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February 14, 2026
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The ICD-10 code range A65–A69 classifies “Other spirochetal diseases,” which are bacterial infections caused by spiral-shaped bacteria. Unlike the sexually transmitted diseases in the A50–A64 range, these are primarily transmitted through skin contact, shared objects, or insect vectors.
Nonvenereal syphilis, also called Bejel or endemic syphilis, is a long-lasting bacterial infection. It is caused by a germ called Treponema pallidum subsp. endemicum. This disease mainly affects children who live in hot, dry areas of the world.
The infection spreads when people touch each other’s skin directly. It can also spread when people share cups, eating utensils, or other personal items. Unlike regular syphilis, this type does not spread through sexual contact.
A 7-year-old boy from a rural village in Syria develops painful sores inside his mouth and on his lips. The sores later appear on his arms and legs. The doctor discovers that several children in the same household share drinking cups and eating utensils. After examining the boy and running blood tests, the doctor diagnoses him with nonvenereal syphilis (Bejel) and assigns ICD-10 code A65. The entire family receives education about not sharing personal items, and the boy is treated with antibiotics.
Yaws is a long-lasting skin infection caused by the bacterium Treponema pallidum subsp. pertenue. It creates painful sores and bumps on the skin. If left untreated, it can damage bones and joints badly.
Yaws mostly affect children living in warm, humid tropical regions. It is common in parts of Africa, Asia, and Latin America. The disease spreads through direct contact with the skin sores of an infected person.
A 9-year-old girl from a remote village in Ghana comes to a health clinic with a large, raspberry-like growth on her leg. Her mother reports that it started as a small bump three months ago. The girl often plays barefoot with other children who have similar sores. The healthcare worker recognizes the characteristic “mother yaw” lesion and diagnoses her with yaws, using ICD-10 code A66. She receives a single dose of azithromycin, and health workers screen other children in her village for the disease.
Pinta is a skin infection caused by the bacterium Treponema carateum. It changes the color of the skin but does not affect internal organs. This disease is found almost only in Central and South America.
The disease starts with red, scaly patches on the skin. Over time, these patches turn into permanent white or dark-gray spots. The infection spreads when people touch each other’s skin, but not through sexual contact.
A 15-year-old boy from a rural area in Colombia visits a clinic complaining of discolored patches on his hands and face. The patches started as small red spots a year ago but have now turned into large white and grayish areas. His skin looks spotted, with different colors in different places. The doctor recognizes this as pinta, a disease still found in his region, and documents it with ICD-10 code A67. The boy receives antibiotic treatment, though the skin color changes may be permanent.
Relapsing fevers are infections that cause repeated attacks of high fever. Each fever episode comes with headaches and muscle pain. The fever goes away for a while, then comes back again.
This type spreads through body lice. When an infected louse bites you, it can pass the bacteria into your body. Poor hygiene and crowded living conditions make this infection more likely.
During a humanitarian crisis, a 28-year-old refugee living in an overcrowded camp in Ethiopia develops a high fever of 104°F (40°C) with severe headaches and muscle pain. After three days, the fever suddenly disappears. Five days later, the fever returns with the same symptoms. The camp medical staff notices he has body lice on his clothing. Blood tests confirm louse-borne relapsing fever, and the doctor assigns ICD-10 code A68.0. He is treated with antibiotics and given clean clothes, and the camp initiates a delousing program.
This type spreads through the bite of infected soft ticks. These ticks usually live in rodent burrows and old buildings. They bite people at night while they sleep.
A 35-year-old park ranger in Arizona who sleeps in old cabins during his patrols develops recurring fevers. He experiences high fever for 3 days, feels better for a week, then the fever returns. This pattern repeats three times. He mentions sleeping in a rustic cabin where mice are common. The doctor suspects tick-borne relapsing fever, orders blood tests that confirm the diagnosis, and assigns ICD-10 code A68.1. The ranger receives antibiotic treatment and is advised to avoid sleeping in rodent-infested buildings.
Doctors use this code when they know someone has relapsing fever but don’t know whether it came from lice or ticks. This happens when medical records don’t have enough information.
