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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
Specific
tertiary bejel
General
syphilis
References
- Cunha BA
Bejel, Pinta, and Yaws
Merck Manual
http://www.merckmanuals.com/professional/sec14/ch174/ch174b.html