Bacterial and Fungal Infections Flashcards
1
Q
Method of infection for pharyngitis/ tonsillitis (strep throat)
A
Inhalation of infected droplets
2
Q
Bacteria responsible for pharyngitis/tonsillitis
A
Gram +ve B-hemolytic streptococcus
3
Q
Signs and symptoms of pharyngitis/tonsillitis
A
- Fever
- Sore throat
- Malaise
- Petechiae may occur on soft palate
4
Q
Diagnosis of pharyngitis/tonsillitis
A
Throat swab
5
Q
Treatment for pharyngitis/tonsillitis
A
Antibiotics
6
Q
Complciation of strep throat
A
Scarlet fever
7
Q
What is scarlet fever
A
Systemic infection wherein bacterial toxin damages small blood vessels –> red skin rash (face) and strawberry tongue
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
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
10
Q
Diagnosis of impetigo
A
Bacterial culture
11
Q
Treatment for impetigo
A
Topical or systemic antibiotics
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
13
Q
Treatment of osteomyelitis
A
+/- debridement and antibiotics
14
Q
Progression of tuberculosis
A
- Primary TB affects lungs – asymptomatic
- 5% progress to active disease
- Secondary TB = reactivation
- Miliary TB = disseminated
15
Q
Diagnosis of TB
A
Tuberculin (PPD)
NOTE: Positive test indicates exposure only
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
17
Q
Pathogen of Leprosy (Hansen’s Disease)
A
Mycobacterium leprae
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
19
Q
Treatment for leprosy
A
Rifampin and dapsone
20
Q
Pathogen for syphilis (Lues)
A
Treponema pallidum
21
Q
Trasmission of syphilis (Lues)
A
STI or maternal fetal transmission
22
Q
Diagnosis of syphilis
A
Based on serology (blood test)
Dark field exam of smear - false+
23
Q
Progression of syphilis
A
- Primary syphilis (2 - 3 weeks) = cahcnre develops at site of inoculation
- Secondary syphilis (disseminated 4 - 10 weeks) = systemic symptoms (fever + maculopapular rash)
- Mucous patch of secondary syphilis = superficial areas of irregular grayish mucosal necrosis
- Papillary lesions = condyloma latum
- Latent syphilis = 1 - 30 years
- Tertiary syphilis
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
25
Congenital syphilis triad
* Hutchinson's teeth
* Interstitial keratitis
* Eight nerve deafness
26
Treatment of choice for primary/secondary syphilis
Penicillin
27
Pathogen of actinomycosis
Actinomyces sp. (filamentous gram positive anaerobes)
28
Clinical presentation of actinomycosis
* 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
How to diagnose actinomycosis
* Culture difficult (50%+)
* Anaerobic culture - aspiration use a syringe but remove needle - make arrangements with microbiology before aspiration
30
Treatment for actinomycosis
* Periapical actinomycosis usually responds to conservative treatment
* Drainage and excision of infected tissues
* Penicillin for six weeks - 1 year
* Consultation with infectious diseases
31
6 types of manifestations of candidiasis
* Acute pseudomembranous (thrush)
* Atrophic (eryhtematous)
* Chronic hyperplastic candidiasis
* Angular cheilitis
* Median rhomboid glossitis
* Chronic mucocutaneous
32
How does candidiasis occur
* \>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
Symptoms of candidiasis
* White plaques which wipe off leaving a red underlying mucosal surface
* Burning, sore mouth
* Thrush in very young
34
Diagnosis of candidiasis
Confirmation by cytologic smear (pathology) or culture (microbiology) (CFU) colony forming units
35
Treatment for acute pseudomembranous candidiasis
* Correct local problem (stop steroids/antibiotics/correct blood sugar)
* Topical antifungals
* Nystatin
* Clotrimazole
* Ketoconazole
* Systemic antifungals - diflucan
36
Define atrophic (erythematous) candidiasis
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
Treatment for atrophic (erythematous) candidiasis
Reline and antifungal therapy
38
Describe chronic hyperplastic candidiasis
* White mucosal plaque or papule
* Focal epithelial hyperplasia in response to chronic candidal infection
* May be mistaken for a papilloma or leukoplakia
39
Diagnosis of chronic hyperplastic candidiasis
Confirmation by smear or biopsy
40
Describe angular cheilitis
* Cracking and fissures at the angle of the mouth
* Loss of vertical dimension, drooling, skin folds
41
5 potential causes of angular cheilitis
* ? Iron/vitamin B12 deficiency
* ? Eczema/ perioral dermatitis/contact sensitivity
* Sometimes pure fungal infectoin
* Sometimes pure bacterial
* Often mixed fungal and bacterial infection
42
Treatment for angular cheilitis
* Correct nocturnal drooling/ vertical dimension
* Clean area with spectrogel/spectroderm
* Topical antifungal creams (ketoconazole)
* Topical antibacterial creams (bactroban OTC)
* Polysporin
* Lotriderm cream
43
Describe median rhomboid glossitis
* 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
Describe chronic mucocutaneous candidiasis
Chronic candidiasis of the skin, mucous membrane and nails
Usually present since birth
Immune defects +/- endocrine disturbances
45
How are oral infections from deep fungal diseases acquired
Implantation with infected sputum or by hematogenous spread
46
Source of histoplasmosis
Yeasts from bird droppings
47
Source of coccidioidomycosis
Valley fever
48
Source of cryptococcosis
Bird droppings and immunocmpromized
49
Source of blastomycosis
Ohio-Mississippi valley
50
5 symptoms of deep fungal diseases
* Cough
* Fever
* Night sweats
* Hemoptysis
* Oral ulcer, non-healing, indurated and painful
51
Diagnosis of deep fungal diseases
* 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
Type of aspergillosis that affects immunocompromized patients
Invasive aspergillosis (versus non-invasive)
53
Usual presentation of aspergillosis
Fungal infection of lung or sinus
54
Cause of aspergillosis
Inhalation of spores of A. fumigatus or A. flavus
55
Non-invasive form of aspergillosis
Aspergilloma (fungus ball) in maxillary sinus or lung (normal immune function)
56
Invasive form of aspergillosis
Swelling with invasion of soft tissues and destruction of bone (usually immunocompromized)
57
Diagnosis of aspergillosis
* 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
Treatment of aspergillosis
Surgical debridement and antifungal therapy
59
Cause of zygomycosis
* Opporunistic infection by Absidia, Mucor, Rhizopus
* Rhinocerebral form in uncontrolled diabetics, immunocompromised patients
60
4 symptoms of zygomycosis
* Facial swelling
* Pain
* Nasal obstruction
* Proptosis
61
Form of fungus involved in zygomycosis
Branchnig non-septate hyphae
62
Treatment for zygomycosis
Surgery and antifungal therapy
