Endemic syphilis

Bejel (endemic syphilis, Arabic syphilis) is a chronic infectious disease that occurs mainly among children and is manifested by erythematous-papular rashes on the skin, lesions of the mucous membranes, bones, joints and cartilage.

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Epidemiology of endemic syphilis

The disease is transmitted mainly by contact and household means, especially in children. This is facilitated by low sanitary culture, cramped housing, drinking from the same vessel, ritual ablutions. Indirect transmission is through infected drinking vessels; direct transmission is through fingers contaminated with saliva containing treponemas. Adults are most often infected by their children. Flies can also be carriers of the disease.

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Causes of endemic syphilis

Bejel is caused by Treponema pallidum (bejel); some antigenic and pathogenic differences between the pathogens of endemic and venereal syphilis reflect only the strain characteristics of these microorganisms.

The reservoir of infection is children aged 2 to 15 years, as well as patients in the latent period.

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The course of endemic syphilis

The incubation period is 3 weeks.

Fleeting manifestations (pass unnoticed) - 1 month.

Early period - from 1 month to 1 year.

Sometimes the latent period is from 1 to 5 years.

Late period - after 1 year.

Symptoms of endemic syphilis

Fleeting manifestations - spots, shallow, slightly painful ulcers, sometimes stomatitis and cracks in the corners of the mouth appear on the oral mucosa. After a few weeks, these clinical manifestations disappear and often remain unnoticed.

Early period - disseminated non-itchy papules appear on the trunk and extremities, in folds - condylomas (vegetating papules). The long bones of the lower extremities are affected, nocturnal bone pains are disturbing, i.e. signs of osteoperiostitis.

Late period - manifests itself in skin gummas, ulcers and scars. Characteristic are gummas of the nasopharynx, of the gangosis type (mutilating nasopharyngitis), the appearance of bone gummas (osteoperiostitis), dyschromia (of the vitiligo type).

Diagnosis of endemic syphilis

Installed on the basis of:

• clinical picture of the disease;
• epidemiological data;
• age of patients (children);
• detection of treponemas in native preparations from the discharge of fresh early rashes (in a dark field microscope);
• positive serological reactions (RV, RIT, RIF).

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Treatment of endemic syphilis

Treatment of patients with endemic syphilis, as well as persons who have been in contact with them, is carried out with prolonged-action penicillin preparations (benzathine-benzylpenicillin, bicillin-1, etc.) in doses that are used to treat yaws. If there are contraindications to the use of penicillin, treatment is carried out with erythromycin or tetracycline.

Prevention of endemic syphilis

• Timely identification of sick children, their isolation from healthy children and appropriate treatment.
• Clinical and serological examination of all family members and persons who were in close contact with the patient to identify active and latent forms of the disease.
• Preventive treatment of all persons who have been in contact with patients with bejel.
• Improving living conditions and raising the sanitary culture of the population.