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19- Infections Flashcards

1
Q

What are the 3 types of infectious diseases that exist?

A

1.) Bacterial infections
2.) Fungal infections
3.) Viral infections

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2
Q

What is impetigo?

A

It is a type of bacterial infection which affects the superficial surface of the skin.
Arises in areas of damaged skin.

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3
Q

What are the causes of impetigo?

A

1.) Streptococcus pyogenes
2.) Staphylococcus aureus (infections from open wounds)

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4
Q

What are some characteristics of impetigo?

A

1.) More common in children
2.) Very contagious
3.) It is preceded by a herpes simplex infection (cold sores)
4.) Can appear to look similar to herpes infections

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5
Q

What does impetigo usually present it self like?

A

Usually like a blister or yellow adherent yellow crust

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6
Q

What are the treatment options for impetigo?

A
  • Antibiotics (cloxacillin or clindamycin) oinment like treatment.
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7
Q

What is streptococcal pharyngitis?

A

Also known as a sore throat but is caused by streptococcus bacteria and is more serious
* It is mostly viral and self-limiting

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8
Q

What are the clinical findings of streptococcal pharyngitis?

A

1.) Fever, headache, malaise
2.) Dysphagia (pain upon swallowing)
3.) Erythema of the pharynx (redness of pharynx)
4.) Lymphadenopathy (swelling of lymph nodes)

**Possible side effect is Scarlet Fever

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9
Q

What is the result of Scarlet Fever?

A

It comes from group A streptococcus infection

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10
Q

How does Scarlett Fever present itself?

A

Initially as a white strawberry tongue. White colour will disappear in a few days and will exhibit a strawberry tongue

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11
Q

How can streptococcal pharyngitis be diagnosed?

A

Through a throat swab.

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12
Q

What can untreated streptococcal pharyngitis lead to ?

A

It can lead to rheumatic fever. A cross reactivity reaction. Which is type II hypersensitivity

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13
Q

How is Streptococcal Pharyngitis treated?

A

It is treated through a Penicilin, which targets the bacteria

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14
Q

What is Syphilis?

A

It is an STI infection (bacterial) which is caused by spirochetes (worm-like bacteria)

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15
Q

What is the spirochete bacteria called that causes Syphilis?

A

Treponema pallidum

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16
Q

How many stages of Syphilis exist?

A

3 stages + congenital syphilis

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17
Q

What is the first presentation of syphilis? (primary syphilis)

A

1.) It exhibits as chancre, which is a painless, indurated ulcer commonly found on the genitals but can arise on the oral mucosa

2.) Can exhibit a painless regional lymphaedenopathy (hardening of the lymph nodes)

3.) Very contagious

4.) Spontaneously resolves in 3-12 weeks

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18
Q

How can the causative spirochetes of syphilis be seen?

A

In a dark-field microscopy on a smear.

  • Also with a VDRL (Venereal disease Research Laboratory) test
    *Warthin-Starry stain
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19
Q

What occurs in the secondary presentation of syphilis?

A

1.) Flu-like symptoms
2.) Mucous path involving the oral mucosa
3.) Maculopapular rash on the body (flat lesion & bump like appearance)
4.) Very contagious (like primary)

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20
Q

What occurs in the tertiary stage of syphilis?

A

1.) Not very contagious
2.) Can occur years after the second stage
3.)Can pose serious concerns including neurological involvement & cardiovascular manifestations

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21
Q

What are the oral manifestations of tertiary syphilis?

A

1.) Syphilllitic glossitis: a thickened white plaque on the tongue dorsum

2.) Gumma: a destructive granuloma that usually involves skin but can involve oral mucosa. It most commonly involves the palate. Can be destructive

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22
Q

What occurs in Congenital Syphilis?

A

1.) The spirochete treponema pallidum can cross the placenta and infect the fetus in the 3rd trimester

2.) Leads to a symptom known as Classic Hutchinson’s Triad

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23
Q

What are the 3 pre-disposing symptoms of Classic Hutchinson’s Triad

A

1.) Interstitial keratitis (eye inflammation)
2.) 8th nerve deafness
3.) Mulberry molars and Hutchinson’s Incisors (dental anomalies & nothing of the incisors)

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24
Q

What causes Tuberculosis?

A

It is due to mycobacterium tuberculosis. It occurs prior to the pasteurization of milk, and oral lesions secondary to bovine TB were common.

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25
Q

How is Tuberculosis spread nowadays?

A

Either from blood or from direction implantation from infected sputum

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26
Q

What are the 2 main forms of TB?

A

1.) Primary infection
2.) Secondary infection

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27
Q

How does primary infection of TB typically occur?

A

Occurs in previously unexposed people. It primarily affects the lungs.

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28
Q

How does secondary infection of TB typically occur?

A

Occurs in 5-10% of patients due to immunosuppression.

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29
Q

What are the common oral sites in which Tuberculosis can affect?

