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PubMed1989

Ocular manifestations of endemic syphilis (bejel).

Bejel or nonvenereal syphilis is a treponemal infection that is still endemic in many parts of the world including Saudi Arabia. The authors have examined 17 patients with clinical findings consistent with bejel. All patients had positive serologic tests for bejel. There were 11 male and six female patients, with a mean age of 54 years (range, 37-73 years). Results of clinical examination showed uveitis in nine patients, optic atrophy in six, and chorioretinitis scars in six. In four patients who needed intraocular surgery, two aqueous specimens showed positive antibodies for Treponema pallidum.

Adult↗

PubMed1995

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

Assigning responsibility for the origins of treponemal disease has been complicated because of the (diagnostic) impreciseness of the historical written record and the inability to microbiologically distinguish among the treponematoses. Bedouin skeletal remains of individuals from the Negev area of Israel who had bejel, skeletons from the Todd human skeleton collection of individuals in whom syphilis was diagnosed, and skeletal remains from Guam of individuals who had yaws were analyzed to quantitatively assess their skeletal damage. The osseous reactions, although reproducible for each variety of treponemal disease, are not uniform among these skeletons. Examination of population frequency, demographics, character, and skeletal distribution of osseous treponemal damage in these skeletal sites provides clear, reproducible clues to the identity of the underlying treponematosis: bejel and yaws are common (> 20% according to skeletal findings) in the population. Syphilis and bejel usually spare the hands and feet. Yaws tends to be more polyostotic. Analysis of these parameters as population phenomena in pre-Columbian archeological sites should afford the opportunity to define the origins of the various treponemal disorders.

Archaeology↗

PubMedDate not supplied

Endemic nonvenereal treponematosis (bejel) in Saudi Arabia.

A total of 2,515 individuals attending a large military hospital in Saudi Arabia who had appropriate radiologic evidence of treponematosis were studied clinically and serologically. The indications are that nonvenereal treponematosis (bejel) exists in considerable numbers among the nomadic communities living in rural areas. In contrast, venereal syphilis is less common in this population and is found almost exclusively in urban populations. Some of the high-risk regions for bejel have been identified. Many individuals from nomadic communities complained of persistent pain in the lower limbs, which was often associated with radiologic evidence of osteoperiostitis of the long bones. It also appears that within the last 30 years bejel has become clinically attenuated, with the majority of seropositive individuals having latent disease. A hypothesis is put forward that persistent lesions are sustained by superinfection and that improvements in hygiene have resulted in a decrease in the incidence of reexposure. Measures to control the infection are outlined.

Adolescent↗

PubMed1995

Bejel in Malatya, Turkey.

Bejel is a form of endemic syphilis which is transmitted by non-venereal route. According to our knowledge, no cases of bejel have been reported from Turkey for more than 30 years. In this report, three children and their father who suffer from bejel are presented. The history, physical findings, laboratory investigations, treatment and results of the cases are reviewed, and the related literature is discussed.

Adolescent↗

PubMed1984

Endemic non-venereal syphilis (bejel) in Saudi Arabia.

A total of 2515 people attending a large military hospital in Saudi Arabia was studied clinically, serologically, and (when appropriate) radiologically for evidence of treponematosis. The indications are that non-venereal endemic syphilis (bejel) is prevalent among the nomadic communities living in rural areas. In contrast, venereal syphilis is much less common, and is found almost exclusively in urban populations. Some of the high risk regions for bejel have been identified, and many people from these locations complained of persistent pain in the legs, which was often associated with radiological evidence of osteoperiostitis of the long bones. Bejel also seems to have become clinically "attenuated" within the last 30 years, with the majority of seroreactors having latent disease. A hypothesis suggesting a reason for this change is put forward, and ways of controlling the infection are outlined.

Adolescent↗

PubMed1999

[Bejel: an unusual cause of stomatitis in the child].

INTRODUCTION: Bejel (endemic syphilis) is usually encountered in children living in intertropical areas, although imported cases have been exceptionally reported in Europe. OBSERVATION: We report on a young girl aged 5 diagnosed in France, who had painless stomatitis and enlarged cervical nodes. Diagnosis of bejel was confirmed by serology, and spirochetes were shown inside mucous patches by biopsy specimen silver staining. Favorable clinical and serological outcome occurred following benzathin-penicillin therapy. Contamination is likely to have occurred in Mali where she had been living for several years, but secondary stage manifestations only appeared in France, where she was living for several months. DISCUSSION: Although rare in France, bejel should not be overlooked in children originating from countries where endemic syphilis has a high prevalence.

Biopsy↗

PubMed1984

Burned-out endemic syphilis (Bejel): facial deformities and defects in Saudi Arabia.

Endemic syphilis (bejel) is an endemic, contagious, non-sexually transmitted treponematosis of primitive communities which, if not treated, can cause deformities and defects of the face in its late stage. Several burned-out cases from Saudi Arabia are shown, and the techniques of plastic surgical repair are presented by word and illustrations. We describe in detail a total rhinoplasty (with panfacial reconstruction) in which a scalping flap was used as outer cover and superimposed on a classical island forehead flap based on a subcutaneous pedicle containing both frontal vessels for inner lining.

Adolescent↗

PubMed1988

Late endemic syphilis: case report of bejel with gummatous laryngitis.

An elderly Bedouin woman originally thought, on clinical and histological grounds, to have tuberculosis of the larynx was found to have gummatous laryngitis due to late endemic syphilis (bejel). This disease is highly prevalent in the Bedouin tribes of the Middle East. Doctors dealing with Arab patients, either in the Middle East or elsewhere, should be aware of this possibility.

Aged↗

PubMed1952