Bejel in Cuba: molecular identification of Treponema pallidum subsp. endemicum in patients diagnosed with venereal syphilis.

Molecular identification of Treponema pallidum subsp. endemicum, the agent of bejel, in Cuban patients diagnosed with syphilis indicates the clear limitations of a diagnosis based exclusively on serology, geographical occurrence, clinical symptoms, and anamnestic data. This finding has important implications for Global Public Health Systems, including paradigms changes regarding the location of endemic outbreaks, clinical aspects, and transmission of this neglected disease.