A

1.) The palate and gingiva
2.) Lymph nodes often involved

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30
Q

What are the clinical presentations of tuberculosis?

A

1.) Chronic, painless ulcer or nodule
2.) Can look similar to OSCC

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31
Q

In Tuberculosis if there is oral involvement, there is also _____ involvement

A

Lung involvement

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32
Q

What are the diagnostic methods of Tuberculosis?

A

1.) If it stains positive with a Ziehl-Nielsen stain (will be able to pick up TB)
2.) Identification of an acid-fast bacili

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33
Q

What are the treatment options for Tuberculosis?

A

Antibiotics for a very strict and long regimen.

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34
Q

What is the etiology of Actinomyocosis?

A

1.) It is a filmentaous, gram-positive branching of anaerobic bacteria (bacteria that does not want exposure to oxygen)

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35
Q

What is the bacteria of Actinomyocosis known as?

A

It is known as Actinomyces israelii

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36
Q

How does Actinomycosis present itself?

A

It presents itself as a draining facial fistula (Starts in the mouth and drains into the skin)

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37
Q

How long does an Actionmycosis last?

A

It may last weeks or months, especially if we don’t get the root cause

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38
Q

What kind of bacteria is an actinomycosis?

A

It is a normal oral, commensal bacteria that can be found in necrotic pulp canals (meaning it can become pathologic - dead teeth can arbour this infection)

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39
Q

How does actionmycosis often spread?

A

It is often spread from necrotic tooth after trauma or a difficult dental extraction

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40
Q

What are the small yellow substances expelling from the pus draining from an actinomycosis lesion?

A

Sulphur granules

41
Q

What is the treatment of actinomycosis?

A

surgical debridement + high dose antibiotics

42
Q

What is zygomycosis?

A

It is a type of fungal infection in which fungus grows in decaying organic materials

43
Q

What class of fungus does the zygomycosis infections come from?

A

The zyogmycetes class of fungus

44
Q

In what kind of people does zygomycosis exacerbate?

A

1.) In uncontrolled diabetics
2.) In immunocompromised patients

45
Q

What are indication of zygomycosis histologically?

A

large, non-septate fungal hyphae

46
Q

What occurs if zygomycosis is left untreated?

A

1.) Involvement of orbit and loss of vision (spread through the eyes = loss in vision)
2.) Possible intracranial spread

47
Q

What treatments are used in zygomycosis?

A

1.) Surgical debridement
2.) IV antifungal medications

  • Needs to be treated early and aggressive
48
Q

What is oral candidiasis?

A

It is a fungal infection caused by Candida Albicans

49
Q

What are the two forms of candidiasis?

A

1.) Yeast form
2.) Hyphal form

50
Q

What is the non-pathologic form of candidiasis?

A

Yeast form
- normal in 50% of people
- not pathologic

51
Q

What is the pathologic form of candidiasis?

A

Hyphal form
- Disease form
- Invades tissues

52
Q

What is the most common clinical presentation of candidiasis?

A

Erythematous (atrophic) = most common and classic presentation of candida.

53
Q

What does pseudomembranous mean in candidiasis?

A

Has a white plaque appearance (thrush)

54
Q

What are the causes of Pseudomembranous Candidiasis?

A

1.) Antibiotic use
2.) Immunosuppression (leukemia, AIDS, uncontrolled diabetics etc)
3.) Xerostomia
4.) Corticosteroid use (inhaler)
5.) Poor denture hygiene

55
Q

What is erythematous (atrophic) candidiasis?

A

When the tissue has a burning or tender appearance to it. The tissue is erythematous. It is the most common form of candidiasis.

56
Q

What is angular cheilitis?

A

A form of perioral candidiasis (meaning it is around the mouth/corner of the mouth)

57
Q

What are the clinical presentations of Angular Cheilitis?

A

1.) It is cracking at lip commissures
2.) Often tender/painful
3.) Where patients have intraoral candida as well

58
Q

For diagnosis of Candidiasis, why is a cytology smear more efficient than a culture?

A

Because a culture can identify candida that is NOT pathologic, leading to a high false positive rate

59
Q

What are the treatments used for candidiasis?

A

1.) Antifungal medications
2.) Nystatin, Fluconazole - most common used for oral infections.

60
Q

What is Herpes Simplex Virus?

A

It is a viral virus due to the HSV-1 & HSV-2.

61
Q

Which herpes virus variant is more associated with oral lesions?

A

HSV-1

62
Q

Which herpes virus variant is more associated with genital herpes?

A

HSV-2

63
Q

What are the 2 main presentations of the Herpes Simplex Virus?

A

1.) Acute herpetic gingivostomatitis
2.) Recurrent herpes infections

64
Q

What is the more common presentation of the Herpes Simplex Virus?

A

Recurrent herpes infections

65
Q

Which presentation of Herpes Simplex Virus is more apparent in kids?

