Microbiology of ENT infections Flashcards
Most common cause of bacterial sore throat
Most sore throats are viral!
Most common bacterial cause is Group A strep
Abx for acute follicular tonsilits
Penicillin
unable to swallow IV benzylpenicillin
Gram positive cocci chains
Beta-haemolysis
Strep pyogenes
Strep pyogenes quinsy in hospital infection control
SICP’s
Contact precaution
Risk assess need for droplet precaution
Fever, arthritis, pancarditis
3 weeks post sore throat
Rheumatic fever
Late complications of strep. sore throat
Rheumatic fever
Glomerulonephritis!!
What type of toxin produced by diptheria?
Exotoxin!
this is cardiotoxic and neurotoxic
Treatment for diptheria
Treatment: Antitoxin and Supportive and Penicillin/erythromycin
Country with diptheria
Russia
Diptheria toxin
Vaccine - The vaccine is made from a cell-free purified toxin extracted from a strain of C. diphtheriae
White patches on red, raw mucous membranes in throat/ mouth
Candidia/thrush
Treatment for Thrush
Nystatin
Difference between acute sinusitis and secondary bacterial infection
Mild discomfort over frontal or maxillary sinuses due to congestion often seen in patients with upper respiratory viral infections.
However, severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection
Abx for sinusitis
only give is more than 10 days
1st line penicillin V
2nd line: doxycycline (not in children!!)
Treatment for aspergillus niger
Topical clotrimazole
Treatment for Otitis externa
Topical aural toilet.
Swab reserved for unresponsive cases
Then treat depending on culture results.
Eg Topical clotrimazole (trade name canesten) for Aspergillus niger, along with thorough aural toilet
Prognosis and complications of glandular fever
Protracted but self limiting illness Anaemia, thrombocytopenia Splenic rupture Upper airway obstruction Increased risk of lymphoma, especially in immunosuppressed.
Lab confirmation of glandular fever
Heterophile antibody Paul-Bunnell test Monospot test Epstein-Barr virus IgM Blood count and film
Two phases of primary infection with EBV
Primary infection in early childhood rarely results in infectious mononucleosis
Primary infection in those >10 years often causes infectious mononucleosis
Primary gingivostomatitis due to HSV1
Disease of pre-school children primary infection systemic upset lips, buccal mucosa, hard palate vesicles 1-2mm ulcers
Treatment for primary gingivostomatitis due to HSV1
Fever, local lymphadenopathy
May take up to 3 weeks to recover
spread beyond mouth
aciclovir treatment
Occupational hazard of dentistry
Use of gloves essential in prevention
Herpetic whitlow
Lab confirmation of HSV
Swab of lesion in virus transport medium
detection of viral DNA by PCR
What is herpangina?
Vesicles/ulcers on soft palate
CHILDHOOD INFECTION!
Due to coxsackie virus!
Which virus causes herpangina?
Coxsackie!! (not HSV)
Diagnosis of herpangina
diagnosis clinically or by PCR test of swab in viral transport medium
Hand foot and mouth disease
Also due to coxsackie viruses (enteroviruses)
family outbreaks common
diagnosis clinically or by PCR test of swab in viral transport medium
