Pathology of Nonvenereal Endemic Syphilis ;  Bejel

 Dr Sampurna Roy MD   

Syn:  Endemic Syphilis ; Nonvenereal Syphilis

Bejel is a syphilis-like disease transmitted by a non-venereal route, such as from an infected baby to the breast of its mother, from mouth to mouth, or from utensils to mouth. 

Related post:  Pathology of Syphilis ; Neurosyphilis ; Congenital Syphilis ;  Yaws .

Bejel is caused by a spirochete, Treponema pallidum subspecies endemicum.

Poor children who live in rural arid areas under unsanitary conditions are commonly affected.

Other than on the nursing breast, primary lesions are rare.

Secondary lesions in the mouth are identical to the mucous lesions of venereal syphilis and may spread  from the upper airway to the larynx. 

Lesions of perineum and bone and gummas of the breast occur, but cardiovascular and neurologic lesions and congenital transmission are rare.

Numerous spirochetes are present in the epidermis, neutrophils invade the skin, plasma cells are prominent  in the dermis, and there is a syphilitic vasculitis.

Serologic tests for syphilis are positive, but the clinical presentation is different.

Penicillin is an effective remedy.

On the origin of the treponematoses: a phylogenetic approach.

Bejel: Acquirable only in childhood?

Overview of endemic treponematoses.

Bejel in Malatya, Turkey.

Treponemal disease revisited: skeletal discriminators for yaws, bejel, and venereal syphilis.

Ocular manifestations of endemic syphilis (bejel).

Review:endemic treponematoses are not always eradicated.