CH4 Infectious Diseases & Lesions Flashcards by ZARISH M

Infectious bacterial skin infections
Usually seen in young children
Requires nonintact skin for infection
Caused by Streptococcus pyogenes and Staphylococcus aureus
Treatment: Topical or systemic antibiotics

Impetigo

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Inflammation of the tonsils and pharyngeal mucosa
Likely spread by contact with infectious nasal or oral secretions
Group A β-hemolytic streptococci: Scarlet fever and rheumatic fever

Tonsillitis & Pharyngitis

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Clinical features include sore throat, fever, tonsillar hyperplasia, and erythema of the oropharyngeal mucosa and tonsils

Tonsillitis & Pharyngitis

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Usually occurs in children
Fever
Generalized red skin rash caused by a toxin released by the bacteria

Scarlet Fever

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Oral manifestations in addition to streptococcal tonsillitis and pharyngitis include:
Petechiae on the soft palate
Strawberry tongue
Fungiform papillae are red and prominent, with the dorsal surface of the tongue exhibiting either a white coating or erythema

Scarlet Fever

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A childhood disease that appears after a group A β-hemolytic streptococcal infection
Characterized by an inflammatory reaction involving the heart, joints, and central nervous system

Heart valve damage may occur
This may require that the patient be premedicated before dental hygiene treatment

Rheumatic Fever

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Rare oral ulcerations like Painful, Non-healing, Slowly enlarging ulcers
Usually caused by the organism Mycobacterium tuberculosis
Oral lesions: Chronic granulomatous lesions with areas of necrosis surrounded by macrophages, multinucleated giant cells, and lymphocytes (Biopsy will determine)
Skin test
Chest radiographs

Tuberculosis (bacterial infection)

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Which bacterial infection are these signs and symptoms of ?
Fever, chills, fatigue, malaise, weight loss, persistent cough

Tuberculosis

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Which type of tuberculosis is WIDESPREAD?

Miliary tuberculosis

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Which type of tuberculosis has to do with the SUBMANDIBULAR & CERVICAL LYMPH NODES?

Scrofula or Tuberculous Lymphadenitis

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True or False?

Tuberculosis incidence has been related to HIV infection and increased immigration from countries where tuberculosis is endemic

True

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True or False?

Tuberculosis is considered an occupationally transmitted disease in dentistry

True

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True or False?

Standard precautions can prevent transmission

True

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True or False?

If the patient has active tuberculosis, routine treatment can be deferred

True

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An infection caused by a filamentous bacterium: Actinomyces israelii

Draining abscesses

Treatment: Long-term, high doses of antibiotics

Actinomycosis (bacterial infection)

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Caused by a spirochete: Treponema pallidum
Organisms die when exposed to air and changes in temperature
Transmitted by: Direct contact, Sexual contact, Transfusion of infected blood to a fetus from infected mother

Syphilis (bacterial infection)

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Which stage of Syphilis is associated with CHANCRE?

Primary stage

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Which stage of Syphilis is associated with MUCOUS PATCHES?

Oral lesions that appear as multiple, painless, grayish-white plaques covering ulcerated mucosa
These lesions are the most infectious
They undergo spontaneous remission but may recur for months or years

Secondary stage

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Which stage of Syphilis is associated with NOTHING?

Latent stage

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Which stage of Syphilis is associated with GUMMA?

A firm noninfectious mass; destructive lesion that can result in perforation of the palatal
Involves the cardiovascular system and the nervous system

Tertiary stage

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Treponema pallidum can cross the placenta and enter the fetal circulation
Causes serious, irreversible damage to the child, including facial and dental abnormalities

Congenital Syphilis (bacterial infection)

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Treatment of Syphilis

Penicillin

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A painful, erythematous gingivitis with necrosis of interdental papillae
Most likely caused by both a fusiform bacillus and a spirochete (Borrelia vincentii)
Associated with decreased resistance to infection

Necrotizing Ulcerative Gingivitis “NUG” or “Trench Mouth”
(bacterial infection)

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Necrosis results in cratering of the interdental papillae
Sloughing of necrotic tissue causes a pseudomembrane to form over the tissue

Necrotizing Ulcerative Gingivitis “NUG” or “Trench Mouth”
(bacterial infection)

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Treatment of Necrotizing Ulcerative Gingivitis (Trench Mouth)

Gentle debridement Antibiotics if fever present

Inflammation around the crown of a partially erupted, impacted tooth Most commonly a lower third molar Trauma from an opposing molar and impacted food under the soft tissue flap (operculum) may precipitate

Pericoronitis (bacterial infection)

Treatment of Pericoronitis

Irrigation of the pocket Systemic antibiotics Long-term solution is removal of the offending tooth Mechanical debridement

Acute inflammation of the bone and bone marrow Most commonly the result of a periapical abscess May follow fracture of a bone May result from a bacteremia

Acute Osteomyelitis

Nonviable bone Necrotic debris Acute inflammation Bacterial colonies in marrow spaces

