Medicine:Nonvenereal endemic syphilis

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Nonvenereal endemic syphilis
Other namesnonvenereal syphilis, endemic syphilis, bejel
Infiltration of skin due to endemic syphilis.jpg
Disfiguring infiltration of the nose, glabella, and forehead with clustered nodules in left interciliary region of boy with endemic syphilis, Iran, 2010.
Pronunciation
SpecialtyInfectious disease

Bejel, or endemic syphilis, is a chronic skin and tissue disease caused by infection by the endemicum subspecies of the spirochete Treponema pallidum. Bejel is one of the "endemic treponematoses" (endemic infections caused by spiral-shaped bacteria called treponemes), a group that also includes yaws and pinta. Typically, endemic trepanematoses begin with localized lesions on the skin or mucous membranes. Pinta is limited to affecting the skin, whereas bejel and yaws are considered to be invasive because they can also cause disease in bone and other internal tissues.[1]

Signs and symptoms

Bejel usually begins in childhood as a small patch on the mucosa, often on the interior of the mouth, followed by the appearance of raised, eroding lesions on the limbs and trunk. Periostitis (inflammation) of the leg bones is commonly seen, and gummas of the nose and soft palate develop in later stages.[citation needed]

Causes

Although the organism that causes bejel, Treponema pallidum endemicum,[2] is morphologically and serologically indistinguishable from Treponema pallidum pallidum, which causes venereal syphilis, transmission of bejel is not venereal in nature.[3]

Diagnosis

The diagnosis of bejel is based on the geographic history of the patient as well as laboratory testing of material from the lesions (dark-field microscopy). The responsible spirochaete is readily identifiable on sight in a microscope as a treponema.[4]

Epidemiology

Bejel is mainly found in arid countries of the eastern Mediterranean region and in West Africa, where it is known as sahel.

See also

References

  1. "Advances in the diagnosis of endemic treponematoses: yaws, bejel, and pinta". PLOS Neglected Tropical Diseases 7 (10): e2283. 2013. doi:10.1371/journal.pntd.0002283. PMID 24205410. 
  2. "The endemic treponematoses". Microbes and Infection 4 (1): 83–94. January 2002. doi:10.1016/S1286-4579(01)01513-1. PMID 11825779. 
  3. "Endemic non-venereal syphilis (bejel) in Saudi Arabia". The British Journal of Venereal Diseases 60 (5): 293–7. October 1984. doi:10.1136/sti.60.5.293. PMID 6487985. 
  4. "Endemic treponemal diseases". Transactions of the Royal Society of Tropical Medicine and Hygiene 108 (10): 601–7. October 2014. doi:10.1093/trstmh/tru128. PMID 25157125. 

External links

Classification