infectious diseases
Bejel, Pinta, and Yaws
Introduction
Bejel, pinta, and yaws (endemic treponematoses) are chronic, tropical, nonvenereal spirochetal infections spread by body contact. Symptoms of bejel are mucous membrane and cutaneous lesions, followed by bone and skin gummas. Yaws causes periostitis and dermal lesions. Pinta lesions are confined to the dermis. Diagnosis is clinical and epidemiologic. Treatment is withazithromycin. Spirochetes are distinguished by the helical shape of the bacteria. Pathogenic spirochetes includeTreponema,Leptospira, andBorrelia. BothTreponemaandLeptospiraare too thin to be seen using brightfield microscopy but are clearly seen using darkfield or phase microscopy.Borreliaare thicker and can also be stained and seen using brightfield microscopy. Thecausative agentsof bejel, pinta, and yaws are Bejel:Treponema pallidumsubspeciesendemicum Yaws:T. pallidumsubspeciespertenue Pinta:Treponema carateum species are morphologically and serologically indistinguishable from the agent of Syphilis , Transmission is by close skin contact—sexual or not—primarily between children living in conditions of poor hygiene. Bejel (endemic syphilis) occurs mainly in hot, dry regions of the eastern Mediterranean and Saharan West Africa. Transmission results from mouth-to-mouth contact or sharing eating and drinking utensils. Yaws (frambesia) is the most prevalent of the endemic treponematoses and occurs in humid equatorial countries. Transmission requires direct skin contact and is favored by skin trauma. Pinta, which is more limited in geographical distribution, occurs among the natives of Mexico, Central America, and South America and is not very contagious. Transmission probably requires contact with broken skin. UnlikeT. pallidumsubspeciespallidum, other human treponemal subspecies are not transmitted via blood or transplacentally. 