Endemic syphilis (Bejel)

Abstract

Endemic syphilis or Bejel is a non-venereal syphilis. The disease is endemic in many parts of the world including Saudi Arabia. It has been estimated that 4.7% of the patients presenting to hospitals in Saudi Arabia have positive serology to Treponema pallidum and Bejel is known to be endemic among the bedouin population in the Kingdom of Saudi Arabia [1–3]. The onset of the disease is in early childhood and starts with lesions in the buccal mucus membranes. It is believed that most of the cases are due to the communal sharing of drinking vessels. The disease may also be associated with skin lesions. Bejel may become latent for many years or decades. Endemic syphilis usually occurs in patients living in primitive environments with low standard of hygiene. Congenital transmission of the disease has not been reported and patients develop no clinical evidence of cardiovascular or neurological involvement which makes this entity different from venereal syphilis. The main objective of this report is to describe the ocular findings among two patients with endemic syphilis. Both patients had evidence of antibodies to Treponema pallidum in the aqueous humor.