A 42-year-old woman visits an emergency room with recurring fevers, severe headaches, and muscle aches. She reports having similar symptoms that come and go every few days. Blood tests confirm relapsing fever bacteria in her blood, but she cannot remember any tick bites and denies having lice. She recently traveled to multiple countries and stayed in various accommodations. Since the doctor cannot determine the exact source of infection, ICD-10 code A68.9 is used for documentation and treatment purposes.
This category includes various specific infections caused by other spirochete bacteria.
Noma is a very serious infection that destroys the tissues of the mouth and face. It starts as mouth sores and spreads quickly. The disease literally eats away at the soft tissue, gums, and even bones of the face.
This disease mainly affects malnourished children living in extreme poverty. It happens most often in Africa. Without treatment, it can be deadly or cause severe facial disfigurement.
A 4-year-old severely malnourished girl from Niger is brought to a hospital with a foul-smelling mouth infection. What started as swollen gums a week ago has rapidly progressed. The infection has created a large hole in her cheek, exposing her teeth and jawbone. She recently recovered from measles and lives in extreme poverty with limited access to food. The medical team diagnoses her with Noma, assigns ICD-10 code A69.0, and immediately starts aggressive antibiotic treatment and nutritional support to save her life and prevent further facial destruction.
Trench mouth, also called acute necrotizing ulcerative gingivitis, is a painful gum infection. It causes bleeding gums, bad breath, and painful sores in the mouth. The gums become red, swollen, and covered with a grayish film.
The name comes from World War I, when soldiers living in trenches often got this infection due to stress, poor nutrition, and bad oral hygiene.
A 22-year-old college student experiencing extreme stress during final exams develops severe gum pain and bleeding. He notices extremely bad breath and a metallic taste in his mouth. His gums are covered with a gray coating, and they bleed heavily when he tries to brush. He admits to surviving on energy drinks and junk food for weeks and hasn’t brushed his teeth regularly due to stress. The dentist diagnoses him with acute necrotizing ulcerative gingivitis (trench mouth), uses ICD-10 code A69.1, and prescribes antibiotics along with instructions for proper oral hygiene and stress management.
Lyme disease is an infection caused by bacteria called Borrelia burgdorferi. It spreads through the bite of infected black-legged ticks (also called deer ticks). The disease can affect the skin, joints, heart, and nervous system.
Early signs include a circular red rash that looks like a bullseye, fever, headache, and tiredness. If not treated early, the infection can spread to joints and cause arthritis, or affect the brain and heart.
A 38-year-old woman from Connecticut who enjoys hiking develops a distinctive circular red rash on her thigh that looks like a bullseye target. She remembers finding a small tick on her leg after a hiking trip two weeks ago. She also has a fever, severe fatigue, and headaches. Her doctor recognizes the characteristic erythema migrans rash and diagnoses her with early Lyme disease, assigning ICD-10 code A69.2. She receives a 3-week course of doxycycline antibiotics. The doctor advises her to use tick repellent and perform tick checks after future outdoor activities.
Doctors use this code for rare spirochetal infections that don’t fit into the other categories. These are uncommon diseases caused by spiral-shaped bacteria that have been identified but are not listed separately in the classification system.
A 45-year-old marine biologist develops a rare skin infection after handling contaminated water samples in a research facility. Laboratory tests identify spiral-shaped bacteria in the wound, but the specific species doesn’t match any of the common spirochetal diseases like syphilis, Lyme disease, or yaws. The infectious disease specialist confirms it’s a spirochetal infection from an unusual environmental source. Since this specific infection doesn’t have its own code in the A65-A69.2 range, the doctor assigns ICD-10 code A69.8 for “other specified spirochetal infections” and treats the patient with appropriate antibiotics.
Understanding ICD-10 codes A65-A69 is essential for properly diagnosing and treating spirochetal diseases. These bacterial infections can cause serious health problems if left untreated. Healthcare providers must recognize the signs and symptoms to assign correct codes for accurate medical records and appropriate treatment plans.
While some spirochetal diseases like yaws are becoming rare due to global health efforts, others like Lyme disease are increasing in certain regions. If you suspect symptoms of spirochetal diseases, especially after travel to endemic areas or tick exposure, seek medical attention immediately.
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