Which are the symptoms of Bejel / Endemic Syphilis?

Symptoms of Bejel / Endemic Syphilis

Bejel, also known as endemic syphilis, is a chronic infectious disease caused by the bacterium Treponema pallidum. It is primarily found in arid regions of Africa, the Middle East, and Asia. Bejel shares similarities with syphilis but has distinct characteristics and a milder course of infection.

Primary Stage:

The primary stage of bejel typically begins with a painless sore called a chancre. This sore usually appears on the genitals, mouth, or anus, but can also occur on other parts of the body. The chancre develops within 10-90 days after exposure to the bacteria. Unlike syphilis, the bejel chancre is usually not as firm and may go unnoticed due to its painless nature.

Secondary Stage:

If left untreated, bejel progresses to the secondary stage. This stage is characterized by a variety of symptoms that can affect multiple body systems. Common symptoms include:

• Rash: A non-itchy rash may develop on the palms of the hands and soles of the feet. The rash can also appear on other parts of the body.


• Mucous Membrane Lesions: Painful sores may develop in the mouth, throat, and genital areas.


• Fever and Malaise: Generalized symptoms such as fever, fatigue, and body aches may occur.


• Swollen Lymph Nodes: Enlarged lymph nodes, particularly in the groin area, may be present.


• Joint Pain: Some individuals may experience joint pain and swelling.

Tertiary Stage:

If bejel remains untreated for an extended period, it can progress to the tertiary stage. However, unlike syphilis, the tertiary stage of bejel is rare. Tertiary bejel can manifest as:

• Gummatous Lesions: Soft, non-cancerous growths called gummas may develop on the skin, bones, and other organs. These lesions can cause significant damage if left untreated.


• Cardiovascular Complications: In rare cases, bejel can lead to cardiovascular complications, including inflammation of the heart and blood vessels.


• Neurological Symptoms: Late-stage bejel may cause neurological symptoms such as difficulty coordinating movements, paralysis, and sensory abnormalities.

Latent Stage:

Between the secondary and tertiary stages, bejel can enter a latent stage where no visible symptoms are present. However, the infection remains in the body and can be transmitted to others.

Diagnosis and Treatment:

Diagnosing bejel involves a combination of clinical evaluation, medical history, and laboratory tests. Blood tests can detect antibodies against Treponema pallidum to confirm the infection.

Bejel can be effectively treated with antibiotics, such as penicillin, which can eliminate the bacteria and prevent further complications. Early diagnosis and treatment are crucial to prevent the progression of the disease.

Prevention:

Preventing bejel involves practicing safe sexual behaviors, including the use of barrier methods such as condoms. Regular screening for sexually transmitted infections is also important, especially in high-risk populations.