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Bejel

Disease Details

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Description: Bejel is a chronic, non-venereal disease caused by the bacterium *Treponema pallidum* subsp. *endemicum*, primarily affecting the skin and bones of children in arid regions of the Middle East and Africa.
Type: Bejel, also known as endemic syphilis, is an infectious disease. It is not genetically transmitted but is instead spread through close personal contact, often in childhood, in areas where the disease is endemic. The causative agent is the bacterium *Treponema pallidum* subspecies *endemicum*.
Signs And Symptoms: Bejel usually begins in childhood as a small patch on the mucosa, often on the interior of the mouth, followed by the appearance of raised, eroding lesions on the limbs and trunk. Periostitis (inflammation) of the leg bones is commonly seen, and gummas of the nose and soft palate develop in later stages.
Prognosis: Bejel is a bacterial infection caused by Treponema pallidum endemicum, primarily affecting skin, bones, and mucous membranes. It is treated with antibiotics, typically penicillin. The prognosis for bejel is generally good if diagnosed and treated early. Patients usually respond well to treatment, and symptoms can be fully resolved. However, untreated bejel can lead to serious complications, including deformities and chronic health issues. Early intervention is key to achieving the best outcomes.
Onset: Bejel, also known as endemic syphilis, typically has an insidious onset, meaning it develops gradually over time. The initial phase often involves the appearance of mucosal and skin lesions, particularly in the mouth and on the skin surfaces.
Prevalence: Bejel, also known as endemic syphilis, is caused by the bacterium *Treponema pallidum* subspecies *endemicum*. It primarily affects populations in arid regions of the Middle East and the Sahel in Africa. The prevalence of bejel is poorly documented but it tends to be higher in rural and economically disadvantaged areas where healthcare access is limited. Transmission is typically through nonsexual skin contact and sharing of eating utensils, rather than sexually, which distinguishes it from venereal syphilis.
Epidemiology: Bejel is mainly found in arid countries of the eastern Mediterranean region and in West Africa, where it is known as sahel.
Intractability: Bejel, also known as endemic syphilis, is a chronic bacterial infection caused by *Treponema pallidum* subspecies *endemicum*. It is not considered intractable. With appropriate antibiotic treatment, typically with penicillin, bejel can be effectively cured. Early diagnosis and treatment are crucial for preventing complications and transmission.
Disease Severity: Bejel, also known as endemic syphilis, is generally considered less severe compared to venereal syphilis. However, if left untreated, it can cause significant damage to the skin, bones, and mucous membranes. The severity can vary depending on the stage of the disease and access to medical treatment.
Healthcare Professionals: Disease Ontology ID - DOID:13431
Pathophysiology: Bejel, also known as endemic syphilis, is caused by the bacterium Treponema pallidum subspecies endemicum. It is a non-venereal disease, meaning it is not transmitted sexually, and is often spread through direct skin contact or sharing of eating utensils.

Pathophysiology:
1. Initial Infection: Bejel begins with primary lesions, usually in the form of painless ulcers (often inside the mouth).
2. Secondary Stage: The bacteria may then spread to the skin, bones, and lymph nodes, causing skin eruptions, mucosal lesions, and bone or joint pain.
3. Latency and Tertiary Stage: If untreated, the infection can become latent (asymptomatic) and later re-emerge in the tertiary stage, leading to more severe tissue damage, including gummas (soft, tumor-like growths), and bone or skin deformities.

Understanding the course of bejel and prompt treatment with antibiotics such as penicillin is crucial in preventing complications associated with the disease.
Carrier Status: Bejel, also known as endemic syphilis, is a non-venereal treponemal disease caused by the bacterium *Treponema pallidum* subsp. *endemicum*. It is primarily spread through direct skin contact, and sometimes through sharing eating utensils. The concept of "carrier status" is not commonly applicable to bejel in the same way it might be for other infections, such as viral diseases where an asymptomatic carrier state is well-documented. For bejel, individuals are typically either infected and symptomatic or have cleared the infection.
Mechanism: Bejel, also known as endemic syphilis, is caused by the bacterium Treponema pallidum subspecies endemicum. The disease primarily affects children in arid regions such as parts of the Middle East and Africa.

Mechanism:
Bejel is transmitted primarily through direct person-to-person contact, often within households due to shared utensils or close living conditions. It primarily manifests in the mucous membranes and skin but can progress to more severe systemic involvement if left untreated.

Molecular Mechanisms:
The molecular mechanisms of bejel involve the adhesion of Treponema pallidum subspecies endemicum to host cells, facilitated by outer membrane proteins. The bacterium has the ability to evade the host immune response through antigenic variation, a process in which the bacterium alters the proteins on its surface to avoid detection. Additionally, T. pallidum has a limited capacity for DNA repair, contributing to its ability to rapidly mutate and potentially enhance its survival and persistence within the host.

