Yaws Osteoperiostitis Treated with Single-Dose Azithromycin

Am J Trop Med Hyg. 2017 May;96(5):1039-1041. doi: 10.4269/ajtmh.16-0943. Epub 2017 Feb 13.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Child, Preschool
  • DNA, Bacterial / isolation & purification*
  • Humans
  • Leg / diagnostic imaging
  • Leg / microbiology
  • Leg / pathology
  • Male
  • Periosteum / diagnostic imaging
  • Periosteum / drug effects
  • Periosteum / microbiology
  • Periosteum / pathology
  • Periostitis / diagnostic imaging
  • Periostitis / drug therapy*
  • Periostitis / microbiology
  • Periostitis / pathology
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Treponema pallidum / drug effects*
  • Treponema pallidum / genetics
  • Treponema pallidum / isolation & purification
  • Wrist / diagnostic imaging
  • Wrist / microbiology
  • Wrist / pathology
  • Yaws / diagnostic imaging
  • Yaws / drug therapy*
  • Yaws / microbiology
  • Yaws / pathology

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Azithromycin