Acute Osteomyelitis

A long-standing inflammation of bone The involved bone is painful and swollen Radiographs reveal a diffuse and irregular radiolucency that can eventually become opaque Known as chronic sclerosing osteomyelitis when radiopacity develops

Chronic Osteomyelitis

Due to an overgrowth of Candida albicans, aka THRUSH This can result from many different conditions: Antibiotics, cancer chemotherapy, corticosteroid therapy, dentures, diabetes mellitus, HIV infection, hypoparathyroidism, infancy, multiple myeloma, primary T cell deficiency, xerostomia

Candidiasis (fungal infection)

A white curdlike material is present on the mucosal surface The mucosa is erythematous underneath The patient may complain of a burning sensation and/or a metallic taste

Pseudomembranous Candidiasis (fungal infection)

The presenting complaint is of an erythematous, often painful mucosa May be localized to one area of oral mucosa or be more generalized

Erythematous Candidiasis (fungal infection)

The most common type of candidiasis The mucosa is erythematous, but only in the mucosa covered by a full or partial denture Most common on the palate and maxillary alveolar ridge Usually asymptomatic

Denture Stomatitis (Chronic Atrophic Candidiasis - fungal infection)

A white lesion that does not wipe off the mucosa responds to antifungal medication If the lesion does not heal with the medication, should refer to oral surgeon for biopsy

Chronic Hyperplastic Candidiasis (Candidal Leukoplakia - fungal infection)

A white lesion that does not wipe off the mucosa responds to antifungal medication If the lesion does not heal with the medication, should refer to oral surgeon for biopsy

Chronic Hyperplastic Candidiasis (Candidal Leukoplakia - fungal infection)

Erythema or fissuring at the labial commissures Most commonly from Candida, but may be caused by other factors such as nutritional deficiency

Angular Cheilitis (fungal infection)

Erythematous, rhomboid-shaped Flat to raised area on the midline of the posterior dorsal tongue Candida has been identified in some lesions, and some lesions disappear with antifungal treatment

Median Rhomboid Glossitis (fungal infection)

Oral lesions may be caused by_____ such as histoplasmosis, coccidioidomycosis, blastomycosis, and cryptococcosis They primarily involve the lungs and there is a regional distribution of these lesions

Deep Fungal Infections

100 + types of _____ (HPV) Verruca vulgaris, Condyloma acuminatum, Focal epithelial hyperplasia HPV is also implicated in neoplasia

Human Papillomavirus Infection (HPV)

A papillary oral lesion caused by a papillomavirus transmitted from skin to oral mucosa Autoinoculation usually occurs through finger sucking or fingernail biting Usually a white, papillary, exophytic lesion that closely resembles a papilloma

Verruca Vulgaris (Common Wart - viral infection)

True or False? Verruca Vulgaris lesion may recur from a conservative surgical excision

True

A benign papillary lesion caused by a papillomavirus Generally transmitted by sexual contact May be transmitted to the oral cavity through oral-genital contact or self-inoculation Papillary, bulbous pink masses that can occur anywhere in the oral mucosa Multiple lesions may be present

Condyloma Acuminatum (viral infection)

Characterized by the presence of multiple whitish to pale pink nodules distributed throughout the oral mucosa Most common in children Lesions are generally asymptomatic and do not require treatment Resolve spontaneously within a few weeks

Focal Epithelial Hyperplasia (Heck Disease - viral infection)

Has a Type 1 and type 2 Oral infections: mostly by type 1 Genital infections are most commonly caused by type 2

Herpes Simplex Infection (viral infection)

Initial infection with herpes simplex virus Painful, erythematous, and swollen gingiva, multiple tiny vesicles/ulcers on perioral skin, vermilion border of lips, and oral mucosa. Systemic symptoms such as fever, malaise and cervical lymphadenopathy Most commonly occurs in children 6mo-6 yrs of age.

Primary Herpetic Gingivostomatitis (viral infection)

Virus persists in a latent state Usually in nerve tissue of the trigeminal ganglion High incidence- up to half of the population experiences

Recurrent Herpes Simplex Infection

Where is the most common area for Recurrent Herpes Simplex Infection to occur?

On the lips (Herpes Labialis)

True or False? Recurrent Herpes Simplex Infection can occur intraorally on keratinized mucosa that is attached to bone

True

True or False? The highest amount of the virus (Recurrent Herpes Simplex Infection) is in the vesicle stage

True

True or False? Sunlight or menstruation can cause Recurrent Herpes Simplex Infection

True

A painful infection of the fingers caused by a primary or secondary infection

Herpetic Whitlow (Recurrent Herpes Simplex Infection - viral infection)

Causes both chickenpox (_____) and shingles (_____) Transmitted through respiratory aerosols and contact with secretions from skin lesions Highly contagious!

