Lecture 1 Flashcards
What is the structure of actinomyces?
-Gram postive rods with branching filaments.
-Soil Microorganisms.
Looks like yeast Hyphae
-Anaerobes
-Source of most antibiotics
What type of pathogen is actinomyces?
Its an oppurtunisitc pathogen and is usually found in the normal flora.
-Causes supportive granulomatous lesions.
What are 3 facts associted with actinomyces in the oral cavity?
- Major component of dental plaque
- Increase in numbers increases risk of gingivits.
- Increase is associated with root surface carries.
What are some important acinomyoces strains?
-Actinomyocin israelii
(Most important pathogen)
-Actinomoyces Odontolyticus
(causes eaerly enamel demeniratilization
What are the 4 stages of plaque formation?
- Early introduction of pellicle
- Initial bacterial colonization
- Late phase bacterial colonization
- Maturation of plaque
What are the facts about step 2 of dental plaque formation?
Its known as initial colonization. Usually non pathogenic bacteria. Such as gram postive cocci and Rods.
E.g sterp mutans
-strp snguis
-actinomyoces viscosus.
Why is actinomyces israelii a major pathogen?
Common in mouth and female genitourinairy tract.
-Major cause of actinomycosis but not the only reason.
What is Actinomycosis and why is it so dangerous? How is treated? whats the mortality rate?
- Rare but chronic slowly progressive disease. Causes the formation of granulomatous disease.
- Mimics periapical and periodontal abscesses. Its a malignant disease.
- Most commonly occuring by actinomyces israelii
- treated via antibiotics or surgery
Mortality up to 28% depending on site and time of discovery.
What are the different types of actinomycosis and what is the highest percentage?
- Cervicofacial
- Abodminal
- Thoracic.
Whats the clincial exam and manifestation of cervicofacial actinomyoces?
- Inflamed mas under the mandible.
- Low grade fever
- milky puss with yellow flecks
- Relapsing refractory clincal course.
-Short term antibiotics
What are sulfur granules?
Its centerally calcified but surrouned by branching filaments and pmns/
- Causes necrosis, abscess formation and draining sinuses.
- Its not only common in actinomycosis but can also be found in nocardia.
What are other names for cervicofacial actinomycosis? what are the common location? Whats the percentage of bone involvement?
- also known as lumpy jaw syndrom or Wooden tongue
- usually starts as periapical abscess and mainfests at the angle of the mandible, the chin, Cheek, TMJ and retromandibular area
- Bone involvment is about 10 %
What are the causes of cervicofacial actinomycosis?
- Tooth extraction
- dental carries
- puncturing the mucosa
- poor oral or dental hygiene
- Periodontal disease.
How can you diagnose Actinomycosis?
- Patient history
- Fine needle aspiration
- Microscopic exam of discharge
- Culture (less than 50% positive)
Hiw can you treate actinomyoces?
- Prolonged (Months) or antibiotic treatment
- Penicilin G IV for 4 weeks
- Then Oral penicilin for 4-6 months
- Low risk of developing penicilin resistance.
- Tetracycline
- erythromyoicn
- clindamycin
-Drainage via incisions if the antibiotics are doing sheeet.
What are the causes of thoracic actinomycosis? Symptoms?
caused by aspirating the pathogen into the lung. Its basically a spread of the cervicofacial form
Signs and symptoms:
- Lethargy and weight loss
- Fever, cough shortness of breath
- Night sweats
- Chest wall sinus with sulfer granules
About 90% of the time its wrongly diagnosed into something else such as cancer.
What are the complications of pulmonary actinomycosis?
- its life threatening
- Spread into lung and cause pneumonia
- Thoraci draining fistulas
- can spread into blood stream and causes bacteremia
- CNS involvement
- -Brain abscesses or meningitis.
What are the causes and of abdominal actinomycosis?
Usually following abdominal surgery
- Spread from GI tract or femal GU tract
- Linked to prolonged IUD use.
What are other locations can Actinomycoisis be found? What makes someone more likely to develop actinomycosis?
Maxilla, Perapical, tonsils and more.
- Alcoholism
- steroids
- immunosuppressents
- Transplant
- Trauma or surgery
- Chemotherapy
What are the distinguishing features of spirochetes?
-Long slender, helically coiled spiral or corkscrew (Twisty shit)
What are the 3 pathogenic genres of spirochetes and what they cause?
- Treponema: causes syphilis, bejel, yaws, pinta and necrotizing ulcerative gingivitis
- Borrelia- causes relapsing fever and lyme disease
- Leptospira- leptospirosis
What are some features of spirochetes?
- Theyre similar to gram negative bacteria
- strict anaerobes or microaerophillic
- Contraction of filaments gives it its heliical shape,
- Can be seen via darkfield or phase contrast microscopy
What are the structures that make up spirochetes?
- Outer envelop
- Axial filament (gives the spirochete shape)
- Protoplasmic cylinder
What is syphillis?
Syphillis is the treponema pallidum stain..
- transmission is blood, saliva, semen and contact with legions
- Cant be cultured
- Sensitive to penicillin
-Its basically legions found in the body. Tongue,
What is Yaws?
Treponema pallidum with subspecious pertenue cuases yaw which chronic ulcerative lesions of skin, mucosae and bone
-usually in children in tropical countries
What is pinta?
Pinta is due to spirochee : treponema carateum.
-It causes dipegmentation
- restricted to dark skin races
- in the americas and mexico.
What are the disnguishing features of oral spriochetes? sight of infecction? primary infection?
What Antibiotic are they sensitive to?
How can you prevent it?
Primary intraoral site is the gingival cervice.
Primary infections are necrotizing ulcerative gingivits
-Chronic periodontits.
Sensitive to penicilin and metronidazole
Can be prevented with good oral hygiene
What are the features of oral treponemas? how are they classified? can they be grown in vitro?
What type of anaerobes are they
-size classification (large- small)
Incontrast to T.Pallidum oral spirochetes can be grown in vitro
-Strict anaerobes but slow growing
What are the 4 species of treponemes?
1) T. Denticola
2) T. VIncentii
3) T.pectinovarum
4) T.socrasnkii
