Infective Stomatitis - Bacterial Flashcards
Impetigo is a skin infection caused by:
Streptococcus pyogenes & Staphyloccus aureus
Impetigo affects what age group?
Young children
What location on the body does impetigo present>
Face & Extremities
Facial lesions usually develop around the nose and mouth.
What things predispose someone to impetigo infection
Poor hygiene
Crowded living conditions
Hot & humid climate
Previous trauma: abrasions, insect bites, dermatitis
How is Impetigo spread?
Through skin contact
How does impetigo present?
Vesicles that rupture, leaving light brown (amber) colored crusts (cornflakes glued to the surface)
In what specific way does impetigo differ from HSV
lesions persist until treated. This is unlike HSV
How is Impetigo treated?
Topical or Systemic antibiotics
- mupirocin topical
- cephalexin, dicloxacillin
Tonsillitis and pharyngitis in origin is due to what?
Bacterial or viral in origin:
group A, beta-hemolytic streptococci
Tonsillitis and pharyngitis cause what hallmark condition?
Strep Throat
- sore throat, headache, fever, tonsillar hyperplasia, yellowish tonsillar exudate, erythema, palatal petechiae, and lymphadenopathy
What age group does Tonsillitis and pharyngitis target?
Children aged 5-15 years
How is Tonsillitis and pharyngitis spread?
Spread by contact with infectious nasal or oral secretions.
How to treat Tonsillitis and pharyngitis
Culture & treat with antibiotics:
- penicillin, amoxicillin, cephalosporin
Complications of Strep throat
Scarlet fever
Rheumatic fever
Glomerulonephritis
Characteristics of Scarlet fever
- Group A, beta-hemolytic streptococci
- children aged 3-12 years
- organisms elaborate an erythrogenic toxin that attacks blood vessels
- Skin rash, fever, palatal petechiae, “strawberry tongue”
Characteristics of Rheumatic fever
Affects heart, joints, central nervous system, damages heart valves
Syphillis is caused by?
Treponema pallidum
How is Syphilis spread?
Direct contact with mucosal surfaces (sexual contact, mother to fetus)
There is an increased incidence of Syphilis in what groups of people
African Americans
Prostitutes
Drug abusers
How common is Syphilis in the U.S. compared to other countries
50-100x higher prevalence in the U.S. compared with other industrialized countries
Describe primary syphilis
- Chancre: painless ulcer at site of inoculation
- External genitalia, anus, lip
- 3-90 days after initial exposure
- regional lymphadenopathy
- TPHA + FTA-ABS (????)
- Highly infectious
Describe secondary syphilis
- 4-10 weeks after initial infection
- Mucous patches
- “snail track” ulcers
- Condylomata lata (papillomas), maculopapular cutaneous rash
- Lymphadenopathy, sore throat, fever
- Highly infectious
Laten syphilis
1-30 years
Describe Tertiary syphilis
- develops in 30% of patients
- Gumma : unique type of necrosis
- indurated, nodular or ulcerated lesion
- intramurally, usually affects palate (perforation) or tongue
- Glossitis, atrophy and loss of dorsal tongue papillae (Luetic glossitis)
- Syphilitic leukoplakia
- Cardiovascular system and CNS involvement
Describe congenital syphilis
Frontal bossing
Underdeveloped Mx
High arched palate
Saddle nose deformity
Hutchinson’s triad
Interstitial keratitis of cornea
VIII nerve deafness
Dental abnormalities
- screwdriver-shaped “Hutchinson’s incisors”
- “mulberry molars” bumps on occlusal surface
Blood tests in Congenital Syphilis
VDRL and RPR - sensitive but not specific
TPHA and FTA-ABS
Mucosal smear not recommended, oral flora has spirochetes
- Antibiotics: penicillin
Tuberculosis is caused by:
Mycobacterium tuberculosis:
- acid-fast bacillus
What is Tuberculosis
Primary infection of lungs
What contributes the progression of Tuberculosis from an infection to active disease?
Immunodeficiency (old age, poverty, HIV/AIDS)
How is Tuberculosis spread?
Spread through airborne droplets from patients with active disease
Clinical features of Tuberculosis
Fever night sweats fatigue weight loss productive cough hemoptysis - Lymph node involvement "Scrofula"
Tuberculosis chronic direct infection with skin causes what?
Lupus vulgaris
Tuberculosis direct infection orally causes what features?
Chronic painless ulceration usually involving tongue or palate
- atypical periodontal disease
Biopsy of Tuberculosis shows what?
Tissue culture and biopsy shows grandmas with central areas of necrosis
What tests are done for Tuberculosis
- AFB - Acid fast bacillus stain shows typical red bacilli
- PCR (polymerase chain reaction)
- PPD skin test and chest radiograph
What treatment is used for tuberculosis
Isoniazid (INH)
rifampin
Actinomycosis is caused by what?
Actinomyces israelii: normal saprophytic anaerobic inhabitant of oral cavity
In what group of people is Actinomycosis common
History of surgery or trauma
Where does Actinomycosis occur most commonly?
55% of cases occur in cervicofacial areas
- injury, periodontal pocket, nonmetal tooth, extraction socket, infected tonsil
How does Actinomycosis present?
Abscesses and draining sinus tracts
- Culture: colonies of organisms are yellow “sulphur granules”
How do you treat Actinomycosis
Long-term high doses of antibiotics
- can range from 6 weeks to 12 months, depending on extent of infection.
Localized acute infections (periodical or pericoronal actinomycosis) may be treated more conservatively.
- removal of infected tissue usually produces sufficient aeration that antibiotics aren’t needed (follow-up)
Necrotizing Ulcerative Gingivitis is caused by what?
Bacillus fusiformis
Borrelia vincetii
When does NUG most frequently occur?
during situations of stress, immunodeficiency or malnourishment
What age group is most affected by NUG
Young and middle-aged adults
How does NUG present orally
- Interdental papillae are highly inflamed and hemorrhagic
- Papillae are blunted with areas of “punched-out” necrosis that are covered with a grape pseudomembrane
- Fetid odor and intense pain
How do you treat NUG
- Debridement by scaling or curettage
- Chlorhexidine rinses
- Systemic antibiotics if fever or lymphadenopathy is present.
