Treponema pallidum endemicum

Treponema pallidum endemicum is a bacterium that causes bejel, a chronic infection primarily found in the Middle East and parts of Africa. Bejel is a nonvenereal form of syphilis, meaning it is not transmitted through sexual contact. Instead, it spreads through direct contact with lesions, such as kissing or sharing utensils, often in unhygienic environments, particularly among children.12

The infection typically begins with eruptions in the mouth and on the skin. While these may resolve, the infection can progress to involve bones, causing lesions and later gummy ulcers. Bejel is diagnosed through microscopic examination of lesion material and patient history. Treatment, similar to syphilis, involves antibiotics. Other related endemic treponematoses include pinta and yaws, which are also nonvenereal spirochete infections.13