Bacterial, Viral, HIV Flashcards
superficial, blistering infection of skin caused by S. aureus and/or group A streptococci; highly contagious and more common in children; poor hygiene, crowded living conditions, hot, humid climates
bullous impetigo
superficial, blistering infection of skin caused by S. aureus and/or group A streptococci; highly contagious and more common in children; poor hygiene, crowded living conditions, hot, humid climates
bullous impetigo
Multiple blisters, 1-3 cm in diameter, contain clear fluid; rupture easily, form an erythematous erosion, covered by a yellow-brown crust, “cornflakes glued to the surface”; perioral but not intraoral; lesions are pruritic; do not have systemic clinical features of a bacterial infection
Bullous impetigo
chronic infection caused by Treponema pallidum; primarily through sexual contact and mother to fetus; primary infection usually in young adults; three basic stages
Syphilis
3-90 days after inoculation with signs and symptoms lasting 3-8 weeks; characterized by the chancre (solitary, papular, round to oval, usually painless lesion which develops central ulceration), at site of inoculation; regional, usually bilateral lymphadenopathy
Primary syphilis
Systemic symptoms 4-10 weeks after exposure; sore throat, malaise, HA, weight loss, fever; maculopapular cutaneous rash-widespread but painless; mucous patches; condyloma lata: soft, flat topped papillary lesions usually found in anogenital region and on rare occasion the mouth; Lues maligna (immunocompromised)
Secondary syphilis
Aortic aneurysm, left ventricular hypertrophy congestive heart failure; psychosis, dementia, paresis; Gumma: destructive granulomatous ulceration occurring in skin, oral mucosa, soft tissue, bones or internal organs; oral: on palate or tongue with possible palatal perforation; Leuitic glossitis with diffuse atrophy of the tongue papillae and possible hyperkeratosis
Tertiary syphilis
Maternal transmission possible when mother pregnant during the primary or secondary stages of disease; usually results in miscarriage or stillbirth; congenital malformations usually present; Hutchinson’s triad (ocular interstitial keratitis, eighth nerve deafness, hutchinson’s incisors)
Congenital syphilis
Multiple blisters, 1-3 cm in diameter, contain clear fluid; rupture easily, form an erythematous erosion, covered by a yellow-brown crust, “cornflakes glued to the surface”; perioral but not intraoral; lesions are pruritic; do not have systemic clinical features of a bacterial infection
Bullous impetigo
chronic infection caused by Treponema pallidum; primarily through sexual contact and mother to fetus; primary infection usually in young adults; three basic stages
Syphilis
3-90 days after inoculation with signs and symptoms lasting 3-8 weeks; characterized by the chancre (solitary, papular, round to oval, usually painless lesion which develops central ulceration), at site of inoculation; regional, usually bilateral lymphadenopathy
Primary syphilis
Systemic symptoms 4-10 weeks after exposure; sore throat, malaise, HA, weight loss, fever; maculopapular cutaneous rash-widespread but painless; mucous patches; condyloma lata: soft, flat topped papillary lesions usually found in anogenital region and on rare occasion the mouth; Lues maligna (immunocompromised)
Secondary syphilis
Aortic aneurysm, left ventricular hypertrophy congestive heart failure; psychosis, dementia, paresis; Gumma: destructive granulomatous ulceration occurring in skin, oral mucosa, soft tissue, bones or internal organs; oral: on palate or tongue with possible palatal perforation; Leuitic glossitis with diffuse atrophy of the tongue papillae and possible hyperkeratosis
Tertiary syphilis
Maternal transmission possible when mother pregnant during the primary or secondary stages of disease; usually results in miscarriage or stillbirth; congenital malformations usually present; Hutchinson’s triad (ocular interstitial keratitis, eighth nerve deafness, hutchinson’s incisors)
Congenital syphilis
chronic infectious granulomatous disease; transmission by airborne droplet infection; 50% of those exposed are usually infected as measured by PPD skin test conversion; 10-15% of those infected go on to develop disease; usually pulmonary but in children and immunosuppressed can occur in any organ
Tuberculosis
Initial infection commonly affects lungs; non specific chronic inflammatory reaction usually resulting in a localized, calcified nodule at the initial site of involvement- Ghon complex; vital organisms may remain dormant for many years; rarely leads directly to active disease
primary tuberculosis
Active disease presenting with low-grade fever, night sweats, and weight loss; productive cough, often combined with hemoptysis or chest pain; organisms may spread through lymphatic or vascular channels leading to lymphadenopathy; consumption: cachetic-like wasting due to progressive tuberculosis
secondary tuberculosis
Scrofula: contracted through the drinking of contaminated milk, presents with enlargement of oropharyngeal lymphoid tissues and cervical lymph nodes; lymph nodes may calcify or may undergo caseous necrosis with fistulas tract formation; Lupus vulgaris: irregular scaly, plaque-like lesion of skin with weakening of the epithelium and permanent scarring. May involve underlying cartilage w/ destruction
secondary tuberculosis
from the enterovirus family; can be caused by any one of several strains of coxsackievirus, but most commonly caused by coxsackievirus A16; patients complain of sore throat, fever and accompanying cough, vomiting and diarrhea
hand, foot and mouth disease
oral lesions- 2-7 mm ulcerations, diffusely distributed on any oral mucosa or peri-oral; cutaneous lesions- erythematous macules with central vesicles-rarely occur outside hands and feet
Hand, foot and mouth disease
Oral and perioral lesions are fairly common and may precede skin outbreak; vermilion border of lips and palate most common sites; unlike herpetic lesions the oral ulcers are relatively painless
VZV (primary)
