Microbiology of Oral Ulcers Flashcards
What viruses can cause oral ulceration?
Herpes Simplex Virus
Coxsackie Virus
Treponema pallidum
Which type of Herpes simplex virus is responsible for oral ulcers?
Type 1 - aquired in childhood
How is HSV 1 spread?
saliva contact
What can HSV1 cause?
primary gingostomatitis
What populations commonly present with primary gingostomatitis?
preschool children - primary infection
What is the presentation of primary gingostomatitis?
lip, buccal mucosa and hard palate inflammation
systemic upset
local lymphadenopathy
1-2mm vesicles
What is the treatment of HSV 1 primary gingostomatitis?
aciclovir
What happens after the primary infection of HSV 1?
becomes latent in the trigeminal ganglion
What does HSV 1 affect when it reactivates?
mucosal surfaces - normally same place as last time
What does herpes simplex virus type 2 cause?
genital herpes or less commonly cold sores
What is the presentation of HSV 2 cold sores?
oral herpetic lesions - if intra oral it wont normally be HSV
How is HSV diagnosed?
swab the lesion then do PCR of viral DNA
What is a complication of HSV?
herpes simplex encephalitis
What type of virus is the coxsackie virus?
enterovirus - feacal oral spread
What diseases does the coxsackie virus cause?
Hand, foot and mouth disease
Herpangia
What is the presentation of Herpangia?
vesicles/ulcers on the soft palate - stops the child from eating
What population is affected by Herpangia?
primary school age
How is Herpangia diagnosed?
PCR swab or just clinical
What is the presentation of hand, foot and mouth disease?
blisters on hands and in mouths
How does hand, foot and mouth disease get spread?
feacal oral spread - saliva sharing in young children
How is hand, foot and mouth disease diagnosed?
viral PCR or just clincial
What disease does Treponema pallidum cause?
Primary syphilis
What is the presentation of primary syphilis?
painless ulcer at the site of entry of the bacterium
boggy/thick ulcers and swollen lips
most common site is genital but some oral
What is the treatment of primary syphilis?
penicillin
What are the posible complications of primary syphilis?
secondary and tertiary syphilis
What are apthous ulcers?
recurring, self limiting ulcers lasting under 3 weeks
painful ulers in the mouth that have inflammatory halos
When do apthous ulcers occur?
begin in childhood and become less severe in the 3rd decade
What systemic diseases are associated with ulcers?
Bechets disease - oral, genital, uveitis, middle east and Asia
Gluten sensitive enteropathy or IBD - diarrhoea and weight loss
Reiters disease - arthritis
Skin diseases - lichen planus, pemphigus, pemphigoid
