Microbiology Flashcards
If had patient w/ hx of XLA w/ swelling and pus exuding what should do?
Radiograph - presence foreign bodies
Drainage of pus
Swab of pus
What organisms expect to see from infection XLA socket?
Anaerobic infection:
Prevotella
Fusobacterium
Treponema
How manage pt w/ infected socket?
Drain abscess and debride
If unwell/ sign spreading infection - prescribe ab
Pt w/ dental abscess post XLA was prescribed metro why has this not worked?
Metro is also effective against anaerobes
Issues: ab resistance, acquired resistance, ab not sensitive to organism, pt compliance, no local measure used - ab can’t reach site
Pt presents w/ redness and crusting at corner of mouth and erythema in denture bearing area - what is most likely cause?
Fungal infection - angular chelitis
If patient presented with suspected fungal infection - how manage?
Swab denture bearing area Swab commissure of mouth Blood test Oral rinse Swab of denture
What might see in blood test if pt has fungal infection?
Decreased iron, vit B
What is oral rinse?
Saline rinse - non-specific to infective organism
What must swab be?
Dampened in saline
How manage pt w/ fungal infection?
Remove predisposing factors
OHI/ denture hygiene
Antifungals - systemic/ topical
Likely organism of fungal infection?
Hyphae candida - often Candida albicans (dimorphic)
See c. glabrata/ staph aureus
Different between hyphae and yeast form?
Hyphae - long/pathogenic
Yeast - rounded
What antifungals are indicated?
Miconazole - c.albicnas/ staph aureus
Nystatin - c.glabrata
Fusidic acid - s.aurues/ c.glabrata
Have patient w/ fluctuant swelling in buccal sulcus adjacent to carious retained root - how would take specimen?
Aspirate - retains environment (important in anaerobic infection)
Select correct medium to prevent oxygen exposure - agar/ reducing agent
FNA of pus - prevent contamination
Likely microbial infection in fluctuant swelling?
Mixed sample - anaerobes/ neutrophils
Black pigmenting anaerobes - prevotella/ porphymonas
Fusobacteria
Peptostreptococcus
Strep. viridian (caries)
How manage fluctuant swelling?
Local measures
XLA cause
Ab - systemic unwell/ spreading infection
Ab for fluctuant swelling?
Penicillin - amoxilcillin
Metro if allergy
What is abscess?
Pathological pus filled cavity
What is common see on sample of actinomycosis?
Molar tooth colony - yellow granule (sulphur) -made of bacteria/ immune cells which become walled off
What microbes responsible actinomycosis?
Actinomyces - a.isralei/ oris
Highly branched and filamentous organisms
Histology of acinomycosis?
Slows growing lesion - forms necrotic lesions - granular material walled off w/ immune cells
What need consider when prescribing for actinomycosis?
Length of course
Actinomyces are slow growing - 5 day course not enough - need 6-8 weeks minimum (amoxicillin)
What to be wary of with broad spec ab?
GI upset - risk of C.difficile
What is dx if pt has been loosing weight and presents w/ peusdomembranous yeast infection and corrugated vertical white striations on lat border of tongue?
Oral presentation of HIV
Candidosis infection
Oral hairy leukoplakia
What is oral hairy leukoplakia associated w/?
EBV
Typical presentation oral thrush?
Creamy plaques which rub off giving a bleeding base
Organism responsible for oral thursh?
Candida albicans
How tx pt w/ thrush?
Tx candida - topical/ systemic antifungals
How manage pt if suspect oral manifestation HIV?
Refer GP - underlying immunosuppression/ HIV
Issue w/ prevotella infections?
high resistance to ab - esp penicillin (prevotella - beta lactamase)
What is macrolide?
-Mycin
Erythromycin etc.
