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Neville and Damm > Ch 5 Bacteria - NOMA thru Sinusitis > Flashcards

Ch 5 Bacteria - NOMA thru Sinusitis Flashcards

1
Q

What are the 4 alternate names for NOMA? What does NOMA stand for?

A

1.Cancrum oris 2.Orofacial gangrene 3. Gangrenous stomatitis 4. necrotizing stomatits…noma comes from “devour” in greek

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2
Q

NOMA is polymicrobial, but what are two key players?

A

Fusobacterium necrophorum and Prevotella intermedia

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3
Q

What infection most frequently sets the stage for noma?

A

MEASLES (HSV, Varicella, Scarlet fever, malaria, TB, etc)

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4
Q

Some believe that noma is an extension of what process?

A

NUG (necrotizing ulcerative gingivitis)

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5
Q

What are three situations that can yield noma in the developed world?

A

HIV, severe combined immunodeficiency syndrome, intense immunosuppressive therapy

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6
Q

What age range is most likely to present with noma?

A

1-10 years of age

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7
Q

Noma begins as NUG, and extends to form areas called: ?

A

necrotizing ulcerative mucositis (NUM)

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8
Q

What makes the spread of noma different from other infections??

A

it does not respect or follow tissue planes (spreads through normal anatomic borders like muscle)

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9
Q

Are most noma lesions uni or bilateral?

A

unilateral

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10
Q

What are the two first line abx for necrotizing stomatitis?

A

penicillin and metronidazole

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11
Q

Name 2 of the most common organisms found actinomycosis? What type are they?

A

Actinomyces isaelii and a. viscous….Filamentous, branching, gram positive ANAEROBIC bacteria

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12
Q

In most cases of actinomycosis, what other two bacterial types are commonly found alongside of the culprits?

A

Streptococci and staphylococci

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13
Q

What is the term for large yellow flecks representing colonies of bacteria in actinomycosis? What other infection can mimic these???

A

sulfur granules…BOTRYOMYCOSIS (unrelated to actino, but can produce sulfur granules)

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14
Q

What is botryomycosis an unusual host reaction to? What can be produced in this disease process that mimics actinomycosis?

A

S. Aureus, sulfur granules

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15
Q

What is the classic clinical description of actino?

A

“wooden” induration of fibrosis with a softer, central area of abscess

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16
Q

What is the MOST FREQUENTLY AFFECTED site for an actinomycosis infection?

A

angle of the mandible

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17
Q

Actino histo: “____“-shaped filaments that form a radiating “______” pattern

A

club-shaped…rosette pattern

18
Q

What can you stain actino with to see the organisms?

A

methiamine silver

19
Q

What can be used to diagnose actino on the sulfur granules?

A

fluorescein-conjugated antiserum

20
Q

What is the first line treatment for actinomycosis? What is an alternative if there is an allergy? How long?

A

Its a debate between penicillin and amoxicillin. But use lots of it. Tetracycline if allergic..5-6 weeks UP TO 12 months (holy shit)

21
Q

Cat-scratch disease is an infectious disorder that begins in the _____ but classically spreads to the adjacent ______.

A

skin, lymph nodes

22
Q

What infection is the most common cause of CHRONIC REGIONAL lymphadenopathy in children?

A

Cat-scratch disease

23
Q

What is the causative agent in CAT SCRATCH DISEASE?

A

Barton-ella HENSEL-ae (formerly roch-al-imea henselae)

24
Q

How does bartonella henselae transmit from cat to cat?

A

CAT FLEAS (gross)

25
Q

What are the two ways bartonella henseale is transmitted from cat to human?

A

saliva or scratch

26
Q

Besides cats, what are 4 other documented routes of infection for bartonella henselae?

A

dogs, monkeys, porcupine quills, and thorns

27
Q

What age range is most likely for cat scratch disease?

A

YOUNG. 80% of pts under 21

28
Q

Besides the papule and LAD associated with cat scratch disease, what two systemic manifestations occur?

A

prolonged fever, hepatosplenic disease

29
Q

What two vasoproliferative disorders can be found in immonocompromised pt’s with cat scratch disease?

A
  1. bacillary angiomatosis 2. bacillary PELIOSIS HEPATIS (specific form of hepatosplenic Bartonella disease)
30
Q

Which lesion associated with cat scratch disease in AIDS patients can resemble Kaposi Sarcoma?

A

bacillary angiomatosis

31
Q

What are two stains that can show cat scratch bacilli?

A

Warthin-starry or Brown-Hopps method of Gram stain

32
Q

Cat scratch disease is SELF LIMITING. How long does this take? IF a pt is immunocompromized what are three abx that work against Bartonella?

A

4 months….azithromycin, erythromycin, doxycycline

33
Q

Normal sinuses are lined by __________

A

pseudostratified columnar epithelium with cilia

34
Q

Most acute sinusitis cases are ______ in origin and most chronic cases are _______ in origin

A

acute = viral, chronic = bacterial

35
Q

What are the 3 most common bacteria cultured in acute sinusitis? (even though acute is viral lol)

A

1.Strept penumoniae, Haemophilus influenzae, and Moraxella catarrhalis

36
Q

Chronic sinusitis is defined as recurring acute sinusitis or symptomatic sinus disease lasting longer than _____

A

3 months

37
Q

What are the 3 most common bacteria cultured in chronic sinusitis?

A

Strept, Bacteriodies, or veilonella (anaerobes)

38
Q

Occasionally in chronic sinusitis, what radiographic dystrophic calcification can arise?

A

antrolith

39
Q

A sinus that is unresponsive to therapy and exhibits

focal antrolith formation within a diffuse soft tissue opacification is highly suggestive of _________

A

noninvasive aspergillosis.

40
Q

Focal antral calcification also has been seen in sinuses filled with a fungal ball of ________ (noninvasive mycetoma)

A

Aspergillus fumigatus

41
Q

What is the first line abx for sinusitis? Secondary?(if allergic)

A

amoxicillin…doxycycline or clarithromycin alternatively

Neville and Damm (72 decks)

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