Varicella-Zoster Virus

Secondary chickenpox in an adult Characterized by a unilateral, painful eruption of vesicles along the distribution of a sensory nerve Any branch of the trigeminal nerve may be involved if lesions affect the face Vesicles are often preceded by pain, burning, or paresthesia The disease usually lasts for several weeks Neuralgia may take months to resolve

Herpes Zoster: Shingles

Often transmitted by kissing aka “the kissing disease”

Infectious Mononucleosis (Epstein-Barr Virus)

An irregular, corrugated, white lesion, commonly occurs on the lateral border of the tongue It occurs most commonly in patients infected with HIV

Hairy Leukoplakia (Epstein-Barr Virus)

Transmitted by: Fecal-oral contamination Saliva Respiratory droplets

Coxsackievirus Infections

Difficulty in swallowing (dysphagia) Vesicles on the soft palate Erythematous pharyngitis Resolves in less than 1 week without treatment

Herpangina (Coxsackievirus Infection)

Usually occurs in epidemics in children less than 5 years old- ie; daycare, school, playgroups Multiple macules or papules occur on the skin, typically on the feet, toes, hands, and fingers Oral lesions are painful vesicles that can occur anywhere in the mouth Resolves within 2 weeks

Hand-Foot-and-Mouth Disease (Coxsackievirus Infection)

Characterized by fever, sore throat, and mild headache Hyperplastic lymphoid tissue of the soft palate or tonsillar pillars appears as yellowish or dark pink nodules Lasts several days to 2 weeks and does not usually require treatment

Acute Lympho-nodular Pharyngitis (Coxsackievirus Infection)

Caused by a paramyxovirus virus A highly contagious disease which caused systemic symptoms and a skin rash Koplik spots, small erythematous macules, may occur in the oral cavity

Measles (viral infection)

A viral infection of the salivary glands Most commonly causes bilateral swelling of the parotid glands

Mumps (viral infection)

True or False? HIV is transmitted by sexual contact with an infected person, by contact with infected blood or blood products; from infected mothers to their infants.

True

True or False? Many individuals experience an acute disease shortly after infection with HIV, but others are asymptomatic and progressive immunodeficiency can develop Two antibody tests are used to determine whether a person is infected: ELISA (enzyme-linked immunosorbent assay) is used first When this test is positive twice, it is followed by the Western blot test

True

True or False? As the immune system becomes deficient, life-threatening opportunistic infections and cancers occur

True

Antibodies to HIV usually begin to become detectable about__ weeks after infection

6 weeks

In some people, antibodies may not be detectable for__ months or up to a year or longer This is called the “__________”

6 months “window of infectivity”

HIV stands for

Human immunodeficiency virus

AIDS stands for

Acquired immunodeficiency syndrome

Recurrence is common in HIV-positive patients, it generally signals the beginning of progressively severe immunodeficiency

Oral Candidiasis (Thrush)

Generally follows the usual pattern when it occurs in a person who is HIV positive In the facial and oral area, the lesions follow branches of the trigeminal nerve It is a sign of developing immunodeficiency

Herpes Zoster

Caused by Epstein-Barr virus A predictor of AIDS in HIV-positive individuals Chronic tongue chewing and hyperplastic candidiasis can produce a similar lesion No treatment

Hairy Leukoplakia

Associated with HIV infection May have normal color or be erythematous May be associated with antiretroviral treatment

Human Papillomavirus Infections

An opportunistic neoplasm that may occur in patients with HIV infection Most commonly located on the palate and gingiva

Kaposi Sarcoma

A malignant tumor that may occur in association with HIV infection Appears as a nonulcerated, necrotic, or ulcerated mass May be surfaced by ulcerated or normal-colored erythematous mucosa

Lymphoma

Spontaneous bleeding Punctate or petechiae-like lesions on attached gingiva and alveolar mucosa A bandlike erythema of the gingiva that does not respond to therapy

Linear Gingival Erythema (LGE)

Characterized by intense erythema and extremely rapid bone loss Necrotizing stomatitis Extensive focal areas of bone loss along with features of ___

Necrotizing Ulcerative Periodontitis (NUP)

A decrease in platelets may occasionally be seen in patients with ___ It may be due to an autoimmune type of thrombocytopenic purpura In these patients, “a platelet count and bleeding time should be considered before deep scaling procedures”

HIV

There appears to be an increase in the number of ____ ulcers in patients with HIV infection They respond to steroids

Aphthous Ulcers

Bilateral parotid gland enlargement may occur in patients who are HIV positive May be related to medication or _____

Salivary Gland Disease

What is impetigo?

An infectious bacterial skin infection usually seen in young children Requires nonintact skin for infection Caused by Streptococcus pyogenes and Staphylococcus aureus

What organism causes syphilis?

Treponema pallidum

What are the various forms of Candida?

Pseudomembranous candidiasis Erythematous candidiasis Denture stomatitis Chronic hyperplastic candidiasis Angular cheilitis Chronic mucocutaneous candidiasis Median rhomboid glossitis

What is a wart?

A papillary oral lesion caused by a papillomavirus

What causes mononucleosis?

Often transmitted by kissing aka “the kissing disease”

What is the difference between HIV and AIDS?

HIV is an acute infection whereas AIDS is the most advanced stage of HIV leading to progressive immunodeficiency