bact viral fungal Flashcards
what cause necrotizing gingivitis
-ve bacteria spirochaetes
Other factors – stress, smoking, fatigue, poor oral hygiene, decreased host resistance/immune response
clinical feature of necrotizing gingivitis
painful necrosis and crater-like, punched out ulceration of the interdental papillae
sudden onset
Ulcers covered by greyish pseudomembrane demarcated from surrounding mucosa by linear erythema
what is thought to arise subsequent to necrotizing gingivitis
cancrum oriswha
what cause cancrum oris
malnourished
other systemic infection (measles)
begins as necrosis of gingivae but spreads to adjacent soft tissues and bone resulting in severe, gangrenous necrosis of oral tissues
what is actinomyces infection (actinomycosis) characterized by?
multiple foci of chronic suppuration
firm swellings commonly in the submandibular region with variable pain symptoms
abscesses which leads to marked fibrosis of surrounding tissues
abscess is characterized by many small yellow granules aka ‘sulphur granules’ - represent microbial colonies
what is responsible for syphilis
bacteria infection - spirochaete Treponema pallidum
explain syphilis, what types and how is it acquired briefly
congenital - vertical transmission
lethal during development of baby
Acquired - STD
primary
secondary
tertiary
clinical findings in congenital syphillis
Notched permanent incisors
(Hutchinson’s incisors)
Hypoplastic first molars
(Mulberry molars)
life cycle of tremponema pallidum
exposure to treponema pallidum -> primary disease (1-2 weeks manifestation chancre) -> heal -> secondary disease (2-8 weeks )systemic rashes, condyloma latum, mucous patch) -> latent -> tertiary disease (8-30 years)
what is primary syphilis
happens 1-3 weeks after exposure to T.pallidum
manifested by chancre, which is a
lesion at primary site.
painless, ulcerated and localised.
heals after 2-8 weeks, some scarring seen.
lesion is highly infectious.
pt with primary syphillis may have -ve serology
What is secondary syphilis
happens 2-12 weeks after primary disease
manifested by systemic rashes, mucuous batch and the labial mucosa, and condyloma latum on oral and genital regions
shows positive serology at this stage
what is tertiary syphilis
Latent stage lasting 3-10 years
Positive serology
Slow, persistent reactions (inflammatory, destructive lesions)
clinical manifestation - gumma, which happens anywhere
orally, you may see palatal perforation and syphilitic glossitis
how does someone get TB
infection of Mycobacterium tuberculosis
Airborne infection
Re-emergence of TB
Development of multidrug resistant TB
Immunocompromised patients
progression of TB
stage 1
- initial infection of m.tb
stage 2
- site of infection is ghon focus.
- can heal (scarring) or progress to latent)
stage 3
- antibody mediated immune response is ineffective in curbing mtb.
- formation of tubercle/granuloma, which is surrounded by activated macrophage
- caseous necrosis happens here
- individual is tuberculin positive here.
- this characterized by latent stage
stage 4
- growth of tubercle
- can invade artery -> hematogenous spread of mtb (aka miliary tb)
- disease comes and go - tissue destruction controlled by healing and fibrosis
stage 5
- Caseous centers of
tubercles liquify
- Rapid extracellular growth of M.TB
-Antigen load causes walls of nearby
bronchi to become necrotic and rupture
-rapid spread through lungs
2 forms of leprosy
tuberculoid form
lepromatous form
clinical manifestation of leprosy
Skin Lesions: Hypopigmented or erythematous macules, papules, or nodules that may be numb to touch due to nerve involvement.
Nerve Damage: Thickened nerves, loss of sensation, muscle weakness, and paralysis, particularly in the hands and feet.
state the types of candida infections
acute
- atrophic
- pseudomembranous (oral thrush)
chronic
- atrophic
- hyperplastic
management of fungal infections in general
2% miconazole (gel) applied topically, then swallowed. 4 times a day, after meal, up to 2 weeks. use for one more week after infection goes away
symptoms of acute atrophic candidiasis
Generalised or focal areas of red/inflamed oral mucosa
pain
possible causes of acute atrophic candidosis
denture use
antibiotic use
Acute pseudomembranous candidosis features
areas of generalised or focal inflammation
presence of soft, white/yellow plaques that can be lifted off the mucosa.
These plaques represent inflammatory exudate, dead cells and fungal colonies
how is diagnosis of acute pseudomembranous candidosis made?
oral features and cytology smear
management of acute pseudomembranous candidosis
For a simple case e.g. following antibiotic therapy:
- topical antifungal agents and oral hygiene instruction
For a complex case e.g. immunosuppressed patient:
- medical consultation and topical/systemic antifungal agents
what about Chronic Hyperplastic Candidosis
Correct diagnosis important because lesion can resemble other pathology including lichen planus and early squamous cell carcinoma
biopsy as cytology smear not always reliable
