In simple words: Bejel is a type of syphilis not spread through sexual contact.It's caused by a germ similar to the one that causes regular syphilis. Bejel is mainly found in places with poor sanitation and usually affects children. It causes sores, rashes, and sometimes bone pain. If it's not treated, it can cause serious problems later on. Doctors can treat it with antibiotics.

Nonvenereal syphilis, also known as bejel, endemic syphilis, or Njovera, is a chronic infectious disease caused by the bacterium Treponema pallidum endemicum. It's transmitted through non-sexual contact, primarily affecting children in regions with poor hygiene and dry climates. Symptoms mimic venereal syphilis, including lesions, rashes, and bone pain.Severe cases can lead to gumma formations. Diagnosis involves physical examination, laboratory tests, and assessment of environmental conditions. Treatment typically includes penicillin, with alternative options like chloramphenicol or tetracycline.

Example 1: A 10-year-old child living in a rural area with poor sanitation presents with painless ulcers in the mouth and nasopharynx.The child has no history of sexual activity.Laboratory tests confirm Treponema pallidum endemicum infection., Multiple children in a remote village present with skin rashes and bone pain. Upon investigation, it's discovered they share utensils and drinking water sources. Nonvenereal syphilis is diagnosed based on clinical findings and lab results., An adult refugee from a region with known endemic syphilis presents with gumma lesions. They clarify that these lesions developed years after initial infection during childhood.

Documentation should include the patient's symptoms, exposure history (living conditions, sanitation, contact with infected individuals), physical examination findings, and laboratory test results confirming T. pallidum endemicum. Environmental factors and travel history to endemic areas should also be documented.