
Prognostic Factors
Clinical History
Clinical history
Patients often exhibit characteristic lesions or rash that persist or heal, often residing in or travelling to endemic areas, and later stages may exhibit various joint, bone and skin symptoms.
Physical Examination
Pinta (T carateum)
Pinta, prevalent in the Caribbean, South and Central America, primarily affects young adults and is more common in arid climates. Primary lesions typically appear one to three weeks after infection and can persist for years. Secondary lesions, known as pintids, develop within three to twelve months and may become pigmented and blue over time. Subsequent manifestations are generally confined to the skin.
Endemic syphilis (T pallidum endemicum)
Primary lesions are white, mucinous ulcers in the oral cavity, followed by secondary lesions like macules or papules. Infection can cause ocular manifestations, gangosa, and bone deformities like optic atrophy and uveitis.
Yaws (T pallidum pertenue)
Primary yaws, which can result from direct inoculation, typically start as a paule that may resolve on its own. The secondary stage can present with periosteal infection, lymphadenitis, and multiple skin lesions. Initial lesions usually resolve spontaneously within 6 months but may recur after a period of latency. Relapses can last up to 5 years. Approximately 10-40% of untreated yaws cases progress to late-stage disease, which can involve deformities, gummas, hyperkeratosis, and bone damage.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Leprosy
Syphilis
Leishmaniasis
Pinta
Blastomycosis
Sickle cell disease
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Medical care
Treatment for treponematosis is very effective with a single dose of antibiotic benzathine penicillin or azithromycin, to which the treponemes are highly susceptible. In 2012, recommendations by WHO were updated to a single oral dose of azithromycin as a suitable alternative to benzathine benzylpenicillin on account of ease of administration and low cost. Other medications that can also serve include doxycycline, chloramphenicol, tetracycline, and other cephalosporins, macrolides, and penicillins. Although penicillin treatment failures have been reported, reinfection remains a possibility.
Prevention
WHO introduced a strategy in 2012 to eradicate yaws, treating at risk community members with intramuscular penicillin G and oral azithromycin. This approach, particularly in children, led to a significant decrease in yaw prevalence.
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Use of antibiotics
Azithromycin: This drug exerts its mechanism of action by binding to 50S subunit of ribosome of susceptible microbes and inhibits the breakdown of peptidyl tRNA leading to the arrest of protein synthesis that is dependent on RNA.
Penicillin G benzathine: This intervenes with the mucopeptide synthesis in the cell wall of bacteria causing bactericidal activity.
Tetracycline: This is indicated in treating infections due to gram +ve, and gram -ve microbes, chlamydia, rickettsia, and mycoplasma. This inhibits the protein synthesis in bacteria by binding to the 30S and 50S subunit of ribosome.
Doxycycline: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Chloramphenicol: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Treponematosis is managed and treated on many fronts: diagnosis and assessment, initiation of treatment, monitoring, follow-up, complications management, prevention/education, and epidemiological surveillance. Diagnosis will include clinical examination, identification of symptoms and lesions, and diagnostic testing. Treatment will involve antibiotic medication in the line of benzathine penicillin or azithromycin, or tetracycline, chloramphenicol, doxycycline, and other penicillins and macrolides as alternative treatments. The monitoring and follow-up include the following: clinical improvement, side effects, and serological tests. Complications include disease in its late stages, long-term follow-up, and education for public health purposes. Prevention includes early treatment of the communities and avoidance of infectious lesions, and vector control. Epidemiological surveillance includes the monitoring of the incidence and prevalence of treponematosis within the community and reporting it. These phases are significantly important in effective management for the timely treatment, monitoring of complications, and prevention of the spread of the disease.
Treponematosis, also known as treponemiasis, refers to a group of nonvenereal diseases caused by Treponema species that are both morphologically and serologically similar. These include Treponema pallidum subspecies pallidum, which causes veneral syphilis. These diseases are transmitted through direct contact among children in warm arid climates, subtropical, or tropical climates. The pathogenic treponemes affecting humans are Treponema pallidum pallidum causing syphilis, Treponema pallidum endemicum causing endemic syphilis or bejel, Treponema carateum causing pinta, and Treponema pallidum pertenue causing yaws.
