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osomop 4th > bacterial infections > Flashcards

bacterial infections Flashcards

1
Q

what is actinomycosis?

A

a rare, chronic suppurative granulomatous disease

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2
Q

what bacteria is associated with actinomycosis?

A
  • filamentous anaerobic gram postive bacilli
  • human commensal flora protect us against it
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3
Q

what is the age and sex demographic of actinomycosis

A
  • m = f
  • 30-60 years old
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4
Q

what are the predisposing factors of actinomycosis?

A
  • Poor oral hygiene
  • Trauma
  • Poorly controlled diabetes mellitus
  • Immunosuppressed
  • Alcoholism
  • Malnutrition
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5
Q

what is the clinical appearance of actinomycosis?

A

> Cervicofacial commonest clinical presentation

> Submandibular region

> Slow growing painless, indurated swelling

> Abscesses with sinus discharge to oral mucosa or skin

> Discharge contains visible granules “sulphur like”

> Pain and trismus in advanced stages

(50% Affect mandible, cheek 15%, chin 15%, angle, submaxillary ramus 10%
Rarely see tongue, paranasal air sinuses middle ear, larynx, thyroid)

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6
Q

what is the diagnosis pathways for actinomycosis?

A

> imaging
aspiration and culture
histopathology

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7
Q

what is the management of actinomycosis?

A

> Removal of dental focus
Antimicrobials
Surgical debridement

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8
Q

what is cat scratch disease?

A
  • Regional lymphadenopathy and fever resulting from the scratch or bite of an infected cat (in particular kittens)
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9
Q

what bacteria cause cat scratch disease?

A
  • Bartonella henselae – gram negative bacilli
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10
Q

what is the age and sex demographic of cat scratch disease?

A
  • M>F
  • mean age of 33 years
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11
Q

what is the clinical presentation of cat scratch disease?

A

> Benign self-limiting illness

> Papule/pustule at site of inoculation (3-30 days)

> Regional lymphadenopathy

> Surrounding tissue changes

> Suppuration

> Atypical presentation in immunocompromised

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12
Q

what is the diagnosis of cat scratch disease?

A
  • History of flea or cat bite
  • Exclusion of other causes
  • PCR positivity for Bartonella DNA
  • ELISA positive for B. henselae
  • Tissue biopsy
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13
Q

what is the management of cat scratch disease?

A
  • avoidance
  • self limiting
  • antimicrobial therapy
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14
Q

what is impetigo?

A

common contagious superficial bacterial skin infection
> face and personal region

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15
Q

who does impetigo commonly effect?

A

> usually affects children 3-5 years old

> summer / early autumn time

> trauma creates a portal of entry

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16
Q

what bacteria cause impetigo ?

A

staphylococcus aureus and streptococcus pyogenes

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17
Q

what is more common - non bullous or bullous impetigo?

A
  • non bullous
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18
Q

what is the clinical appearance/ features of non bullous impetigo ?

A

> Erythematous macule, papule

> Ruptures

> “Honey-coloured” yellow crust on skin

> Lesions expand and coalesce

> Pruritis, pain, lymphadenopathy

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19
Q

what is the clinical appearance/ features of bullous impetigo?

A

( New born and infants)

> Vesicles or bullae

> S. aureus

> Blister formation

> Rupture and shed to produce an erythematous moist base that oozes serum

> Systemic symptoms

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20
Q

how do you diagnosis of impetigo?

A
  • gram stain and culture of pus
  • histopathology
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21
Q

what is the management of impetigo?

A

> spontaneous resolution

> antimicrobial agents

22
Q

what is Lyme disease?

A

multisystem bacterial infection

natural hosts include most animals, so forest and farm workers at great risk

endemic in certain countries

23
Q

what bacteria causes Lyme disease?

A

Borrelia burgdorferi

24
Q

what are the stage 1 symptoms for Lyme disease?

A
  • Spreading annular rash 14-30 days following tick bite
  • Affects 80%
25
Q

what are the stage 2 symptoms of Lyme disease?

A
  • Weeks-months
    Cardiac, neurological abnormalities, musculoskeletal symptoms
26
Q

what is the stage 3 symptoms of Lyme disease?

A
  • months years
  • chronic skin, CNS or joint abnormalities
27
Q

what are erythema migrans ?