acute herpetic gingivostomatitis; occurs in both children and adults (most frequent before age 5); acute onset of malaise, fever, and lymphadenopathy; gingival swelling and erythema seen in all cases; # of lesions is highly variable
Primary HSV 1 infection
Multiple vesicles and ulcers can occur anywhere in the oral cavity, moveable and attached mucosa; clear initially but turn to yellow vesicles; quick to rupture and leave shallow, painful ulcers; mild cases resolve within 5-7 days; rare (keratoconjunctivitis, pneumonitis, meningitis); adult onset often develop pharyngotonsillitis
HSV1
At site of primary inoculation or adjacent to; most common site is lips-vermilion border; herpes labialis, studies claim 15-45% of US population affected; burning, twitching, itching in prodromal stage; symptoms most sever in initial 8 hrs; intraoral recurrence almost always limited to bound keratinized mucosa
secondary HSV1 infection
acantholysis and ulceration of the epithelium; epithelial cells at margin of ulcer show ballooning degeneration and multiple angulated nuclei; Tzanck cells; mixed inflammation
Herpes Simplex Virus
Primary infection is responsible for causing chicken pox; it is spread through air droplets and direct contact with active lesions with an incubation period of 10-21 days; following a latency period and reactivation the clinical malady known as herpes zoster can occur (potentially decades later); malaise, rhinitis, pharyngitis
Varicella-zoster virus
most cases between ages of 5 and 9; macules, papules, vesicles, ulcers begin on face and trunk; classic presentation described as “dewdrop on a rose petal”; skin lesion are pruritic and erupt for 4 days
Varicella (primary infection)
Oral and perioral lesions are fairly common and may precede skin outbreak; vermilion border of lips and palate most common sites; unlike herpetic lesions the oral ulcers are relatively painless
VZV
same latent state as HSV in the dorsal spinal ganglia; predisposing factors: trauma, stress, decreased immunocompetence; elderly patients; immunosuppressive drugs; 3 phases: prodrome, acute, chronic
VZV (recurrent infection)
remains dormant and follows peripheral nerve distribution when activated; 10-20% of individuals will get in their lifetime; burning, intense pain, tingling or extreme sensitivity as initial presenting signs followed by vesicles, ulcers, crusts; unilateral distribution, may lead to scarring; most common on trunk and trigeminal nerve area
VZV (recurrent)
“toothache” can precede oral lesions; vesicles ulcerate in 3-4 days; crusts develop after 7-10 days; scarring with hypopigmentation not uncommon
VZV (recurrent)
Virus responsible for the symptomatic disease of Mononucleosis; transmitted by saliva and once exposed the virus remains in the individual for life; secondary association with chronic fatigue syndrome and oral hairy leukoplakia; associated with Nasopharyngeal carcinoma, Burkitt’s lymphoma, Gastric carcinoma
Epstein-Barr Virus (HHV-4)
the “kissing disease” very common in teenagers and young adults (exposure during childhood usually asymptomatic); most experience fever, lymphadenopathy, pharyngitis; malaise and anorexia occur up to 2 weeks before the fever; tonsillar enlargement with surface exudate and soft palate petechial hemorrhages are common oral findings
mononucleosis (EBV)
Petechiae are present in up to 25% of cases and disappear within 48 hours of onset; NUG is a fairly common finding; elevated white blood cell count, and/or monospot test
Mononucleosis (EBV)
malignant neoplasm of vascular endothelial origin initially described in elderly Mediterranean men; in US, majority of cases are associated with HIV; HHV-8 believed responsible for neoplastic development
Kaposi’s sarcoma
Presents as multiple flat or raised, red-purple lesions of the skin and or oral cavity; trunk, arms, head and neck are the most common sites; any mucosal site can be affected; can invade bone and created tooth mobility
Kaposi’s sarcoma
the most common intraoral manifestation of HIV infection; most outbreaks occur when the individuals CD4 count fallw below 400 cell/mm3
oral candidiasis
HIV related periodontal diseases of bacteria origin can be classified into 3 forms
Linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis
Present as a 1-3mm red band along the gingiva margin and may or may not accompanied by occasional bleeding and discomfort; seen most frequently in association with anterior teeth, but commonly extends to the posterior
linear gingival erythema
more common in adults than in children; characterized by the presence of ulceration, sloughing and necrosis of one or more interdental papillae with no loss of peridontal attachment; may be accompanied by pain, bleeding and fetid halitosis
NUG
pain, spontaneous bleeding of the gums and rapid destruction of gum tissue and bone, which may lead to tooth loss
NUP
most common EBV related lesion in patients with AIDS; reliable indicator for HIV infection and a predictor for subsequent development of AIDS; white corrugated or folded lesion on the lateral borders of the tongue; start on lateral margins of the tongue and sometimes inside the cheeks; may be unilateral or bilateral, and are painless
oral hairy leukoplakia
Over 130 subtypes; increased prevalence in HIV infected patients->most in anogenital areas; oral cavity- solitary or multiple nodule with cauliflower-like growths, spike-like projections or slightly elevated sessile papules, typically painless and the most common locations are the labial and buccal mucosa
HPV
HIV associated; most by inoculation, non-sexual contact; solitary; caused by HPV subtypes 6 and 11
squamous papilloma
HIV associated: sexual transmission is main route of infection; multiple; commonly HPV subtypes 2, 6, 11
condyloma acuminatum
2nd most common malignancy in HIV infection; more commonly detected in HIV+ heterosexuals and injecting drug users; soft tissue mass, often with ulceration; frequently found on palate and gingiva; prognosis poor
Non-hodgkin’s lymphoma
most common immune-mediated HIV-related oral disorder; painful ulcers commonly on the cheek, soft palate and tongue; halo of inflammation and a yellow-gray pseudomembranous covering
recurrent aphthous ulcers
