A child with the nephrotic syndrome associated with endemic syphilis. A case report.

Until recently, endemic non-venereally transmitted syphilis was well known in Europe and other countries' and several outbreaks occurred among children up to the beginning of this century! Typically, it affects small communities where there is a high incidence of positive serological tests for syphilis: Although persons of any age may be affected, it is generally a disease of young children. -' In different parts of the world endemic syphilis is known under various local names, e.g. 'njovera' in Rhodesia, 'dichuwa' in Botswana, 'bejel' in Syria and Iraq, 'firjal' or 'latta' in certain areas of Israel and Jordan. Unfortunately, many non-syphilitic cutaneous and oropharyngeal lesions are sometimes erroneously called by these names: Today, endemic syphilis is mainly found in dry, arid parts of the world where health standards are poorY Overcrowding during the cold winter nights, the sharing of feeding utensils' and broken skin lesions favour the tra.nsmission of Treponema pallidum from one person to another in a non-venereal manner. A primary chancre is hardly even seen3.' and most cases pr~ent with condylomata lata, ulcerative lesions of the mltcous membranes or the other skin lesions of secondary syl>hilis.... Whether the primary lesions are overlooked, ar~ present in an unobtrusive way or are entirely absent; is not known.