Non-venereal syphilis
Non–venereal syphilis is a chronic infectious disease that manifests itself with erythematopapular rashes (in the early stages) and gummas (in the later period).
This disease has a number of other synonymous names: bedzhel, dichuchva, balyash, frenga, zuhria, treponematosis, endemic syphilis, Arabic syphilis. Non-venereal syphilis belongs to the category of endemic diseases (that is, those that are characteristic of a certain area).
The most common cases of non-venereal syphilis are in Equatorial Africa and the arid regions of the Middle East. Children aged 2-10 years are especially susceptible to this disease. Very often there are multiple cases of morbidity in one family. In some localities, 40-60% of the population may be ill at the same time.
The causative agent of non- venereal syphilis
The causative agent of this disease is one of the subspecies of gram–negative spirochete of the species Pale Treponema (Treponema pallidum), namely Treponema pallidum endemicum.
It is a close relative of Treponema pallidum pallidum, a bacterium that causes syphilis.
There are two other known subspecies of this spirochete: Treponema pallidum pertenue and Treponema pallidum carateum. The first is the causative agent of yaws, the second is the causative agent of pint.
All these diseases (except ordinary syphilis) are sometimes called varieties of non-venereal syphilis, but the ICD-10 defines them under different encodings. Non–venereal syphilis (or bedzhel) received the code A65, yaws – A66, pinta – A67.
Causes of the disease
Infection with non-venereal syphilis occurs in a domestic way: through direct contact, when using common towels and dishes, during ritual ablutions, etc.
The factors provoking morbidity are the low socio-cultural level of the population, poor sanitary conditions, lack of medical care.
Symptoms of bedzhel and stages of the disease
The course of non-venereal syphilis includes separate stages. The early stage includes the incubation period (from 1-2 weeks to 3 months), as well as primary and secondary rashes. The late (tertiary) stage includes gummas (characteristic nodes in tissues where their destruction occurs; ulcers, after which noticeable scars remain).
First, in the place through which the pathogen entered the body, a bedzheloid chancre appears. Then rashes form on the mucous membrane of the mouth, as well as in the area of the genitals and anus. They tend to macerate (get wet).
Further manifestations of the disease spread to the skin of the trunk and limbs. These are brown-red rashes that peel off and itch a lot. Such rashes in the absence of treatment last from six months to a year.
This is usually followed by a tertiary stage: part of the rash is transformed into gummous (nodular or ulcerative) rashes. At this stage, infection is less likely, but tertiary bedzhelids are very painful and pose a danger to the patient himself. At this stage, the disease deeply affects the subcutaneous base, bones, joints, tendons. Extensive ulcers with fistulous passages and purulent secretions are formed.
Diagnosis of non-venereal syphilis
The basis for the diagnosis of “non-venereal syphilis” is an examination of the patient, an assessment of the sanitary and epidemiological situation at the intended site of infection, a number of serological studies.
Treatment of non-venereal syphilis
Despite such severe manifestations, the disease is completely curable. In the early stages, treatment is reduced to antibiotic therapy, the course is about two weeks. Usually, prolonged-acting drugs are used, with long intervals between injections.
If the disease has passed into the tertiary stage, restorative surgical operations may be necessary.
After healing, persistent immunity is not observed, re-infection is possible.
