Spirochetosis: Understanding Chronic Spirochete Infections

Spirochetosis is infection caused by spirochetes—spiral-shaped, motile bacteria. Major species and diseases:

Key Spirochetal Diseases

• Treponema pallidum: Syphilis (congenital, primary, secondary, tertiary)
• Borrelia burgdorferi: Lyme disease
• Borrelia recurrentis/hermsii: Relapsing fever (louse-borne, tick-borne)
• Leptospira interrogans: Leptospirosis (zoonotic, water/soil exposure)
• Treponema pallidum pertenue: Yaws (tropical, skin/bone)
• Treponema pallidum endemicum: Bejel (endemic syphilis)

Transmission

• Tick bites (Lyme, relapsing fever)
• Sexual contact (syphilis)
• Contaminated water/soil (leptospirosis)
• Direct skin contact (yaws, bejel)
• Congenital (mother to fetus)

Clinical Features

• Fever, chills, myalgia, arthralgia
• Characteristic rashes (EM rash in Lyme; macular in syphilis)
• Neurologic, cardiac, ocular involvement (disseminated stages)
• Relapsing fever: cyclical fevers

Treatment

• Penicillins: Syphilis (PCN G), leptospirosis
• Doxycycline: Lyme, relapsing fever, leptospirosis (alt)
• Ceftriaxone: Neurosyphilis, severe Lyme
• Azithromycin: Yaws (single dose)

Early diagnosis and targeted antibiotics cure most spirochetoses. Chronic/late stages may cause irreversible damage.