bejel /bej″əl/ [Ar, bajal] , a nonvenereal form of endemic syphilis prevalent among children in the Middle East and North Africa, caused by the spirochete Treponema pallidum subsp. endemicum. It is transmitted by person-to-person contact and by the sharing of drinking and eating utensils. Also called dichuchwa, endemic syphilis, frenga, siti. ▪ OBSERVATIONS: The primary lesion is usually on or near the mouth, appearing as a mucus patch, followed by the development of pimplelike sores on the trunk, arms, and legs. Chronic ulceration of the nose and soft palate occurs in the advanced stages of the infection. Destructive changes in the tissues of the heart, central nervous system, and mouth, often associated with the venereal form of syphilis, rarely develop. ▪ INTERVENTIONS: Intramuscular injection of penicillin is effective in curing the infection, but if extensive tissue destruction has occurred, scar tissue forms and may be permanently disfiguring. ▪ PATIENT CARE CONSIDERATIONS: Transmission is by close contact. Public health measures related to case finding and control of the spread of the disease are important.