Infection with Treponema pallidum subspecies pallidum mainly affects children, and children of endemic areas often become infected before reaching puberty. The US Centers for Disease Control and Prevention recommend that all refugee children coming from these countries be screened using a nontreponemal test at the time of initial health screening. According to a World Health Organization estimate in 1997, 460,000 new cases of endemic treponematosis occurred annually worldwide, with over 2.5 million persons currently infected. The disease predominantly affects children and is found in countries of the Middle East and the southern Sahara Desert. In Europe, the infection has been reported in immigrating children from endemic regions. Pinta, endemic to the Caribbean, Central America, and South America, is more frequently seen among young adults; yaws, a disease of the equatorial regions, requires high humidity and rainfall. The WHO estimated that endemic treponematoses, especially yaws, cause widespread disfigurement, disability, and economic hardship in poor countries. Successful pilot project in Haiti and the Dominican Republic related complete eradication of the disease because of mass use of penicillin. Because of the decrease in the focus on public health, it reappeared in the 1970s and 1980s. Treatment with either penicillin or azithromycin can achieve a cure rate of 95 to 97%. Treponematosis does not disclose any racial or sexual predilection.
Bejel and Yaws are transmitted among children through direct skin-to-skin contact with infectious lesions. Bejel can also spread through mouth-to-mouth contact or by sharing utensils for eating. Pinta is more frequently seen in older teenagers and children. Treponemes penetrate mucosal surfaces or damaged skin potentially presenting as ulcers or papules after a few weeks. The bacteria can spread both topically and through the blood stream and may heal on their own. In the secondary stage, after the treponemes have disseminated the disease may resolve spontaneously, persist or recur. Long-term effects can include multiple skin lesions and damage to cartilage or bone. The disease may enter a latent stage, but in some cases, it can progress to a tertiary stage characterized by severe deep tissue destruction.
Treponematoses can be spread through direct contact with contaminated objects or lesions, especially in cases of endemic syphilis. Indirect transmission can occur through mouth-to-mouth contact or by sharing utensils for used for eating and drinking cups. Yaws are transmitted through direct contact with skin lesions that shed treponemes whereas endemic syphilis may spread indirectly via contaminated objects.
Clinical history
Patients often exhibit characteristic lesions or rash that persist or heal, often residing in or travelling to endemic areas, and later stages may exhibit various joint, bone and skin symptoms.
Pinta (T carateum)
Pinta, prevalent in the Caribbean, South and Central America, primarily affects young adults and is more common in arid climates. Primary lesions typically appear one to three weeks after infection and can persist for years. Secondary lesions, known as pintids, develop within three to twelve months and may become pigmented and blue over time. Subsequent manifestations are generally confined to the skin.
Endemic syphilis (T pallidum endemicum)
Primary lesions are white, mucinous ulcers in the oral cavity, followed by secondary lesions like macules or papules. Infection can cause ocular manifestations, gangosa, and bone deformities like optic atrophy and uveitis.
Yaws (T pallidum pertenue)
Primary yaws, which can result from direct inoculation, typically start as a paule that may resolve on its own. The secondary stage can present with periosteal infection, lymphadenitis, and multiple skin lesions. Initial lesions usually resolve spontaneously within 6 months but may recur after a period of latency. Relapses can last up to 5 years. Approximately 10-40% of untreated yaws cases progress to late-stage disease, which can involve deformities, gummas, hyperkeratosis, and bone damage.
Leprosy
Syphilis
Leishmaniasis
Pinta
Blastomycosis
Sickle cell disease
Medical care
Treatment for treponematosis is very effective with a single dose of antibiotic benzathine penicillin or azithromycin, to which the treponemes are highly susceptible. In 2012, recommendations by WHO were updated to a single oral dose of azithromycin as a suitable alternative to benzathine benzylpenicillin on account of ease of administration and low cost. Other medications that can also serve include doxycycline, chloramphenicol, tetracycline, and other cephalosporins, macrolides, and penicillins. Although penicillin treatment failures have been reported, reinfection remains a possibility.
Prevention
WHO introduced a strategy in 2012 to eradicate yaws, treating at risk community members with intramuscular penicillin G and oral azithromycin. This approach, particularly in children, led to a significant decrease in yaw prevalence.
Infectious Disease
Azithromycin: This drug exerts its mechanism of action by binding to 50S subunit of ribosome of susceptible microbes and inhibits the breakdown of peptidyl tRNA leading to the arrest of protein synthesis that is dependent on RNA.
