Bacterial infection of orofacial tissue Flashcards
What does infection look like
- Calor (hot)
- Dolor (painful)
- Rubor (redness)
- Tumor (swelling)
- Loss of function
Define abscess
A localised collection of pus
Define pus
A collection of bacteria, tissue and white cells
Define cellulitis
Spreading infection with no collection pus
Describe the local features of infection
- Redness
- Pain
- Induration (hardness)
- Heat
- Swelling
Describe the regional features of infection
- Trismus
- Dysphasia
- Difficulty breathing
- Lymphadenopathy
What is Trismus
Restriction of the range of motion of the jaws
What is dysphagia
Difficulty swallowing
What questions might we ask when looking at an infection
- Is pus present?
2. What is the patients temperature
How can we check if pus is present
- Fluctuance
2. Aspiration
Give examples of bacterial infections
- Cavernous sinus thrombosis
2. Mediastinitis
Where can gingival abscesses form
- Buccal
- Lingual
- Palatal
How can infections of dental origin present
- Gingival abscesses
- Submandibular space infection
- Facial space infection
- Submasseteric abscess (below mandible)
- Masticator space infection
How can we manage bacterial infections
- History
- Examination
- Investigation
- Diagnosis
- Treatment- do we sent patient to hospital
When might we send a patient to hospital
If patient has:
- Difficulty breathing
- Difficulty swallowing
- Difficult speaking
When coming to a diagnosis for bacterial infection what do we need to determine
Whether infection is an abscess of cellulitis
If pus is present what should you do
Should be drained as soon as it is practical to remove the source of infection
How do we treat cellulitis
Antibiotics
What antibiotics can we prescribe for infections
- Amoxicillin 500mg TID
- Metronidazole 400mg TID
- Erythromycin 500mg QID
In whom do we need to make special considerations if they have an infection
Medically compromised
Give examples of patients who are medically compromised
- Neutropenic (chemotherapy)
- Head and neck radiotherapy
- Bisphosphonate treatment
- Immune compromised
- Diabetes
Which infection should we particularly cautious of
Ludwigs angina
What is Ludwig’s angina
Bilateral submandibular space infection
Name some bacterial diseases of the skin
- Folliculitis
- Boils
- Carbuncles
- Furuncles
- Erysipelas
- Impetigo
What is erysipelas
Superficial spreading od the streptococcal infection of the skin
How can erysipelas present
Oedema/ cellulitis of derma
Patient may be systemically unwell
What is Impetigo
Skin infection caused by streptococcal and staphylococcal bacteria
How can Impetigo present
Vesicles that can rupture with exudate spreading more infection
Yellow crust
What problems can skin infections lead in diagnosis
Skin infections can be diagnosed or confused fro dental infections
If we come across a patient who has a dental condition manifesting as a skin infection what should we do
- Check and find the culprit tooth
2. Palate the sinus track
In what types of patients can sepsis be dangerous
- Very young
- Very old
3 Immune suppressed - Neutropenic
- Recent infection or operation
- iVDA
Describe an adult suffering from sepsis §
§§1. Altered mental state/ behaviour
- Raised respiratory rate (>20/min)
- Systolic BP lower than 100
- Pulse rate higher than 90bmp
- Not passed urine during in 12 hours
- Temperature less than 36
- potential signs of skin infection or rash
What causes necrotising fasciitis
Streptoccal infection gaining entry though wound or infection site
Toxins. complement cause necrosis of tissues
Give some signs and symptoms of actinomyocosis
- Patietn is chronically ill
- Weigth loss
- Cough
- Low grade fever
where does actinomyocosis occur
In non healing wounds or infection (possibly after extraction)
How does actinomyocosis present clinically
As a chronic non draining sinus
What causes actinomyocosis
Sulfur gaules of gram positive bacteria