Chronic infection with this pathogen can lead to a variety of clinical symptoms due to its ability to invade multiple tissues and organs over time. The immune response to the infection, including inflammatory processes, can cause tissue damage, contributing to the progression of the disease.
Treatment: Bejel, also known as endemic syphilis, is treated with penicillin. Specifically, a single intramuscular injection of benzathine penicillin G is usually effective. If someone is allergic to penicillin, alternatives like doxycycline or tetracycline may be considered, but these options require a longer treatment course.
Compassionate Use Treatment: Bejel, also known as endemic syphilis, is a non-venereal treponemal infection primarily affecting children in arid regions. The bacterium involved is Treponema pallidum ssp. endemicum, closely related to the bacterium causing venereal syphilis.

### Compassionate Use Treatment:
Compassionate use treatments are special cases where a patient might receive an investigational drug outside of clinical trials, usually in instances where no other treatments are available and the patient has a serious condition. Given that bejel is effectively treated with antibiotics, the need for compassionate use of investigational treatments for bejel is minimal.

### Off-label or Experimental Treatments:
1. **Penicillin**: The standard and highly effective treatment, similar to venereal syphilis, involves intramuscular injections of benzathine penicillin G. This is not an off-label use but rather the recommended treatment.

2. **Tetracycline or Doxycycline**: These antibiotics can be considered as an alternative for those allergic to penicillin, though this also is not necessarily off-label but rather a second-line recommendation.

3. **Azithromycin**: There is some evidence of its efficacy in treating other treponemal infections, and it might be considered off-label for bejel. However, studies are limited, and penicillin remains the gold standard.

Given the high efficacy and safety profile of penicillin and other conventional antibiotics, off-label or experimental treatments for bejel are rarely needed. For the most precise and current treatment guidelines, consulting the latest medical literature or health authorities would be advisable.
Lifestyle Recommendations: Bejel, also known as endemic syphilis, is a non-venereal treponemal infection. Lifestyle recommendations for mitigating and managing bejel include:

1. **Promote Hygiene:** Maintain good personal and community hygiene to reduce transmission.
2. **Access to Clean Water:** Ensure access to clean drinking water and facilities for proper sanitation.
3. **Avoid Sharing Utensils:** Avoid sharing eating and drinking utensils which can help prevent the spread.
4. **Community Education:** Educate the community about the disease, its transmission, and preventive measures.
5. **Regular Health Checkups:** Encourage regular health checkups to detect and treat infections early.

For detailed guidance and treatment, seeking medical consultation is essential.
Medication: Bejel, also known as endemic syphilis, is primarily treated with antibiotics. The treatment of choice is usually penicillin, administered either as a single intramuscular injection of benzathine penicillin G or an alternative appropriate antibiotic regimen for those allergic to penicillin.
Repurposable Drugs: Bejel, also known as endemic syphilis, is a non-venereal treponemal infection caused by the bacterium *Treponema pallidum* subsp. *endemicum*. Information specific to repurposable drugs for bejel is limited. However, the treatment regimen for bejel is similar to that for syphilis. Penicillin remains the primary and most effective treatment. There are no known repurposable drugs specifically recommended for bejel outside the standard antibiotic treatments used for syphilis.
Metabolites: Bejel, also known as endemic syphilis, is caused by the bacterium *Treponema pallidum* subspecies *endemicum*. It is a non-venereal treponemal infection primarily found in arid regions of the Middle East and parts of Africa.

**Metabolites**: There is no specific focus on unique metabolites in the diagnosis or treatment of bejel itself. Instead, the diagnosis is commonly confirmed through serological testing for treponemal antibodies, which can cross-react with other treponematoses, including syphilis. Conventional diagnostic methods do not typically involve the analysis of specific metabolites.

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Nutraceuticals: Bejel, also known as endemic syphilis, is primarily treated with antibiotics such as penicillin. Currently, there is no substantial evidence or scientific research supporting the use of nutraceuticals (food-based substances with health benefits) or nanotechnology (nan) in the treatment of bejel. Conventional medical treatment remains the standard approach.
Peptides: Bejel, also known as endemic syphilis, is primarily caused by the bacterium *Treponema pallidum* subspecies *endemicum*. Current treatments do not typically involve peptides or nanotechnology-based approaches. Instead, the standard treatment is an antibiotic regimen, usually involving penicillin. There is no widely used peptide or nanoscale treatment as of now for this disease.