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DENT 317 - Oral Pathology > Bacterial and Fungal Infections > Flashcards

Bacterial and Fungal Infections Flashcards

1
Q

Method of infection for pharyngitis/ tonsillitis (strep throat)

A

Inhalation of infected droplets

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2
Q

Bacteria responsible for pharyngitis/tonsillitis

A

Gram +ve B-hemolytic streptococcus

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3
Q

Signs and symptoms of pharyngitis/tonsillitis

A
  • Fever
  • Sore throat
  • Malaise
  • Petechiae may occur on soft palate
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4
Q

Diagnosis of pharyngitis/tonsillitis

A

Throat swab

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5
Q

Treatment for pharyngitis/tonsillitis

A

Antibiotics

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6
Q

Complciation of strep throat

A

Scarlet fever

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7
Q

What is scarlet fever

A

Systemic infection wherein bacterial toxin damages small blood vessels –> red skin rash (face) and strawberry tongue

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8
Q

2 non-oral manifestations of scarlet fever

A
  • Acute glomerulonephritis
  • Rheumatic fever (may damage heart valves [mitral in particular] and place at risk for subacute bacterial endocardititis
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9
Q

Define impetigo

A
  • Acute pustular skin eruption usually due to Staph. aureus
  • Perioral skin may be affected
  • Community acquired MRSA becoming more common
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10
Q

Diagnosis of impetigo

A

Bacterial culture

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11
Q

Treatment for impetigo

A

Topical or systemic antibiotics

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12
Q

Bacterial cause of osteomyelitis

A

S. aureus from direct invasion following trauma or hematogenous from focus of infection from a distant site.

NOTE: Mandible more commonly affected since less vascular

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13
Q

Treatment of osteomyelitis

A

+/- debridement and antibiotics

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14
Q

Progression of tuberculosis

A
  1. Primary TB affects lungs – asymptomatic
    1. 5% progress to active disease
  2. Secondary TB = reactivation
  3. Miliary TB = disseminated
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15
Q

Diagnosis of TB

A

Tuberculin (PPD)

NOTE: Positive test indicates exposure only

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16
Q

6 characteristics/symptoms of TB

A
  • Consumption - cachectic
  • Lupus vulgaris - skin
  • Scrofula - involvement of cervical lymph nodes
  • Oral TB rare - microorganisms fron infected sputum gain access through an ulcer
  • Granuloma w/ caseous necrosis
  • Ziehl-Neelsen stain Acid fast bacilli
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17
Q

Pathogen of Leprosy (Hansen’s Disease)

A

Mycobacterium leprae

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18
Q

5 manifestations of leprosy

A
  • Tuberculoid leprosy - high immune rx
  • Lepromatous leprosy - absence of cellular response
  • Affects peripheral nerves - cool areas
  • Pts develop peripheral numbness and damage hands and feet
  • Well-formed granulomas - Fite stain
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19
Q

Treatment for leprosy

A

Rifampin and dapsone

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20
Q

Pathogen for syphilis (Lues)

A

Treponema pallidum

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21
Q

Trasmission of syphilis (Lues)

A

STI or maternal fetal transmission

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22
Q

Diagnosis of syphilis

A

Based on serology (blood test)

Dark field exam of smear - false+

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23
Q

Progression of syphilis

A
  1. Primary syphilis (2 - 3 weeks) = cahcnre develops at site of inoculation
  2. Secondary syphilis (disseminated 4 - 10 weeks) = systemic symptoms (fever + maculopapular rash)
    1. Mucous patch of secondary syphilis = superficial areas of irregular grayish mucosal necrosis
    2. Papillary lesions = condyloma latum
  3. Latent syphilis = 1 - 30 years
  4. Tertiary syphilis
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24
Q

5 symptoms of tertiary syphilis

A
  • Aneurysm of aorta
  • Tabes dorsalis, psychosis, dementia, paresis
  • Gumma - ulceration and chronic granulomatous inflammation
  • Palatal perforation
  • Luetic glossitis
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25
Q

Congenital syphilis triad

A
  • Hutchinson’s teeth
  • Interstitial keratitis
  • Eight nerve deafness
26
Q

Treatment of choice for primary/secondary syphilis

A

Penicillin

27
Q

Pathogen of actinomycosis

A

Actinomyces sp. (filamentous gram positive anaerobes)

28
Q

Clinical presentation of actinomycosis

A
  • Acute or chronic infection with fistula formation and pus drainage
  • Abscess formation with sulfur granules
  • Trauma allows bacteria to enter tissue
  • Chronic infectoin associated with fibrosis
29
Q

How to diagnose actinomycosis

A
  • Culture difficult (50%+)
  • Anaerobic culture - aspiration use a syringe but remove needle - make arrangements with microbiology before aspiration
30
Q

Treatment for actinomycosis

A
  • Periapical actinomycosis usually responds to conservative treatment
  • Drainage and excision of infected tissues
  • Penicillin for six weeks - 1 year
  • Consultation with infectious diseases
31
Q

6 types of manifestations of candidiasis

A
  • Acute pseudomembranous (thrush)
  • Atrophic (eryhtematous)
  • Chronic hyperplastic candidiasis
  • Angular cheilitis
  • Median rhomboid glossitis
  • Chronic mucocutaneous
32
Q