A

Acute herpetic gingivostomatitis. Minority of patients actually exhibit this full blown response.

66
Q

Which presentation of Herpes Simplex Virus is more apparent in adults?

A

Recurrent herpes infections

67
Q

How is HSV-1 spread?

A

It is spread through saliva and vesicles (acute herpetic gingivostomatitis). It represents first contact with HSV virus.

68
Q

What is the incubation range for acute herpetic gingivostomatitis?

A

Days to 2 weeks.

69
Q

What is prodrome?

A

It is a fever, headache and lymphadenopathy which come from Acute Herpetic Gingivostomatitis.

70
Q

Acute Herpetic Gingivostomatitis involves ____ and _____ mucosa as well as _______ skin

A

Unattached, attached & perioral

71
Q

What do patients exhibit in acute herpetic gingivostomatitis?

A

Bright red gingival erythema & vesicles which subsequently ulcerate

72
Q

How many days does it take for the primary infection to self-limit and resolve itself?

A

7-10 days

*Antivirals can used if within the first 3 days
* Pain control to help patients as it resolves on it own

73
Q

Where does the HSV virus migrate to? (hint: it remains latent in this ganglion)

A

In the trigeminal nerve. This is why we have recurrences throughout our lives, the virus is with you for life.

74
Q

What is the most common form of recurrent infection?

A

A recurrent herpes labialis (RHL), involving lip vermilion.

75
Q

What are the triggers of recurrent herpes simplex?

A

Sunlight, stress, certain foods.

*May trigger erythema multiforme.

76
Q

What are the treatments used for recurrent herpes simplex?

A

1.) Antivirals
2.) Acyclovir or valacyclovir (Valtrex)

77
Q

Where does recurrent intraoral herpes occur?

A

in the mouth from HSV-1.

78
Q

Where is the most common area of recurrent intraoral herpes?

A

The palate or gingiva. The lesion is involved with the attached mucosa (keratinized mucosa)

79
Q

What are the treatments used for recurrent intraoral herpes?

A

Antiviral medications

80
Q

What are the diagnosis methods for Herpes Simplex Virus?

A

1.) Viral culture
2.) Cytology
3.) Biopsy

81
Q

What is Varicella Zoster Virus? (HHV-3 OR VZV)

A

It is the virus responsible for chickenpox (varicella) and for shingles (zoster)

82
Q

What is the initial symptoms of varicella-zoster virus?

A

Fever, malaise, headache, and vesiculopustular rash

83
Q

What occurs after chickenpox is resolved?

A

The virus remains dormant in the sensory nerve ganglia.

84
Q

What do shingles represent?

A

It is a recurrence of the virus which increases with age.

85
Q

What are unique features of shingles?

A

1.) It has a dermatomal distribution, which means it will be strictly limited to one side of the body.
2.) It follows a 1 attack rule (has multiple recurrences)

86
Q

What can trigger Shingles?

A

1.) Chemotherapy
2.) Malignancy
3.) Immunosuppression
4.) Old age

87
Q

What are the oral manifestation of shingles?

A

1.) Multiple vesicles noted on attached mucosa
2.) Stops at the midline

88
Q

What are the possible long-term side effects of shingles?

A

1.) Postherpetic neuralgia: chronic neuropathic pain

2.) Ramsay Hunt Syndrome: Facial paralysis (7th nerve drop), vertigo

89
Q

What are the treatments used for varicella zoster virus?

A

1.) Antivirals medications
- Only effective if used early in the infection.

90
Q

What is Epstein Barr Virus? (EBV OR HHV-4)

A

It is known as the infectious mononucleosis “kissing disease”

91
Q

What are the other EBV diseases?

A

1.) Oral hairy leukoplakia
2.) Lymphoma
3.) Nasopharyngeal carcinoma

92
Q

What is cytomegalovirus? (CMV or HHV-5)

A
  • It is an oral lesion which can proliferate into oral ulcers in immunocompromised patients
  • Xerostomia
  • Sialadenitis
93
Q

What is Coxsackie virus?

A

It is a viral virus responsible for
1.) Hand-Foot-Mouth disease
2.) Herpangina
3.) Acute lymphonodular pharyngitis

94
Q

Who and where are the Coxsackie virus more prevalent in?

A

1.) In children.
2.) Oral lesions anterior to first molars.
3.) lesions involving feet and hands.

95
Q

What is the treatment needed for Coxsackie Virus

A

There is no treatment used for Coxsackie Virus.

96
Q

What is HIV?

A

It is known to be as the Human Immunodeficiency Virus, which is an RNA retrovirus.

97
Q

What determines the severity of the HIV virus?

A

The CD4 count. The lower the CD4 count, the worst you are off

98
Q

What is the last stage of HIV infection?

A

AIDS (acquired immunodeficiency syndrome)

99
Q

How many attack of varicella zoster virus can you have?

A

1 is the rule, unless you have recurrences

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