title: Yaws Osteoperiostitis Treated with Single-Dose Azithromycin.
abstract: AbstractThe etiologic agent of yaws,Treponema pallidumsubsp.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.
authors.affiliation: Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.|Lisbon Institute of Hygiene and Tropical Medicine, Lisbon, Portugal.
authors.forename: Camila
authors.initials: C
authors.lastname: González-Beiras
authors.affiliation: Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.|STI Unit, University Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Martí
authors.initials: M
authors.lastname: Vall-Mayans
authors.affiliation: Department of Imaging and Radiology, Complejo Hospitalario de Pontevedra, Pontevedra, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: González-Escalante
authors.affiliation: Department of Pathology, Sullivan Nicolaides Pathology, Brisbane, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: McClymont
authors.affiliation: Department of Pathology, Sullivan Nicolaides Pathology, Brisbane, Australia.
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.affiliation: Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain.|Lihir Medical Centre-International SOS, Newcrest Mining, Lihir Island, Papua New Guinea.
authors.forename: Oriol
authors.initials: O
authors.lastname: Mitjà
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000302:isolation & purification*; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008297:Male; D010521:Periosteum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D010522:Periostitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D014953:Wrist / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D015001:Yaws / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D017963:Azithromycin