Actinomyces & candida Flashcards
Actinomyces
Gram +, filamentous, uneven staining, sometimes branches.
Facultive anaerobe.
Commensal of mouth, gut, vagina.
What do actinomyces cause? When is it common?
Painful slow growing abscess
Common if recent dental Tx, poor OH or perio
How do you diagnose actinomyces?
Microbial culture
Immunoassay
MRI
Splendore-Hoeppli reaction
Protein-lipid complex that forms around the actinomyces bacteria to wall it off from host’s immune system.
Bact cannot be phagocytosed or intracellularly killed. Therefore bact survives and so is chronic. Bact secretes things which damage tissue.
Actinomyces Tx
Drainage of abscess Long course (6-8w) Ab
Candida
Dimorphic/trimorphic fungus (yeast, pseudohypae or hyphae)
Difference between candida forms
Yeast - separate daughter cells, commensal
Pseudohyphal - tubular shape with daughter cell loosely attached
Hyphal - thin long tubes with daughter cell attached at points along tube, pathogenic
Candida culture
Sabouraud’s agar - creamy white colonies
Agar to test type of candida present.
Chromatic candida agar - detects target enzymes so different candida.
Candidiasis
Must have predisposing factor e.g. immunosuppressed, low saliva flow, prosthetics
Affects mucosa/skin - red patch - oral, vagina, lungs, blood stream.
Oral candidiasis
- Thrush (acute pseudomembranous candidiasis)
White patches that scrape off leaving red lesion underneath.
HIV association - Denture stomatitis (chronic atrophic) - red lesion where epithelium damaged.
- Chronic hyperplastic - smoking - candida inhabit dysplastic epithelium (aids cancer progression)
- Acute atrophic - red tongue - long term corticosteroids
- Erythematous lesions - HIV association
- Angular cheilitis - poor diet, H+N radio
Denture predisposing factors
Prosthetics - prevent epithelial exfoliation
Immunosuppressed - chemo, prolonged Ab tx, genetics
Low saliva flow
