Introduction
Treponema pallidum is a well-known bacterial species that encompasses numerous subspecies. Certain subspecies of Treponema pallidum are responsible for the spectrum of nonvenereal treponemal infections.
What Are Nonvenereal Treponemal Infections?
Nonvenereal treponemal infections are a spectrum of infections in humans caused by a group of bacteria that falls under the different subspecies of Treponema. These infections are widely known by the synonym nonvenereal treponematoses. It encompasses the following infections:
- Yaws.
- Bejel.
- Pinta.
What Is Treponema Pallidum?
- Treponema pallidum is a specific bacterial species that fall under the genus Treponema. It further incorporates certain bacterial subspecies that are known for causing human infections of varying grades and severity.
- The pallidum subspecies of Treponema pallidum are reported to be the most destructive and aggressive subspecies among the entire species.
- Pallidum subspecies are the culprit behind one of the highly significant diseases- syphilis- that can be transmitted from one person to another by means of sexual contact. Hence it is categorized under sexually transmitted diseases (STDs).
- However, other subspecies like pertenue, carateum, and endemicum also have the potential to give rise to various infections in human beings.
- All these subspecies bear resemblance to one another in their structure and functioning, but at the same time, differ in other aspects.
- Unlike pallidum subspecies, these nonvenereal subspecies do not precipitate sexually transmitted diseases and are hence medically known by the name nonvenereal treponema.
- The spreading methodology adopted by nonvenereal treponema is quite different.
What Are the Causative Agents Responsible for Nonvenereal Treponemal Infections?
Treponema pallidum subspecies pertenue, Treponema pallidum subspecies carateum, and Treponema pallidum subspecies endemicum are the widely known infectious agents that are responsible for various nonvenereal infections in humans. All these microbes belong to the genus Treponema which comes under Spirochaetes. The Pertenue subspecies is the causative factor behind yaws; similarly, carateum infection leads to pinta, and endemicum gives rise to bejel. However, these subspecies appear like the very picture of the pallidum subspecies, the transmission strategy differs greatly.
What Are the Different Nonvenereal Treponemal Infections?
Routinely encountered forms of nonvenereal treponemal infections include the following diseases:
- Yaws
- It is a peculiar transmissible disease that is precipitated by nonvenereal treponemal bacterial subspecies; the pertenue.
- Yaws are not categorized as STDs; instead, the infection tends to catch from an infected person to a healthy person upon skin touch.
- It often exhibits a slight preference in younger age groups, specifically affecting children.
- The infection progresses through different stages - primary, secondary, and tertiary.
- The initial stage is demarcated by the presence of tiny bumps or nodules. At first, it develops as a single nodule and then gives rise to multiple bumps. These bumps generally remain without any pain. Over time these bumps give rise to ulcerations and then progress into the next stage.
- The secondary stage manifests in the form of rashes over body surfaces, typically involving the buttocks, arms, face, and legs producing severe pain and discomfort for the patients. The first two stages of yaws are more responsive to treatment and can easily be tackled with medicines. If the condition is left unattended without any treatment, it may advance into the final stage, which is a complex stage.
- The final stage produces extensive deformations and destructions. It is often associated with skeletal and facial disfigurement (change in structure). Unlike the other two stages, the tertiary stage is quite resistant to treatment as it produces bony changes.
- Yaws are effectively managed with antibiotics like Penicillin and Azithromycin.
- Bejel
- Bejel is a nonvenereal treponemal infection that is widely known by the synonym endemic syphilis. It is more prevalent in hot and arid climatic conditions.
- The endemicum subspecies is the bacterium that is responsible for the nonvenereal version of syphilis.
- Bejel is manifested in the form of patches of ulcers, specifically seen in and around the mouth. Once the disease advances, it affects other areas of the body, like legs, trunks, and arms. Its final stage is demarcated by the remarkable involvement of the bones, along with numerous bumps and nodules in the dome portion of the mouth (palate).
- It also elicits an associated enlargement of the lymph nodes, which indicates the progression of the infection in the body. However, the skin ulcers remain painless.
- Similar to yaws, bejel also spreads upon touch or contact with the infected area.
- Penicillins are the most widely recommended medicine for endemic syphilis. However, in certain cases, other drugs like Tetracycline and Doxycycline are also advised and are reported to be effective for bejel.
- Pinta
- It is quite an unfamiliar form of nonvenereal treponemal infection involving the skin.
- Treponema carateum bacteria is the sole agent responsible for this peculiar condition, typically affecting the skin over the legs, arms, face, chest, and trunk.
- Pinta elicits three different stages of disease progression - early, intermediate, and late phases.
- The early phase is distinguished by the presence of tiny spots over the skin surface, which are highly pigmented. Initial spots appear over the legs and arms and later extend into other areas of the body. These discolored areas later develop itchiness and scratchiness, producing discomfort for the patients.
- The intermediate stage develops with specific discharging lesions, which appear more flaky and dry. Those flaky skin spots are technically known by the name pintids.
- Once the disease progresses into its late phase, it elicits stiffening and condensing of skin (hyperkeratosis) in certain areas like palms and sole. Skin in the affected area appears dry, pale, and lifeless.
- One of the unique features of pinta is that the course and progression of the disease span over a longer period. It also spreads upon touch or skin contact.
- Benzathine penicillin is the most extensively recommended medicine for the treatment of pinta.
What Are the Other Conditions That Resemble That of Nonvenereal Treponemal Infection?
Because of its rarity, nonvenereal infections are often mistaken for other conditions. Some of the familiar conditions also produce manifestations closely resembling that of nonvenereal treponemal infections, and some of them include the following:
- Syphilis (sexually transmitted disease).
- Aphthous ulcers (mouth ulcers).
- Oral herpes simplex infection (viral infection).
- Mycosis (fungal infection).
- Psoriasis (skin condition precipitated by hyperactivity of the immune system).
- Leprosy (skin patches caused by bacteria).
- Pellagra (vitamin deficiency disorder).
Conclusion
Nonvenereal treponemal infections are quite rare and hence unfamiliar. Very often, they are misdiagnosed as venereal infections due to the absence of specific tests for the detection of nonvenereal microbes. However, these infections can be easily tackled with the help of appropriate antibacterial therapy.
