Bacterial infection of orofacial tissue

Question 1

What does infection look like

Answer 1

1. Calor (hot)
2. Dolor (painful)
3. Rubor (redness)
4. Tumor (swelling)
5. Loss of function

Question 2

Define abscess

Answer 2

A localised collection of pus

Question 3

Define pus

Answer 3

A collection of bacteria, tissue and white cells

Question 4

Define cellulitis

Answer 4

Spreading infection with no collection pus

Question 5

Describe the local features of infection

Answer 5

1. Redness
2. Pain
3. Induration (hardness)
4. Heat
5. Swelling

Question 6

Describe the regional features of infection

Answer 6

1. Trismus
2. Dysphasia
3. Difficulty breathing
4. Lymphadenopathy

Question 7

What is Trismus

Answer 7

Restriction of the range of motion of the jaws

Question 8

What is dysphagia

Answer 8

Difficulty swallowing

Question 9

What questions might we ask when looking at an infection

Answer 9

1. Is pus present?

2. What is the patients temperature

Question 10

How can we check if pus is present

Answer 10

1. Fluctuance

2. Aspiration

Question 11

Give examples of bacterial infections

Answer 11

1. Cavernous sinus thrombosis

2. Mediastinitis

Question 12

Where can gingival abscesses form

Answer 12

1. Buccal
2. Lingual
3. Palatal

Question 13

How can infections of dental origin present

Answer 13

1. Gingival abscesses
2. Submandibular space infection
3. Facial space infection
4. Submasseteric abscess (below mandible)
5. Masticator space infection

Question 14

How can we manage bacterial infections

Answer 14

1. History
2. Examination
3. Investigation
4. Diagnosis
5. Treatment- do we sent patient to hospital

Question 15

When might we send a patient to hospital

Answer 15

If patient has:

1. Difficulty breathing
2. Difficulty swallowing
3. Difficult speaking

Question 16

When coming to a diagnosis for bacterial infection what do we need to determine

Answer 16

Whether infection is an abscess of cellulitis

Question 17

If pus is present what should you do

Answer 17

Should be drained as soon as it is practical to remove the source of infection

Question 18

How do we treat cellulitis

Answer 18

Antibiotics

Question 19

What antibiotics can we prescribe for infections

Answer 19

1. Amoxicillin 500mg TID
2. Metronidazole 400mg TID
3. Erythromycin 500mg QID

Question 20

In whom do we need to make special considerations if they have an infection

Answer 20

Medically compromised

Question 21

Give examples of patients who are medically compromised

Answer 21

1. Neutropenic (chemotherapy)
2. Head and neck radiotherapy
3. Bisphosphonate treatment
4. Immune compromised
5. Diabetes

Question 22

Which infection should we particularly cautious of

Answer 22

Ludwigs angina

Question 23

What is Ludwig’s angina

Answer 23

Bilateral submandibular space infection

Question 24

Name some bacterial diseases of the skin

Answer 24

1. Folliculitis
2. Boils
3. Carbuncles
4. Furuncles
5. Erysipelas
6. Impetigo

Question 25

What is erysipelas

Answer 25

Superficial spreading od the streptococcal infection of the skin

Question 26

How can erysipelas present

Answer 26

Oedema/ cellulitis of derma | Patient may be systemically unwell

Question 27

What is Impetigo

Answer 27

Skin infection caused by streptococcal and staphylococcal bacteria

Question 28

How can Impetigo present

Answer 28

Vesicles that can rupture with exudate spreading more infection Yellow crust

Question 29

What problems can skin infections lead in diagnosis

Answer 29

Skin infections can be diagnosed or confused fro dental infections

Question 30

If we come across a patient who has a dental condition manifesting as a skin infection what should we do

Answer 30

1. Check and find the culprit tooth | 2. Palate the sinus track

Question 31

In what types of patients can sepsis be dangerous

Answer 31

1. Very young 2. Very old 3 Immune suppressed 4. Neutropenic 5. Recent infection or operation 6. iVDA

Question 32

Describe an adult suffering from sepsis §

Answer 32

§§1. Altered mental state/ behaviour 2. Raised respiratory rate (>20/min) 3. Systolic BP lower than 100 4. Pulse rate higher than 90bmp 5. Not passed urine during in 12 hours 6. Temperature less than 36 7. potential signs of skin infection or rash

Question 33

What causes necrotising fasciitis

Answer 33

Streptoccal infection gaining entry though wound or infection site Toxins. complement cause necrosis of tissues

Question 34

Give some signs and symptoms of actinomyocosis

Answer 34

1. Patietn is chronically ill 2. Weigth loss 3. Cough 4. Low grade fever

Question 35

where does actinomyocosis occur

Answer 35

In non healing wounds or infection (possibly after extraction)

Question 36

How does actinomyocosis present clinically

Answer 36

As a chronic non draining sinus

Question 37

What causes actinomyocosis

Answer 37

Sulfur gaules of gram positive bacteria