RT Book, Section
A1 Philip, Susan S.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193137192
T1 Non–Sexually Transmitted Treponematoses
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193137192
RD 2024/04/18
AB A  variety  of  treponemal  diseases  other  than  syphilis  occur  endemically  in  many  tropical  areas  of  the  world.  They  are  distinguished  from  disease  caused  by  T  pallidum  by  their  nonsexual  transmission  via  direct  skin  contact,  their  relatively  high  incidence  in  certain  geographic  areas  and  among  children,  and  their  tendency  to  produce  less  severe  visceral  manifestations.  As  in  syphilis,  skin,  soft  tissue,  and  bone  lesions  may  develop  (although  pinta  is  limited  to  skin  lesions),  organisms  can  be  demonstrated  in  infectious  lesions  with  darkfield  microscopy  or  immunofluorescence  but  cannot  be  cultured  in  artificial  media;  the  serologic  tests  for  syphilis  are  positive;  molecular  methods  such  as  PCR  and  genome  sequencing  are  available,  but  not  widely  used  in  endemic  areas;  the  diseases  have  primary,  secondary,  and  sometimes  tertiary  stages.  There  is  evidence  that  infection  with  these  agents  may  provide  partial  resistance  to  syphilis  and  vice  versa.  Treatment  with  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  usually  the  recommended  alternative.  In  randomized  controlled  trials,  oral  azithromycin  (30  mg/kg  once)  was  noninferior  to  benzathine  penicillin  G  for  the  treatment  of  yaws  in  children.