A Suspected Case of Imported Yaws in New York

Abstract

Introduction: Yaws is an endemic non-venereal treponematoses, which is caused by Treponema pallidum, subspecies pertenue and is spread from person-to-person through direct skin contact with an infected lesion. Yaws causes a chronic skin infection that is characterized by papillomas and ulcers and if left untreated can be disfiguring and debilitating. Cases typically occur in warm, humid, tropical climates and cases are commonly seen in children under 15 years old. However, due to migration, cases can be seen outside of its endemic region. Case Description: We present a case of a 39-year-old African American male who presented with painless bilateral ulcers on his dorsal feet that began as blisters approximately 1-2 weeks prior to presentation at our clinic. Our patient had recent travel history to Jamaica and reported potential sources of trauma to his feet by walking barefoot on the beach and roofing in sandals prior to onset. These findings led to the clinical diagnosis of Yaws. A regimen of azithromycin and basic wound care led to significant improvement. Discussion: Non-venereal endemic treponematoses, such as Yaws, are typically not seen outside of their endemic region. However, due to migration and the ease of travel non-venereal endemic treponematoses can be found elsewhere and it is important for healthcare workers to keep these diseases on their differential, especially in a patient with travel history. After making the diagnosis of Yaws, proper treatment and basic wound care can result in rapid significant improvement and prevent the progression of Yaws lesions to the subsequent stage.