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M2 | Microbiolgy > Salivary Gland Infections > Flashcards

Salivary Gland Infections Flashcards

1
Q

What is Sialadenitis?

A

An inflammation of salivary tracts

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2
Q

Sialadenitis infective causes are …?

A
  1. Viral
  2. Bacterial
  • Parotid glands ( more common )
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3
Q

Viral causes of Sialadenitis

A
  1. Mumps ( most common )
  2. CMV
  3. Rare viruses :
    a. Parainfluenza virus types 2 & 3
    b. Echoviruses
    c. Coxsackie viruses
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4
Q

Important properties of mumps

A
  • Lipoprotein envelope with spikes of 2 transmembrane glycoproteins
  • Helical nucleocapsid
  • Single-stranded, linear, nonsegmented negative-polarity RNA
  • RNA dependent RNA polymerase
  • Single serotype
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5
Q

What are the 3 proteins with viral RNA in mumps?

A
  1. Nucleocapsid (N) protein:
    * forms helical nucleocapsid
    * represents major internal protein
  2. P (Phosphoprotein)
  3. L (Large polymerase) proteins
    * L & P proteins & nucleocapsid together has RNA-dependent RNA transcriptase activity
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6
Q

What are the 3 proteins forming the viral envelope?

A
  1. Matrix (M) protein:
    * underlies viral envelope
    * important in virion assembly
  2. Two transmembrane glycoproteins:
    a. Hemagglutinin neuraminidase(HN):
    * Hemagglutination activities
    * Attachment to host cell
  3. Fusion (F) glycoproteins
    * Membrane fusion
    * Hemolysin activities
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7
Q

How mumps is transmitted?

A

Respiratory droplets

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8
Q

Explain pathogenesis of mumps virus

A
  • Infects URT —> spreads through blood to infect :
    parotid glands, testes, ovaries, pancreas & meninges
  • Virus ascend from buccal mucosa up Stensen’s duct to parotid gland
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9
Q

Pathogenesis of mumps through vertical transmission

A

Maternal antibody passes placenta & provides protection during first 6 months of life

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10
Q

Mumps occurs only once; subsequent parotitis caused by :

A
  1. Other viruses such as parainfluenza viruses
  2. Bacteria
  3. Duct stones
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11
Q

What are the clinical findings of mumps ?

A

1 Prodromal stage:

  • fever
  • malaise
  • anorexia followed by tender swelling of parotid glands, either unilateral or bilateral ( puffy cheeks)
  1. Drinking citrus juices increase in parotid pain
  2. Loss of appetite
  3. Headache
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12
Q

Incubation period of mumps virus

A

18 to 21 days

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13
Q

When mumps virus resolves ?

A

1 week ; disease is benign

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14
Q

Complications of mumps virus

A
  1. Orchitis :
    * in postpubertal males
    * bilateral——-> sterility
    * they have fibrous tunica albuginea, which resists expansion ——-> pressure necrosis of spermatocytes
    * Unilateral orchitis is painful but does not lead to sterility
  2. Meningitis :
    * benign, self-limited & without sequelae
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15
Q

How to diagnose mumps virus ?

A
  1. Cell culture :
    * isolate virus from saliva, spinal fluid & urine
  2. PCR
  3. Fourfold rise in antibody titer
  4. Complement fixation (CF) test :
    * both S (soluble) antigen (consists of NP)
    & V antigen (consists of HN glycoprotein)
  • Antibody to S antigen indicates ——> current infection (appears early & short lived)
  • If only V antibody is found——> patient has had mumps in past
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16
Q

Important properties of Actinomyces Israelii

A
  • Anaerobic

* Gram-positive filamentous, branching rods

17
Q

What is the habitat of Actinomyces Israelii?

A

Habitat is human mouth

* anaerobic crevices around teeth

18
Q

Transmission of Actinomyces Israelii

A
  1. Occurs during dental disease or local trauma such as broken jaw or dental extraction
  2. Organism aspirated into lungs, causing thoracic actinomycosis
19
Q

Explain pathogenesis of Actinomyces Israelii

A
  • Infection is initiated by trauma that introduces these endogenous bacteria into mucosa
  • Organisms grow in anaerobic niche, induce mixed inflammatory response ——> spread with formation of sinuses ( contain granules & drain pus to surface through sinus tracts)
  • Infection causes hard, non tender swelling that develops slowly & may spread to neighboring organs, including bones
20
Q

Clinical findings of Actinomyces Israelii

A
  1. Cervicofacial disease
  2. Thoracic actinomycosis
  3. Abdominal actinomycosis
  4. Genital actinomycosis
21
Q

What are the manifestations of Cervicofacial disease of Actinomyces Israelii?

A
  • Swollen, erythematosus process in jaw area “lumpy jaw”
  • With progression, mass becomes fluctuant, producing draining fistulas
  • Disease extend to contiguous tissue, bone & lymph nodes of head & neck
22
Q

What are the manifestations of Thoracic actinomycosis?

A
  1. resemble those of subacute pulmonary infection:
    * mild fever, cough & purulent sputum
  2. Lung tissue is destroyed, sinus tracts may erupt through to chest wall & invasion of ribs
23
Q

What are the manifestations of Abdominal actinomycosis?

A
  • Follows ruptured appendix or ulcer

* In peritoneal cavity, pathology is same, but any organs involved

24
Q

What are the manifestations of Genital actinomycosis ?

A
  • Rarely occur in women with retained intrauterine device for long period of time
25
Q

How to diagnose Actinomyces Israelii ?

A
  1. Examining pus:
    * from draining sinuses, sputum, or specimens of tissue for presence of sulfur granules
  2. Gram staining : showing Gram-positive branching rods
  3. Culturing of pus or tissue specimens
    * anaerobic conditions
  4. Immunofluorescence (identification)
26
Q

Describe the structure of sulfur granules

A
  • granules are hard
  • lobulated & composed of tissue & bacterial filaments
  • club shaped at periphery

M2 | Microbiolgy (17 decks)

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