A

> Rash pathognomonic of Lyme disease

> Red rash, increases in size

May have a central clearing

Presents at site of bite

Days to months

28
Q

how do you diagnose Lyme disease?

A

> clinical diagnosis

> antibody test - repeat testing

29
Q

what is the management of Lyme disease?

A

> antibiotic depending on symptoms

> Jarisch-Herxheimer reaction can occur

30
Q

what is syphilis?

A

common sexually transmitted infection with 4 main clinical stages

31
Q

what is the bacteria that causes syphilis?

A

> Treponema pallidum - anerobic filamentous spirochete

32
Q

how is syphilis transmitted?

A

> sexual contact - 50%

> vertical

> indirect routes eg. blood transfusions

33
Q

describe primary syphilis - 5 points

A

> Chancre

> Develops at site of inoculation

> Usually solitary lesion

> Lymphadenopathy

> Healing within 8 weeks

34
Q

describe secondary syphilis - 4 points

A

> Two to twelve weeks after first contact

> Two months after healing of primary syphilis

> Due to haematogenous dissemination

> Constitutional and mucocutaneous manifestations

35
Q

what is constitutional symptoms? 6 points

A

> “Flu-like”

> Fever

> Headache

> Weight loss

> Malaise

> General aches and pains

36
Q

what is mucocuntaneous symptoms ? 5 points

A

> Skin rash – non pruritic

> Symmetrical pink/red macules, papules, pustules

> Arms, palms, flanks, soles

> Heal within weeks +/- hypo/hyper pigmentation

> Scalp

37
Q

what are some key features of secondary syphilis patients may suffer from?

A

> 33% have mucous patches

> 50% generalised lymphadenopathy

> Condyloma latum

> Ocular involvement

> Joint involvement

> Glomerulonephritis

> Neurological involvement

38
Q

what is latent syphilis?

A

> shows no signs of disease

> however positive serological testing

39
Q

what are the key features of tertiary syphilis?

A

> Hard palate
- Small pale raised area- ulcer- area of necrosis
- Bone exposure
- Perforate into nasal canal
- Painless

> Osteomyelitis
Glossitis
Leukoplakia
Salivary glands

40
Q

what are the complication of tertiary syphilis?

A

> Cardiovascular syphilis
- Aneurysms of ascending aorta
- Left ventricular hypertrophy
- Congestive heart failure

> Neurosyphilis
- Tabes dorsalis
- Psychosis
- Dementia

41
Q

what is argyll Robertson pupils?

A

> caused by neurosyphilis

> Bilateral, asymmetrical small irregular pupils

> Constricts with accommodation

> No reaction to light

42
Q

what causes congenital syphilis?

A

> T.pallidum can cross placental barrier

> Mother in primary or secondary stage of infection

> Second or third trimester

> can lead to Undesirable outcomes

43
Q

what are the early manifestations of congenital syphilis?

A

> Periostitis

> Diffuse maculopapular rash

> Rhinitis

44
Q

what are late manifestations of congenital syphilis?

A

> Dental anomalies (mulberry molars, hutchinsons incisors, open bite)

> Sensorineural hearing loss

> Interstitial keratitis of the cornea

> saddle nose, frontal bossing

45
Q

how do you diagnose syphilis?

A

> History and clinical examination

> Dark field microscopy

> Serological tests

46
Q

what is the management of syphilis?

A

> Benzyl penicillin
Erythromycin
Tetracycline

> Follow up for two years

> Contact tracing

47
Q

what is tuberculosis?

A

> chronic communicable infectious disease
lung the main organ effected
extra pulmonary infections

48
Q

what bacteria causes tuberculosis?

A

mycobacterium tuberculosis

49
Q

how is tuberculosis transmitted?

A

> via droplet spread

50
Q

what are the predisposing factors of tuberculosis?

A

> Over crowding
Poor health and hygiene
Poverty
Drug abuse
Immunosuppression, AIDS

> Local factors
- Poor oral hygiene
- Local trauma/irritation

51
Q

what are the oral manifestations of tuberculosis/

A

> Oral manifestations are uncommon (0.1-5.0%)

> mainly Young adults

> Tongue

> Painful ulcers

> Lymphadenopathy

52
Q

how do you diagnosis tuberculosis?

A

> history

> clinical examination

> special investigations

osomop 4th (18 decks)

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