Penicillin G benzathine: This intervenes with the mucopeptide synthesis in the cell wall of bacteria causing bactericidal activity.
Tetracycline: This is indicated in treating infections due to gram +ve, and gram -ve microbes, chlamydia, rickettsia, and mycoplasma. This inhibits the protein synthesis in bacteria by binding to the 30S and 50S subunit of ribosome.
Doxycycline: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Chloramphenicol: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Infectious Disease
Treponematosis is managed and treated on many fronts: diagnosis and assessment, initiation of treatment, monitoring, follow-up, complications management, prevention/education, and epidemiological surveillance. Diagnosis will include clinical examination, identification of symptoms and lesions, and diagnostic testing. Treatment will involve antibiotic medication in the line of benzathine penicillin or azithromycin, or tetracycline, chloramphenicol, doxycycline, and other penicillins and macrolides as alternative treatments. The monitoring and follow-up include the following: clinical improvement, side effects, and serological tests. Complications include disease in its late stages, long-term follow-up, and education for public health purposes. Prevention includes early treatment of the communities and avoidance of infectious lesions, and vector control. Epidemiological surveillance includes the monitoring of the incidence and prevalence of treponematosis within the community and reporting it. These phases are significantly important in effective management for the timely treatment, monitoring of complications, and prevention of the spread of the disease.
Treponematosis, also known as treponemiasis, refers to a group of nonvenereal diseases caused by Treponema species that are both morphologically and serologically similar. These include Treponema pallidum subspecies pallidum, which causes veneral syphilis. These diseases are transmitted through direct contact among children in warm arid climates, subtropical, or tropical climates. The pathogenic treponemes affecting humans are Treponema pallidum pallidum causing syphilis, Treponema pallidum endemicum causing endemic syphilis or bejel, Treponema carateum causing pinta, and Treponema pallidum pertenue causing yaws.
Infection with Treponema pallidum subspecies pallidum mainly affects children, and children of endemic areas often become infected before reaching puberty. The US Centers for Disease Control and Prevention recommend that all refugee children coming from these countries be screened using a nontreponemal test at the time of initial health screening. According to a World Health Organization estimate in 1997, 460,000 new cases of endemic treponematosis occurred annually worldwide, with over 2.5 million persons currently infected. The disease predominantly affects children and is found in countries of the Middle East and the southern Sahara Desert. In Europe, the infection has been reported in immigrating children from endemic regions. Pinta, endemic to the Caribbean, Central America, and South America, is more frequently seen among young adults; yaws, a disease of the equatorial regions, requires high humidity and rainfall. The WHO estimated that endemic treponematoses, especially yaws, cause widespread disfigurement, disability, and economic hardship in poor countries. Successful pilot project in Haiti and the Dominican Republic related complete eradication of the disease because of mass use of penicillin. Because of the decrease in the focus on public health, it reappeared in the 1970s and 1980s. Treatment with either penicillin or azithromycin can achieve a cure rate of 95 to 97%. Treponematosis does not disclose any racial or sexual predilection.
Bejel and Yaws are transmitted among children through direct skin-to-skin contact with infectious lesions. Bejel can also spread through mouth-to-mouth contact or by sharing utensils for eating. Pinta is more frequently seen in older teenagers and children. Treponemes penetrate mucosal surfaces or damaged skin potentially presenting as ulcers or papules after a few weeks. The bacteria can spread both topically and through the blood stream and may heal on their own. In the secondary stage, after the treponemes have disseminated the disease may resolve spontaneously, persist or recur. Long-term effects can include multiple skin lesions and damage to cartilage or bone. The disease may enter a latent stage, but in some cases, it can progress to a tertiary stage characterized by severe deep tissue destruction.
Treponematoses can be spread through direct contact with contaminated objects or lesions, especially in cases of endemic syphilis. Indirect transmission can occur through mouth-to-mouth contact or by sharing utensils for used for eating and drinking cups. Yaws are transmitted through direct contact with skin lesions that shed treponemes whereas endemic syphilis may spread indirectly via contaminated objects.
Clinical history
Patients often exhibit characteristic lesions or rash that persist or heal, often residing in or travelling to endemic areas, and later stages may exhibit various joint, bone and skin symptoms.
