GI goljan infections of oral cavity

Question 1

Name pathogen and features for exudative tonsilitis

Answer 1

virus (MC)

culture is necessary to differentiate bacterial vs viral infection

Question 2

Name pathogen and features for hairy leukoplakia

Answer 2

EBV;
glossitis assoc w/ bilateral white excrescences on lateral border of tongue;
Pre-AIDS defining lesion

Question 3

Name pathogen and features for herpes labialis

Answer 3

HSV type I;
recurrent vesicular lesions on lips (cranial sensory ganglia);
reactivated by stress, sunlight, menses

Question 4

Tx for HSV type I

Answer 4

oral acyclovir, valacyclovir, famciclovir, topical acyclovir, penciclovir

Question 5

Name pathogen and features for mumps

Answer 5

paramyxovirus;
bilateral parotitis (70%) w/ increase serum amylase

Question 6

complication of mumps

Answer 6

meningoencephalitis;
unilateral orchitis or oophoritis;
pancreatitis

Question 7

Name pathogen and features for herpangina

Answer 7

coxsackievirus;
occurs in children;
multiple vesicles or ulcers on soft palate and pharynx surrounded by erythema

Question 8

Name pathogen and features for hand-foot-mouth disease

Answer 8

coxsackievirus;
young children;
vesicles in mouth and distal extremities

Question 9

Name pathogen and features for cervicofacial actinomycosis

Answer 9

actinomycs israelii;
often follows after abscessed tooth extraction;
draining sinus tract from facial or cervical area

Question 10

How will cervicofacial actinomycosis be Dx?

Answer 10

Sulfur granules in pus;
contain Gram+, branching filamentous bacteria;
anaerobe

Question 11

Name pathogen and features for diphtheria

Answer 11

Corynebacterium diphtheriae;

toxin produces “shaggy” gray pseudomembrane in posterior pharynx and upper airways

Question 12

Tx for cervicofacial actiomycosis

Answer 12

ampicillin;

penicillin G

Question 13

Tx for diphtheria

Answer 13

erythromycin

Question 14

Name pathogen and features for peritonsillar abscess

Answer 14

Streptococcus pyogenes;
uvula deviates to contralateral side;
"hot potato" voice;
foul smelling breath
complication of tonsillitis

Question 15

Tx for peritonsillar abscess

Answer 15

surgical drainage of pus;
pen G or V;
add clindamycin for serious invasive infections

Question 16

Name pathogen for Ludwig’s angina

Answer 16

aerobic/anaerobic streptococcus, Eikennla corrodens

Question 17

Name causes of ludwigs angina

Answer 17

dental extraction (MC);
trauma to floor of mouth

Question 18

features of Ludwig’s angina

Answer 18

cellulitis involving submaxillary and sublingual space;

follows fascial planes and may spread into pharynx, carotid sheath, superior mediastinum

Question 19

Tx for Ludwig’s angina

Answer 19

surgical drainage;

clindamycin AND metronidazole

Question 20

Name pathogen and features for pharyngitis

Answer 20

S. pyogenes;
assoc w/ tonsillitis;
potential for acute rheumatic fever and glomerulonephritis

Question 21

Tx for pharyngitis

Answer 21

pen V

Question 22

Name pathogen and features for scarlet fever

Answer 22

S. pyogenes;

Pharyngitis, tonsillitis, glossitis;

Question 23

How does S. pyogenes cause scarlet fever?

Answer 23

erythrogenic toxin produces rash on skin and tongue (initial white then strawberry colored)

Question 24

Risks assoc w/ scarlet fever?

Answer 24

increased risk for glomerulonephritis;

nephritogenic strains pose no risk for acute rheumatic fever

Question 25

Tx for scarlet fever

Answer 25

pen G or V

Question 26

Name pathogen and features for sialadenitis

Answer 26

Staphylococcus aureus;

bacterial inflammation of major salivary gland secondary to calculus that obstructs duct in postoperative patients

Question 27

Tx for sialadenitis

Answer 27

oxacillin, nafcillin if methicillin susceptible;
TMP/SMX if community acquired methicillin resistant;
vancomycin if methicillin resistant in hospital

Question 28

Name pathogen and features for congenital syphilis

Answer 28

treponema pallidum (spirochete);
abormalities involving incisors (notches & tapered) and molar teeth (resemble mulberries)

Question 29

Tx for congenital syphilis

Answer 29

aqueous crystalline pen G

Question 30

Name pathogen and features for oral thrush

Answer 30

candida albicans (yeast;
may occur in neonates, immunocompromised, diabetes mellitus;
following ABx therapy

Question 31

Tx for oral thrush

Answer 31

fluconazole, itraconazole