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BDS2; FHHD > M14: Oral Infections > Flashcards

M14: Oral Infections Flashcards

1. Give examples of the main bacterial, fungal and viral agents frequently detected in the mouth 2. Understand the classification of oral infections in terms of endogenous and exogenous infections of hard and soft tissues with examples 3. Describe how predisposing factors that disturb the oral flora can result in oral infections 4. Give examples of antimicrobial agents used to treat oral infectious agents

1
Q

Classifications of oral infections

A
  1. Bacterial, fungal and viral - bacterial infections aren’t due to a single causative agent
  2. Endogenous = caused by micro-organisms usually in mouth e.g. plaque-related caries and periodontal disease
  3. Exogenous = not in normal flora e.g. herpes simplex, primary syphilis and secondary manifestations of systemic infections e.g. TB, viral infections
  4. Hard and soft tissue infections
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2
Q

Name the causative or associated organisms with caries (hard tissue bacterial infection)

A

Streptococcus mutants

Lactobaccilli

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3
Q

Name the causative or associated organisms with dental abscesses (hard tissue bacterial infections)

A

Oral streptococci
Oral anaerobes

Untreated caries lesion causes abscess formation to skin surface

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4
Q

Name the causative or associated organisms with dry socket (hard tissue bacterial infections)

A

Actinomyces spp.

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5
Q

Name the causative or associated organisms with osteomyelitis (hard tissue bacterial infections)

A

Staphylococcus aureus

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6
Q

Name the causative or associated organisms with periodontal disease (gingivitis and periodontitis) - (soft tissue infection)

A

Porphyromonas
Prevotella
Capnocytophaga spp.
Aggregatibacter actinomycetemcomitans

HIV necrotising periodontitis occurs when the patient is immunocompromised so cannot fight off the transient microorganisms

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7
Q

Name the causative or associated organisms with acute ulceration gingivitis (soft tissue infection)

A

Fusobacterium spp.
Treponema spp.
Prevotella intermedia

Acute necrotising gingivitis = AUG - metronidazole will kill the anaerobes; presents as swollen gums with necrosis and loss of interdental papillae

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8
Q

Name the causative or associated organisms with pericoronitis (soft tissue infection)

A

Oral anaerobes
P. gingivalis
P. intermedia

Caused by trauma from opposing tooth and damages soft tissues

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9
Q

Name the causative or associated organisms with sialadenitis (soft tissue infection)

A

S. aureus (skin and nose)

Oral streptococci

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10
Q

Name the causative or associated organisms with actinomycosis (soft tissue infection)

A

Actinomyces israelii

Presents as multiple draining sinuses with sulphur granules present

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11
Q

Name the causative or associated organisms with gonorrhoea (exogenous soft tissue)

A

Nisseria gonorrhoeae

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12
Q

Name the causative or associated organisms with syphilis (soft tissue infection)

A

Treponema pallidum

Secondary syphilis presents as a snail-track ulcer on soft tissue

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13
Q

Name the causative or associated organisms with tuberculosis (soft tissue infection)

A

Mycobacterium tuberculosis

Presents as granulomatous oral ulceration

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14
Q

Name the causative or associated organisms with candidiasis (fungal soft tissue infection)

A

Candida albicans
Candida spp.

Variations:

  • acute pseudomembranous candidiasis = thrush
  • candidate leukoplakia
  • denture stomatitis
  • angular chelitis
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15
Q

Name the causative or associated organisms with herpetic stomatitis and cold sores (primary viral soft tissue infections)

A

Herpes simplex

Gingivostomatitis presents as self-limiting blistering ulcers

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16
Q

Name the causative or associated organisms with herpes zoster (shingles) - (primary viral soft tissue infection)

A

Varicella-Zoster

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17
Q

Name the causative or associated organisms with herpangina (primary viral soft tissue infection)

A

Coxsackie A

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18
Q

Name the causative or associated organisms with oral warts (primary viral soft tissue infection)

A

Papilloma

Presents as oral papillomatosis (wart)
HPV in HIV
Cytomegalovirus infection in HIV + patient
Kaposi’s sarcoma (herpes virus)

