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Bejel, also known as endemic syphilis, is a chronic but curable disease, seen mostly in children in arid regions. Unlike the better-known venereal syphilis, endemic syphilis is not a sexually transmitted disease.


Bejel has many other names depending on the locality: siti, dichuchwa, njovera, belesh, and skerljevo are some of the names. It is most commonly found in the Middle East (Syria, Saudi Arabia, Iraq), Africa, central Asia, and Australia. Bejel is related to yaws and pinta, but has different symptoms.

Causes and symptoms

Treponema pallidum, the bacteria that causes bejel, is very closely related to the one that causes the sexually transmitted form of syphilis, but transmission is very different. In bejel, transmission is by direct contact, with broken skin or contaminated hands, or indirectly by sharing drinking vessels and eating utensils. T. pallidum is passed on mostly between children living in poverty in very unsanitary environments and with poor hygiene.
The skin, bones, and mucous membranes are affected by bejel. Patches and ulcerated sores are common in the mouth, throat, and nasal passages. Gummy lesions may form, even breaking through the palate. Other findings may include a region of swollen lymph nodes and deep bone pain in the legs. Eventually, bones may become deformed.


T. pallidum can be detected by microscopic study of samples taken from the sores or lymph fluid. However, since antibody tests don't distinguish between the types of syphilis, specific diagnosis of the type of syphilis depends on the patient's history, symptoms, and environment.


Large doses of benzathine penicillin G given by injection into the muscle can cure this disease in any stage, although it may take longer and require additional doses in later stages. If penicillin cannot be given, the alternative is tetracycline. Since tetracycline can permanently discolor new teeth still forming, it is usually not prescribed for children unless no viable alternative is available.


Bejel is completely curable with antibiotic treatment.


The World Health Organization (WHO) has worked with many countries to prevent this and other diseases, and the number of cases has been reduced somewhat. Widespread use of penicillin has been responsible for reducing the number of existing cases, but the only way to eliminate bejel is by improving living and sanitation conditions.



Fauci, Anthony S., et al., editors. Harrison's Principles of Internal Medicine. New York: McGraw-Hill, 1997.

Key terms

Endemic disease — An infectious disease that occurs frequently in a specific geographical locale. The disease often occurs in cycles. Influenza is an example of an endemic disease.
Lymph — This is a clear, colorless fluid found in lymph vessels and nodes. The lymph nodes contain organisms that destroy bacteria and other disease causing organisms (also called pathogens).
Syphilis — This disease occurs in two forms. One is a sexually transmitted disease caused by a bacteria. The second form is not sexually transmitted, but passed on by direct contact with the patient or through use of shared food dishes and utensils.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


Nonvenereal endemic syphilis, now found chiefly among Arab children; apparently due to Treponema pallidum.
See also: nonvenereal syphilis.
[Ar. bajlah]
Farlex Partner Medical Dictionary © Farlex 2012


A nonvenereal form of syphilis that is endemic primarily among children in the Middle East and North Africa, characterized by mouth and skin lesions and destruction of long bone tissue, and caused by a strain of the spirochete Treponema pallidum that is transmitted by mouth-to-mouth contact or shared utensils.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A non-venereal infection by Treponema pallidum endemicum—which is indistinguishable from venereal T pallidum pallidum—which causes syphilis, and affects children in Saharan Africa and the Middle East.
Clinical findings, early
Lymphadenitis, condyloma-like oropharyngeal, anogenital lesions.
Clinical findings, late
Lesions mimic tertiary syphilis—e.g., gumma of the nose and soft palate, bony deformities, nodular skin ulcers.
Penicillin, erythromycin, tetracycline.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Nonvenereal endemic syphilis, now found chiefly among Arab children; apparently due to Treponema pallidum.
[Ar. bajlah]
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


A non-venereal form of SYPHILIS affecting mainly children and occurring principally in the Eastern Mediterranean. The condition is becoming rare.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
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Bejel uses the broader context of photography's early manifestation in the daguerreotype, as well as the new medium's commercial establishment and cultural currency, to construct a deeper exploration of Marti's ambivalent attitudes toward new technologies and modernity in general.
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que tambien en esta hay un cierto primitivismo con el que, senala Bejel,
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pallidum subspecies endemicum, which is responsible for nonvenereal endemic syphilis, also known as bejel; and T.
Contributions to the LGBT discussion have been made by, among others, Emilio Bejel (2001), Marvin Leiner (1994), Ian Lumsden (1996), and Dwayne Turner (1989).
"The bejel (a musical instrument used to announce the arrival of VIPs) is one of our most essential instruments, often used during official functions," Al Shair said.