Chapter 5 - Bacterial Infections Flashcards
Gonorrhea
Bacteria: Neisseria gonnorhoeae
Symptoms: purulent discharge, dysuria
STD - most common reportable infectious disease
Congenital Syphillis
Hutchinson’s triad: Hutchinson’s incisors (screw driver shape), ocular interstitial keratitis, 8th nerve deafness
Other characteristics: Mulberry molars
Hutchinson’s Triad
Associated with congenital syphilis
- Hutchinson’s incisors
- Ocular interstitial keratitis
- 8th nerve deafness
Syphilis
Bacteria: Treponema pallidum
STD or vertical transmission
Types: Primary, Secondary, Tertiary, Congenital
Primary Syphilis
Chancre develops at site of inoculation (painless ulceration)
- Anus
- External genitalia
- Oral lesions (2%) - lip
Secondary Syphilis
AKA Disseminated syphilis Symptoms - ORAL --> Mucous patches - Painless lymphadenopathy - ALWAYS - diffuse, painless, maculopapular, cutaneous, widespread rash
Tertiary Syphilis
30% of patients progress to tertiary syphilis from latent syphilis
- Cardiac complications
- Ocular lesions
- Tongue lesions
- Gumma
* Palatal tissue dies, bone dies, hole formed
in palate
- Intraoral lesion
* Syphilitic glossitis - white patches don’t
come off
Gumma
Characteristic of tertiary syphilis
- scattered foci of granulomatous inflammation
Cardiac complications of Tertiary Syphilis
Aneurysm of the ascending aorta Congestive heart failure CNS involvement Paralysis Psychosis Death
Impetigo
Bacteria: Strep pyrogens and staph aureus
Forms: bollus and nonbollus
Increased prevalence: HIV, Type 2 diabetes, dialysis
Impetigo - bollus
Most commonly in infants
Untreated - can lead to meningitis, pneumonia, and glomerulonephritis
Bullae rupture - form thin brown crust
Impetigo - nonbollus
More prevalent that bolls School-aged children (contagious) Effected areas: - Legs (most common) - Face around nose and mouth Amber colored crusts
Diphtheria
Bacteria: Cornebacterium diphtheriae (produces a lethal exotoxin)
Humans are sole reservoir
Affects mucosal tissue first
Tissue necrosis and cardiac complications
Tonsilitis and Pharyngitis
“Strep throat”
Pathogen: Group A strep, influenza, Epstein-Barr virus
- Usually caused by a virus
Symptoms: sore throat, dysphagia, tonsillar hyperplasia, fever, headache, other constitutional symptoms
Sequelae of Streptococcal pharyngitis/tonsillitis
Scarlet fever
Rheumatic fever
Rheumatic heart disease
Acute glomerulonephritis
Tuberculosis
Mycobacterium tuberculosis
ACID FAST BACILLUS
Airborne droplets – look at chest X-rays
Caseating granulomatous inflammation
Oral manifestation of Tuberculosis
Painless chronic ulceration
Lupus Vulgaris
TB of the skin
Scrofula
Myobacterial infection caused by drinking contaminated milk (infected cow)
Leprosy
Mycobacterium leprae
Host – armadillo
Collapsed bridge of the nose
Noma
Polymicrobial:
- Fusobacterium necrophorum
- Prevotella intermedia
Rapidly progressive
Opptunistic infection - most frequently follows measles (immune system compromised, lesions)
Zones of necrosis develop in gingiva or soft tissue – does not follow tissue planes
High mortality rate if untreated
Painless Ulcers (2 diseases)
Syphillis – Chancre
Tuberculosis
Actinomycosis
Actinomyces israelii
Colonization occurs in healthy patients:
- Tonsillar Crypts
- Plaque
- Carious Dentin
Clinical signs are diagnostic
- Suppurative reaction of infection may discharge YELLOW material
- SULFUR GRANULES - colonies of bacteria
Treatment: Long term high dose antibiotics
Two bacteria that cause impetigo
Strep pyrogens (Group A strep) and staph aureus
Scarlet Fever
Result of disseminated Group A
Oral features:
- White strawberry tongue
(white coating with only visible fungiform papillae)
- Red strawberry tongue (erythematous dorsal surface w/ hyper plastic fungiform papillae)
Dermatologic features:
- Skin erythema
- Desquamation
- Pastia’s lines
Oral features of Scarlet Fever
White strawberry tongue - white coating w/ visible fungiform papillae
Red strawberry tongue - erythematous dorsal surface with hyper plastic fungiform papillae
Cat-Scratch Disease
Bartonella henselae
Chronic regional lymphadenopathy - children
Arises after contact with cat –> Scratches, licks, bite
Self limiting condition – antibiotics can be appropriate
Resolves in 4 months
Sinusitis
Most common health complaint in US
Blockage of ostiomeatal complex
May become chronic
Radio-opaque sinus in Xray
Calcification –> antrolith
Sinus infection should be strongly considered when patients complain of pain from several teeth
Treatment – self limiting, ABX, surgery
Chronic sinusitis that becomes calcified?
Antrolith
Maxillary Sinusitis
- Increased pain when —
- Decreased pain when —
Increased –> when head is upright
Decreased –> when patient is supine
Pastia’s lines
Scarlet Fever
Rash in areas of pressure and skin folds presenting as transverse red streaks
Tonsillar concretions
Compacted contents of invaginations in tonsils (tonsillar crypts)
Foul smelling
Actinomyces
Tonsillolithiasis
Calcification of tonsillar concretions
Can be seen on panoramic x-ray (radiopaque) - mid portion of mandibular ramus
At home treatment of tonsillar concretions/tonsillolithiasis
Gargle warm salt water
Use pulsating jets of water
