Bacterial infections Flashcards
Actinomycosis
Chronic, suppurative granulomatous disease
Filamentous anaerobic gram positive bacilli
human commensal flora
M:F
predisposing factors for actinomycosis
poor oral hygiene
trauma
poorly controlled diabetes mellitus
immunosuppressed
alcoholism
malnutrition
clinical presentation actinomycosis
cervicofacial
submandibular region
slow growing painless, indurated swelling
abscesses with sinus discharge to oral mucosa/skin
discharge contains visible granules
pain and trismus in advanced stages
diagnosis actinomycosis
imaging
aspiration and culture
histopathology
management of actinomycosis
removal of dental focus
antimicrobials
surgical debridement
Cat scratch disease
regional lymphadenopathy and fever resulting from the scratch of an infected cat
bartonella henselae - gram negative bacilli
M>F
33yrs
clinical presentation CSD
benign self limiting disease
papule/pastule at site inoculation
regional lymphadenopathy
surrounding tissue changes
suppuration
Diagnosis CSD
History of cat bite
exclusion of other causes
PCR positivity for bartonella dna
ELISA positive for B henselae
tissue biopsy
management of CSD
avoidance
antimicrobial therapy
Impetigo
contagious superficial bacterial skin infection
3-5 yrs
staph aureus. strep pyogenes
trauma creates a portal of entry
face and perioral region
Non-bullous impetigo
common
erythematous macule, papule
rupture
honey coloured yellow crust on skin
lesions expand and coalesce
pruritis, pain, lymphadenopathy
Bullous impetigo
new born and infants
vesicles/bullae
s.aureus
blister formation
rupture and shed to produce an erythematous moist base that oozes serum
systemic symptoms
diagnosis of impetigo
gram stain and culture of pus
histopathology
management of impetigo
spontaneous resolution
antimicrobial agents
Lyme disease
Bacterial infection
B. Burgdorferi
Endemic
Lyme disease symptoms
3 stages
1. spreading annular rash 14-30 days following bite
2. cardiac/neurological/musculoskeletal abnormalities
3. chronic skin, CNS, joint abnormalities
erythema migrans
rash pathognomonic of lyme disease
red rash, increases in size
central clearing
days to months
erythema migrans diagnosis and management
clinica diagnosis
antibody test
jarisch-herxheimer reaction
Syphilis
STI
T. Pallidum
Transmission - sexual contact/vertical/indirect routes e.g., blood transfusion
Primary syphilis
Chancre
Site of inoculation
Solitary lesion
Lymphadenopathy
Healing within 8 weeks
Secondary syphilis
2-12 weeks after first contact
2 months after healing of primary syphilis
due to haematogenous dissemination
constitutional or mucocutaneous manifestations
constitutional symptoms of 2 syphilis
fever
headache
weight loss
malaise
aches and pains
mucocutaneous symptoms of 2 syphilis
skin rash
symmetrical pink/red macules, papules, pustules
heals within weeks
33% have mucous patches
50% generalised lymphadenopathy
condyloma latum
ocular involvement
joint involvement
glomerulonephritis
neurological involvement
latent syphilis
positive serological testing
no sign of disease
tertiary syphilis
rare
2-3 years after primary infection
gummata
- multiple sites
- induratd, nodular or ulcerated lesion
- may produce tissue destruction
tertiary syphilis clinical presentation
hard palate
small pale raised area, ulcerated area of necrosis
bone exposure
perforated into nasal canal
painless
osteomyelitis
glossitis
leukoplakia
tertiary syphilis complications
cardiovascular syphilis
- aneurysms of the ascending aorta
- left ventricular hypertrophy
- congestive heart failure
neurosyphilis
- tabes dorsalis
- psychosis
- dementia
Argyll Robertson Pupils
Neurosyphilis
Bilateral, asymmetrical small irregular pupils
constricts with accommodation
Congenital syphilis
T. Pallidum can cross placental barrier
mother in primary or secondary stage of infection
second or third trimester
congenital syphilis manifestations
Early
Periostitis
Diffuse maculopapular rash
Rhinitis
Late
dental anomalies
sensorineural hearing loss
interstitial keratitis of the cornea
congenital syphilis oral presentations
mulberry molars
hutchinson’s incisors
open bite
congenital syphilis management
benzyl penicillin
erythromycin
tetracycline
Tuberculosis
Chronic communicable infectious disease
mycobacterium tuberculosis
transmitted via droplet spread
lung
extrapulmonary infections
Tuberculosis predisposing factors
over crowding
poor oral health and hygiene
poverty
drug abuse
immunosuppression
local factors
- poor OH
- local trauma/irritation
tuberculosis oral manifestations
uncommon
young adults
tongue
painful ulcers
lymphadenopathy
tuberculosis management
quadruple therapy.