Pinta (T carateum)
Pinta, prevalent in the Caribbean, South and Central America, primarily affects young adults and is more common in arid climates. Primary lesions typically appear one to three weeks after infection and can persist for years. Secondary lesions, known as pintids, develop within three to twelve months and may become pigmented and blue over time. Subsequent manifestations are generally confined to the skin.
Endemic syphilis (T pallidum endemicum)
Primary lesions are white, mucinous ulcers in the oral cavity, followed by secondary lesions like macules or papules. Infection can cause ocular manifestations, gangosa, and bone deformities like optic atrophy and uveitis.
Yaws (T pallidum pertenue)
Primary yaws, which can result from direct inoculation, typically start as a paule that may resolve on its own. The secondary stage can present with periosteal infection, lymphadenitis, and multiple skin lesions. Initial lesions usually resolve spontaneously within 6 months but may recur after a period of latency. Relapses can last up to 5 years. Approximately 10-40% of untreated yaws cases progress to late-stage disease, which can involve deformities, gummas, hyperkeratosis, and bone damage.
Leprosy
Syphilis
Leishmaniasis
Pinta
Blastomycosis
Sickle cell disease
Medical care
Treatment for treponematosis is very effective with a single dose of antibiotic benzathine penicillin or azithromycin, to which the treponemes are highly susceptible. In 2012, recommendations by WHO were updated to a single oral dose of azithromycin as a suitable alternative to benzathine benzylpenicillin on account of ease of administration and low cost. Other medications that can also serve include doxycycline, chloramphenicol, tetracycline, and other cephalosporins, macrolides, and penicillins. Although penicillin treatment failures have been reported, reinfection remains a possibility.
Prevention
WHO introduced a strategy in 2012 to eradicate yaws, treating at risk community members with intramuscular penicillin G and oral azithromycin. This approach, particularly in children, led to a significant decrease in yaw prevalence.
Infectious Disease
Azithromycin: This drug exerts its mechanism of action by binding to 50S subunit of ribosome of susceptible microbes and inhibits the breakdown of peptidyl tRNA leading to the arrest of protein synthesis that is dependent on RNA.
Penicillin G benzathine: This intervenes with the mucopeptide synthesis in the cell wall of bacteria causing bactericidal activity.
Tetracycline: This is indicated in treating infections due to gram +ve, and gram -ve microbes, chlamydia, rickettsia, and mycoplasma. This inhibits the protein synthesis in bacteria by binding to the 30S and 50S subunit of ribosome.
Doxycycline: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Chloramphenicol: This inhibits bacterial growth by blocking the protein synthesis in bacteria via binding to the 30S and 50S subunits of bacteria.
Infectious Disease
Treponematosis is managed and treated on many fronts: diagnosis and assessment, initiation of treatment, monitoring, follow-up, complications management, prevention/education, and epidemiological surveillance. Diagnosis will include clinical examination, identification of symptoms and lesions, and diagnostic testing. Treatment will involve antibiotic medication in the line of benzathine penicillin or azithromycin, or tetracycline, chloramphenicol, doxycycline, and other penicillins and macrolides as alternative treatments. The monitoring and follow-up include the following: clinical improvement, side effects, and serological tests. Complications include disease in its late stages, long-term follow-up, and education for public health purposes. Prevention includes early treatment of the communities and avoidance of infectious lesions, and vector control. Epidemiological surveillance includes the monitoring of the incidence and prevalence of treponematosis within the community and reporting it. These phases are significantly important in effective management for the timely treatment, monitoring of complications, and prevention of the spread of the disease.
Both our subscription plans include Free CME/CPD AMA PRA Category 1 credits.
Digital Certificate PDF
On course completion, you will receive a full-sized presentation quality digital certificate.
medtigo Simulation
A dynamic medical simulation platform designed to train healthcare professionals and students to effectively run code situations through an immersive hands-on experience in a live, interactive 3D environment.
medtigo Points
medtigo points is our unique point redemption system created to award users for interacting on our site. These points can be redeemed for special discounts on the medtigo marketplace as well as towards the membership cost itself.
Community Forum post/reply = 5 points
*Redemption of points can occur only through the medtigo marketplace, courses, or simulation system. Money will not be credited to your bank account. 10 points = $1.
All Your Certificates in One Place
When you have your licenses, certificates and CMEs in one place, it's easier to track your career growth. You can easily share these with hospitals as well, using your medtigo app.
