Yaws Osteoperiostitis Treated with Single-Dose Azithromycin.

AbstractThe etiologic agent of yaws, Treponema pallidum subsp. pertenue, causes a multistage infection transmitted by nonsexual contact with the exudates from active lesions. Bone lesions in the form of osteoperiostitis are common and occur in numerous bones simultaneously in early stages. Although a multinational eradication campaign with mass administration of intramuscular benzathine benzylpenicillin in the 1950s greatly reduced its global incidence, a resurgence of yaws has occurred since around 2000 in western and central Africa and the Pacific Islands. The finding that a single oral dose of azithromycin (30 mg/kg) was as effective as benzathine benzylpenicillin prompted renewed interest by World Health Organization in 2012 toward eradication of this infection by 2020. We previously reported the excellent response to benzathine benzylpenicillin therapy for yaws osteoperiostitis. Herein, we document a confirmed case of yaws with osteoperiostitis successfully treated with single-dose azithromycin and discuss the pathology of yaws periostitis and comment on the implications of this in light of the new campaign toward yaws eradication.

[Osteoarticular involvement in parasitic diseases: bone treponematosis]. / Atteintes ostéo-articulaires d'origine parasitaire: les tréponématoses osseuses.

Bone and joint localizations of treponematosis vary greatly although there are many common features. Osteal and periosteal lesions are common. We report radiographic descriptions of bone and joint treponematosis, which must not go unrecognized due to the increasing incidence of these diseases.

[Tertiary yaws--skeletal manifestations at the distal tibia]. / Tertiäre Frambösie--Skelettmanifestation an der distalen Tibia.

We describe the case of a 16-year old male patient from African presenting tertiary yaws at the distal tibia. Clinical signs, biochemical results and the different diagnostic imaging methods are demonstrated. Differential diagnosis and therapy are described.

Radiological and dermatological findings in two patients suffering from early yaws in Indonesia.

Two children suffering from early yaws in Indonesia are presented. Apart from skin lesions and a positive treponemal serology in both patients, involvement of tubular bones, particularly of the hands, was revealed by radiological examination. In one patient involvement of a distal phalanx was remarkable. Early diagnosis and treatment of yaws is important since a delay in treatment may result in severe and irreversible bone deformities of the late stage of the disease. This report illustrates that radiological changes, although rare, can still be detected in the early stage of yaws in areas where yaws is resurgent nowadays.

Juxta-articular bone lesions in tertiary yaws.

A case of tertiary yaws in an immigrant from the Solomon Islands is presented. The report highlights the atypical features and diagnostic difficulties of late-stage treponemal infection.

[Yaws: a rare case of an "invasively growing" tumor of the maxillary sinus]. / Frambösie: Ein seltener Fall eines "invasiv wachsenden" Tumors der Kieferhöhle.

Yaws is a treponematosis which is rare in Europe. Tertiary stages may present with tumor-like lesions predominantly in the face. These manifestations are called rhinopharyngitis mutilans and goundou. A 40-year-old woman with goundou is presented.

Musculoskeletal lesions in yaws.

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.