Yaws

Submitted by amh10 on 19 March, 2007 - 17:30
  • Caused by Treponema pallidum spp. pertenue.
  • Endemic of rural populations in tropical and subtropical countries.
  • Resurgence of disease as eradication programmes have been stopped.
  • Non-veneral disease.
  • Affects children before puberty.
  • Occurs after contact with traumatized skin with exudate in the early leisons.
  • Primary yaws has an incubation of 3-5 weeks.
  • Initial lesions occur in the legs.
  • Papular lesions enlarge, erode and heal in 6/12.
  • Eruption of similar leisons occur weeks to months later, relapse is common.
  • Seconadry lesions may involve bones (fingers, long bones, jaw).
  • Yaws, like syphilis, has been classified into the following 4 stages:
    1. Primary stage: Initial yaws lesion develops at inoculation site.
    2. Secondary stage: Widespread dissemination of treponemes results in multiple skin lesions similar to primary yaws lesion.
    3. Latent stage: Usually, no symptoms are present, but skin lesions can relapse.
    4. Tertiary stage: Bone, joint, and soft tissue deformities may occur.

    Another classification distinguishes early yaws from late yaws. Early yaws includes primary and secondary stages and is characterized by the presence of contagious skin lesions. Late yaws includes the tertiary stage, when lesions are not contagious.

  • "Late" disease is characterised by cutaneous plaques, ulcers and thickening of the skin on the palms and soles.
  • Gummamtous lesions may develop.
  • NO NEUROLOGICAL OR CARDIOVASCULAR SEQUEALE.
  • Non-infectious by child-bearing age.
  • No congenital disease.
  • Ix with VDRL, FTA (indirect IF test), or TPHA (T. pallidum antigen coats RBCs and a specific reaction with Abs causes agglutination).
  • Rx with penicillin.  This therapy can cause a systemic response called the Jarisch-Herxheimer reaction. This can be of a rapid onset (within 2hrs) of fevers, myalgia, tachycardia, hyperventilation, hypotension and vasodilatation. This is thought to occur as a result of the release of an endogenous pyrogen from the spirochaetes.


      • AMH.

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