How does candidiasis occur

A
  • >50% of the population is an asymptomatic carrier of fungal spores
  • When the local environment is right, the fungal hyphae sprout
  • Occurs in diabetes, dry mouth, immunocompromised patients, denture wearers, antibiotics, steroids
33
Q

Symptoms of candidiasis

A
  • White plaques which wipe off leaving a red underlying mucosal surface
  • Burning, sore mouth
  • Thrush in very young
34
Q

Diagnosis of candidiasis

A

Confirmation by cytologic smear (pathology) or culture (microbiology) (CFU) colony forming units

35
Q

Treatment for acute pseudomembranous candidiasis

A
  • Correct local problem (stop steroids/antibiotics/correct blood sugar)
  • Topical antifungals
    • Nystatin
    • Clotrimazole
    • Ketoconazole
  • Systemic antifungals - diflucan
36
Q

Define atrophic (erythematous) candidiasis

A

Erythematous candidiasis usually associated with a complete denture (red mucosa underneath a poorly fitting denture)

NOTE: Do not misdiagnose as an allergy to denture materials

37
Q

Treatment for atrophic (erythematous) candidiasis

A

Reline and antifungal therapy

38
Q

Describe chronic hyperplastic candidiasis

A
  • White mucosal plaque or papule
  • Focal epithelial hyperplasia in response to chronic candidal infection
  • May be mistaken for a papilloma or leukoplakia
39
Q

Diagnosis of chronic hyperplastic candidiasis

A

Confirmation by smear or biopsy

40
Q

Describe angular cheilitis

A
  • Cracking and fissures at the angle of the mouth
  • Loss of vertical dimension, drooling, skin folds
41
Q

5 potential causes of angular cheilitis

A
  • ? Iron/vitamin B12 deficiency
  • ? Eczema/ perioral dermatitis/contact sensitivity
  • Sometimes pure fungal infectoin
  • Sometimes pure bacterial
  • Often mixed fungal and bacterial infection
42
Q

Treatment for angular cheilitis

A
  • Correct nocturnal drooling/ vertical dimension
  • Clean area with spectrogel/spectroderm
  • Topical antifungal creams (ketoconazole)
  • Topical antibacterial creams (bactroban OTC)
  • Polysporin
  • Lotriderm cream
43
Q

Describe median rhomboid glossitis

A
  • Red painful patch on the mid dorsum of the tongue
  • Chronic candidal infection
  • Role of trauma, negative pressure habit
  • Difficult to treat
  • Often associated with a corresponding palatal lesion
44
Q

Describe chronic mucocutaneous candidiasis

A

Chronic candidiasis of the skin, mucous membrane and nails

Usually present since birth

Immune defects +/- endocrine disturbances

45
Q

How are oral infections from deep fungal diseases acquired

A

Implantation with infected sputum or by hematogenous spread

46
Q

Source of histoplasmosis

A

Yeasts from bird droppings

47
Q

Source of coccidioidomycosis

A

Valley fever

48
Q

Source of cryptococcosis

A

Bird droppings and immunocmpromized

49
Q

Source of blastomycosis

A

Ohio-Mississippi valley

50
Q

5 symptoms of deep fungal diseases

A
  • Cough
  • Fever
  • Night sweats
  • Hemoptysis
  • Oral ulcer, non-healing, indurated and painful
51
Q

Diagnosis of deep fungal diseases

A
  • Biopsy (chronic granulomatous inflammation)
  • Pathologist performs special stains (Grocott or PAS) to see fungus
  • Specific genus species best identified on culture (submit fresh tissue as well as tissue in formalin)
52
Q

Type of aspergillosis that affects immunocompromized patients

A

Invasive aspergillosis (versus non-invasive)

53
Q

Usual presentation of aspergillosis

A

Fungal infection of lung or sinus

54
Q

Cause of aspergillosis

A

Inhalation of spores of A. fumigatus or A. flavus

55
Q

Non-invasive form of aspergillosis

A

Aspergilloma (fungus ball) in maxillary sinus or lung (normal immune function)

56
Q

Invasive form of aspergillosis

A

Swelling with invasion of soft tissues and destruction of bone (usually immunocompromized)

57
Q

Diagnosis of aspergillosis

A
  • Biopsy –> submit tissue in formalin as well as fresh in a sterile container for a deep fungal culture
  • Histology suggests diagnosis
  • Culture of fresh tissue biopsy is definitive
58
Q

Treatment of aspergillosis

A

Surgical debridement and antifungal therapy

59
Q

Cause of zygomycosis

A
  • Opporunistic infection by Absidia, Mucor, Rhizopus
  • Rhinocerebral form in uncontrolled diabetics, immunocompromised patients
60
Q

4 symptoms of zygomycosis

A
  • Facial swelling
  • Pain
  • Nasal obstruction
  • Proptosis
61
Q

Form of fungus involved in zygomycosis

A

Branchnig non-septate hyphae

62
Q

Treatment for zygomycosis

A

Surgery and antifungal therapy

DENT 317 - Oral Pathology (6 decks)

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