Diagnosis
Endemic non-venereal syphilis.
It is a chronic skin starting as painless mucous membrane ulcers then periostitis of the leg bones and gummas of the nose and soft palate.
Epidemiologic Risks
Person to person, especially among the poor by mouth-to-mouth contact or sharing of utensils. Mostly found the eastern Mediterranean and West Africa.
As of 2019 spread as an STD in MSM in Japan (PubMed).
Microbiology
T. pallidum subsp. endemicum.
Empiric Therapy
1.2 IM benzathine penicillin one time.
Last Update: 07/10/19.