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19
Q

Name the causative or associated organisms with hand, foot and mouth disease (secondary viral soft tissue infection)

A

Coxsackie A

20
Q

Name the causative or associated organisms with glandular fever (secondary viral soft tissue infection)

A

Epstein-Barr virus

Presents as :
Infectious mononucleosis
Oral hairy leukoplakia

21
Q

What do disturbances in the oral microflora result in

A
  1. Selective growth of endogenous species e.g. candidiasis in AIDS patients
  2. Displacement of endogenous species e.g. actinomycosis following trauma to oral mucosa/jaw
  3. Introduction of exogenous micro-organisms e.g. oral TB lesions following trauma, E.coli bone infections following radiotherapy
22
Q

What oral infection does old age and infancy predispose and why

A

Candidiases
Root caries

Because there is decrease in antibodies and salivary flow rate

23
Q

What oral infection does pregnancy predispose and why

A

Gingivitis

Unknown cause

24
Q

What oral infection does localised trauma predispose and why

A

Opportunistic infections

Due to loss of tissue integrity

25
Q

What oral infection does generalised trauma predispose and why

A

Candidiasis

Due to general debilitation and dehydration

26
Q

What oral infection does malnutrition predispose and why

A

Candidiasis

Due to iron and folate deficiency

27
Q

What oral infections do endocrine disorders predispose and why

A

Fungal infections

Unknown cause

28
Q

What oral infection does AIDS predispose and why

A

Candidiasis
Opportunistic oral infections

Due to reduction of host immune defences

29
Q

What oral infection does antibiotic therapy predispose and why

A

Candidiasis
Opportunistic oral infections

Due to loss of colonisation resistance
Selection of resistant flora

30
Q

What oral infection does chemotherapy predispose and why

A

Candidiasis
Caries

Due to xerostomia and local mucosal effects

31
Q

What oral infection does oral malignancies predispose and why

A

Caries
Candidiases

Xerostomia and loss of muscular function

32
Q

What is metronidazole

A

It is an antimicrobial with increased activity against anaerobic bacteria

33
Q

Metronidazole prescription

A

400mg BD or 200my TDS for 5-7days

34
Q

Side effects of metronidazole

A

Metallic taste, effects on alcohol

35
Q

What is amoxicillin

A

Broad spectrum antimicrobial with good oral absorption - works by interfering with cell Wal synthesis

36
Q

Amoxycillin prescription

A

250mg - 500mg TDS for 7 days

37
Q

Side effects of amoxicillin

A

Predisposes candidiasis

38
Q

What is tetracycline

A

Antimicrobial for periodontal infections and herpes gingivostomatitis = broad spectrum antibiotic

39
Q

Tetracycline prescription

A

250mg QDS for 5 days

40
Q

Side effects of tetracycline

A

Risk of exacerbating renal failure

Don’t give to patients with renal disease, children <12 and those pregnant or breast feeding

41
Q

What is nystatin and prescribe this

A

Polyene anti fungal (not absorbed by gut)
Patients with xerostomia find it difficult

100,000 units QDS for 7 days

42
Q

What is ketoconazole and prescribe this

A

Systemic imidazole anti fungal
Shouldn’t use in patients with liver diease/alcoholics

200mg OD 14 days

43
Q

What is miconazole and prescribe this

A

Gel and denture lacquer which is applied to clean dentures

25mg/ml used QDS for 14 days

44
Q

What is amphotericin and prescribe this

A

Polyene anti fungal (not absorbed by gut)

Lozenges 10mg QDS for 10-15 days

45
Q

What is fluconazole and prescribe this

A

Systemic triazole anti fungal well absorbed in mouth with a better toxicity profile which is expensive

50mg OD 7-14 days

46
Q

When is topical acyclovir used

A

Treatment for recurrent herpes labialis applied in prodromal phase - antiviral applied 5% cream QDS 6 times daily for 5 days

47
Q

When is systemic acyclovir used

A

For healthcare workers treating immunocompromised patients and those who present herpes infection within 48hrs

Primary HSV = 200mg 5 times daily for 5 days
Herpes zoster = 800mg 5 times daily for 7 days

BDS2; FHHD (26 decks)

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