Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 34-05: Yaws (Frambesia) + Key Features Download Section PDF Listen +++ ++ A contagious disease largely limited to tropical regions that is caused by Treponema pallidum subspecies pertenue Acquired by direct nonsexual contact, usually in childhood, although it may occur at any age + Clinical Findings Download Section PDF Listen +++ ++ Characterized by granulomatous lesions of the skin, mucous membranes, and bone The "mother yaw," a painless papule that later ulcerates, appears 3–4 weeks after exposure Regional lymphadenopathy is usually present Secondary lesions that are raised papillomas and papules Appear 6–12 weeks later Weep highly infectious material Last for several months or years Painful ulcerated lesions on the soles are called "crab yaws" because of the resulting gait Late gummatous lesions may occur, with associated tissue destruction involving large areas of skin and subcutaneous tissues Late effects of yaws may be confused with similar changes occurring in leprosy and include Bone change Shortening of digits Contractures Central nervous system, cardiac, or other visceral involvement is rare + Diagnosis Download Section PDF Listen +++ ++ Organisms can be demonstrated in infectious lesions with darkfield microscopy or immunofluorescence but cannot be cultured in artificial media Serologic tests for syphilis are positive + Treatment Download Section PDF Listen +++ ++ If untreated, may lead to chronic disability and disfigurement Penicillin, 2.4 million units of benzathine penicillin G intramuscularly is generally curative in any stage of the non–sexually transmitted treponematoses In cases of penicillin hypersensitivity, tetracycline, 500 mg orally four times a day for 10–14 days, is the recommended alternative