TAILIEUCHUNG - Chapter 163. Endemic Treponematoses

The endemic, or nonvenereal, treponematoses are bacterial infections caused by close relatives of Treponema pallidum subspecies pallidum, the etiologic agent of venereal syphilis (Chap. 162). Yaws, pinta, and endemic syphilis are distinguished from venereal syphilis by mode of transmission, age of acquisition, geographic distribution, and clinical features. These infections are limited to rural areas of developing nations and are seen in developed countries only in recent immigrants from endemic regions. . | Chapter 163. Endemic Treponematoses The endemic or nonvenereal treponematoses are bacterial infections caused by close relatives of Treponema pallidum subspecies pallidum the etiologic agent of venereal syphilis Chap. 162 . Yaws pinta and endemic syphilis are distinguished from venereal syphilis by mode of transmission age of acquisition geographic distribution and clinical features. These infections are limited to rural areas of developing nations and are seen in developed countries only in recent immigrants from endemic regions. Our quot knowledge quot about the endemic treponematoses is based on observations of health care workers who have visited endemic areas virtually no well-designed studies of the natural history diagnosis or treatment of these infections have been conducted. The treponemal infections are compared and contrasted in Table 163-1. Table 163-1 Comparison of the Treponemes and Associated Diseases Feature Venereal Syphilis Yaws Endemic Syphilis Pinta Organism T. pallidum T. pallidum subsp. T. pallidum T. carateum Mode of subsp. pallidum Sexual pertenue Skin-to-skin subsp. endemicum Household Skin-to-skin transmissio n Usual age transplacenta l Adulthood Early childhood contacts mouth-to-mouth or via shared drinking eati ng utensils Early Late of acquisition Primary Cutaneous Papilloma often childhood Rarely seen childhood Nonulceratin lesion Location ulcer chancre Genital oral ulcerative Extremities Oral g papule with satellites pruritic Extremities anal face Secondary Mucocutane Cutaneous Florid Pintides lesions ous lesions papulosquamouslesi mucocutane pigmented condylomata lata ons osteoperiostitis ous lesions mucous patch split papule condyloma latum osteoperiosti tis pruritic Infectious relapses 25 Common Unknown None Late Gummas Destructive Destructive Nondestructi complicati cardiovascul gummas of skin gummas of ve ons ar and CNS involvement bone cartilage skin bone cartilage dyschromic achromic macules aCNS involvement in the endemic .

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