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 cartilages.

[1], [2], [3], [4], [5], [6], [7], [8]

Epidemiology of endemic syphilis

The disease is transmitted predominantly through contact, especially in children. This is facilitated by a low sanitary culture, the tightness of dwellings, drinking from one dish, ritual ablutions. An indirect path of infection is through infected dishes for drinking; straight - through fingers contaminated with saliva containing treponema. Adults most often get infected from their children. The carrier of the disease can be flies.

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Causes of endemic syphilis

Bejel is called Treponema pallidum (bejel); some antigenic and pathogenic differences between the causative agents 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.

The early period is 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 - on the oral mucosa there are spots, superficial malo-painful ulcers, sometimes stomatitis and cracks in the corners of the mouth. After a few weeks, these clinical manifestations disappear and often go unnoticed.

Early period - there are disseminated unhealthy papules on the trunk and extremities, in the folds - condylomas (vegetative papules). The long bones of the lower limbs are affected, the night bone pains, that is, the signs of osteoperostitis, are disturbed.

The late period is manifested by the skin's gums, ulcers and scars. Characteristic are the gum nasopharynx, the type of gangosis (mutating rhinopharyngitis), the appearance of bone gumm (osteoperioditis), dyschromia (type of vitiligo).

Diagnosis of endemic syphilis

It is installed on the basis of:

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

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Treatment of endemic syphilis

Treatment of patients with endemic syphilis, as well as those in contact with them, is carried out with long-acting penicillin preparations (benzathine-benzylpenicillin, bicillin-1, etc.) at doses that are used to treat yaws. With contraindications to the use of penicillin treatment is carried out with erythromycin or tetracycline.

Prevention of endemic syphilis

• Timely detection of sick children, their isolation from healthy children and appropriate treatment.
• Clinico-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 in contact with patients with disasters.
• Improvement of housing and living conditions, improvement of sanitary culture of the population.