bejel (endemic syphilis)

Epidemiology

• endemic non-venereal spirochete infection with Treponema pallidum subspecies endemicum
• transmission is by close skin contact-sexual or not- primarily between children living in conditions of poor hygiene
• occurs mainly in arid countries of the eastern Mediterranean & West Africa
• transmission results from mouth-to-mouth contact or sharing eating & drinking utensils.

Clinical manifestations

• typical primary, secondary & tertiary disease
• initial mucocutaneous lesion followed by diffuse secondary lesions, a latent period, & late destructive disease
• primary: mucous patch (usually on the buccal mucosa), which may go unnoticed
• secondary: papulosquamous & erosive papular lesions of the trunk a & extremities similar to lesions of yaws
• tertiary:
  • periostitis of the leg bones is common
  • later, gummatous lesions of the nose & soft palate

Laboratory

• see syphilis
• morphologically & serologically indistinguishable from the agent of syphilis Treponema pallidum subspecies pallidum

Management

• penicillin

More general terms

• syphilis

More specific terms

• tertiary bejel