Definition

Bejel, also known as endemic syphilis, is a chronic
but curable disease, seen mostly in children in arid
regions. Unlike the better-known venereal syphilis,
endemic syphilis is not a sexually transmitted disease.

Description

Bejel has many other names depending on the locality:
siti, dichuchwa, njovera, belesh, and skerljevo are
some of the names. It is most commonly found in the
Middle East (Syria, Saudi Arabia, Iraq), Africa, central
Asia, and Australia. Bejel is related to yaws and pinta,
but has different symptoms.

Causes and symptoms

Treponema pallidum, the bacteria that causes bejel,
is very closely related to the one that causes the sexually
transmitted form of syphilis, but transmission is very different.
In bejel, transmission is by direct contact, with
broken skin or contaminated hands, or indirectly by sharing
drinking vessels and eating utensils. T. pallidum is
passed on mostly between children living in poverty in
very unsanitary environments and with poor hygiene.
The skin, bones, and mucous membranes are affected
by bejel. Patches and ulcerated sores are common in
the mouth, throat, and nasal passages. Gummy lesions
may form, even breaking through the palate. Other findings
may include a region of swollen lymph nodes and
deep bone pain in the legs. Eventually, bones may
become deformed.

Diagnosis

T. pallidum can be detected by microscopic study of
samples taken from the sores or lymph fluid. However,
since antibody tests don