SM_30b: Head and Neck Microbiology Flashcards
Main challenge for care providers with regard to the common cold is ____
Main challenge for care providers with regard to the common cold is distinguishing uncomplicated cold from streptococcal pharyngitis, secondary bacterial sinusitis, and otitis media
Group A Streptococcal pharyngitis is caused by ____ and is characterized ____
Group A Streptococcal pharyngitis is caused by Streptococcus pyogenes and is characterized by sudden onset of sore throat, odynophagia, and fever
- 20-30% of childhood pharyngitis
- NOT cough or rhinorrhea (would suggest a viral infection)
- Anterior cervical lymphadenopathy
- Treated with penicillin to shorten duration of symptoms, reduce secondary transmission, and reduce risk of complications
Group A Streptoccocus pharyngitis diagnosis involves ____ or ____
Group A Streptoccocus pharyngitis diagnosis involves rapid antigen detection test or throat culture
Streptococcus pygenes is ____, ____-hemolytic, and has ____ that resists phagocytosis
Streptococcus pygenes is Gram positive cocci in chains, beta-hemolytic, and has M protein that resists phagocytosis
Group A Streptococcus causes ____, ____, and ____
Group A Streptococcus causes pharyngitis, scarlet fever, and rheumatic fever
- JONES: migratory polyarthritis, carditis, subcutaneous nodules (Aschoff bodies), erythema marginatum (rash), Syndenham’s chorea (movement disorder)
Infectious mononucleosis (acute EBV infection) presents as ____, ____, ____, ____, and ____
Infectious mononucleosis (acute EBV infection) presents as fever, tonsillar pharyngitis, posterior cervical lymphadenopathy, possible airway obstruction, and splenomegaly
Infectious mononucleosis (acute EBV infection) diagnosis involves ____ or ____
Infectious mononucleosis (acute EBV infection) diagnosis involves monospot / heterophile antibody or EBV specific serology (EBV VCA IgM)
____ is latently infected by EBV
B-lymphocyte is latently infected by EBV
Describe other notable causes of pharyngitis
Other notable causes of pharyngitis
- Arcanobacterium haemolyticum: pharyngitis and a scarlatiniform rash
- Neisseria gonorrhoeae: sexually transmitted pharyngitis
- Candida spp.: thrush
Herpes simplex virus is a _____ infection, with HSV-1 mostly _____
Herpes simplex virus is a mucocutaneous infection, with HSV-1 mostly orolabial
- Retrograde infection along sensory nerves
- Latent infection in cranial nerves
- HSV-1: cold sores, fever blisters, stomatitis
Herpangina is caused by ____, while hand, foot, and mouth disease is caused by ____ or ____
Herpangina is caused by Coxsackie A virus, while hand, foot, and mouth disease is caused by Coxsackievirus or Enterovirus
This is an ____
This is an aphthous ulcer
Epiglottitis was historically caused by ____ and presents as ____, ____, ____, ____, ____, and ____
Epiglottitis was historically caused by Haemophilus influenzae b and presents as fever, throat pain, dysphagia, drooling, hoarseness, and stridor
- Decreased since introduction of Hib vaccine
*
Epiglottitis is diagnosed by ____ on X-ray or CT
Epiglottitis is diagnosed by thumbprint sign on X-ray or by CT
Haemophilus influenza is a ____ and ____ and type b is ____
Haemophilus influenza is a Gram negative coccobacillus and facultative anaerobe and type b is encapsulated
Ludwig angina is ____ that is usually ____
Ludwig angina is a life-threatening cellulitis of the floor of the mouth and neck and is usually polymicrobial
- Infection typically begins in a lower molar and spreads to sublingual and submaxillary spaces
- Complications: aspiration pneumonia, asphyxia, mediastinitis - airway compromise is leading cause of death
- Neck swelling, neck pain, odynophagia, dysphagia - bull neck, stridor may indicate impending neck obstruction
Ludwig angina is treated with ____
Ludwig angina is treated with antibiotics that cover Gram positive bacteria, Gram negative bacteria, and anaerobes
Bull neck is associated with ____
Bull neck is associated with Ludwig angina
Viridans Group Streptococci is distinguished from Streptococcus pneumoniae by ____ and ____ and from Enterococci by ____
Viridans Group Streptococci is distinguished from Streptococcus pneumoniae by resistance to optochin and lack of bile solubility and from Enterococci by inability to grow in 6.5% NaCl broth
- Alpha-hemolytic (green discoloration on agar plate) or Gamma-hemolytic
Actinomyces is an ____ that causes ____ and is characterized by ____ and ____
Actinomyces is an anaerobic Gram-positive branching filamentous rod (not acid-fast) that causes oral-cervicofacial disease (lumpy jaw) and is characterized by sinus tracts and sulfur granules
Sinus tracts and sulfur granules occur in ____ caused by ____
Sinus tracts and sulfur granules occur in cervicofacial actinomycosis caused by Actinomyces
Fusobacterium necrophorum is a ____ that causes ____
Fusobacterium necrophorum is a filamentous anaerobic Gram-negative bacteria that causes Lemierre syndrome
Lemierre syndrome is caused by ____ and is characterized by ____ and ____
Lemierre syndrome is caused by Fusobacterium necrophorum and is characterized by septic jugular venous thrombophlebitis and septic pulmonary emboli
Otitis media is an infection of the ____ that starts as a ____
Otitis media is an infection of the middle ear that starts as a viral URI
- Edema obstructs Eustachian tube -> increase in negative pressure in middle ear and mucosal secretions -> overgrowth of bacteria
- Presents with fever, ear pain, bulging / erythematous tympanic membrane and middle ear fluid (bulging donut of pus)
Bacterial otitis media is most commonly caused by ____, ____, and ____
Bacterial otitis media is most commonly caused by Streptococcus pneumoniae, non-typeable Haemophilus influenzae, and Moraxella catarrhalis
Streptococcus pneumoniae presents as ____, ____, or ____
Streptococcus pneumoniae presents as otitis media, sinusitis, or invasive pneumococcal infection (pneumonia, bacteremia, meningitis, overwhelming post-splenectomy infection)
- Gram-positive, aerotolerant anaerobe, alpha-hemolytic
Pneumococcal vaccine is a ____ vaccine
Pneumococcal vaccine is a conjugate vaccine
Moraxella catarrhalis can cause ____
Moraxella catarrhalis can cause otitis media
- Also bronchitis, sinusitits, laryngitis, bronchopneumonia is COPD
- Beta-lactamase positive
- Fastidious, nonmotile, Gram-negative, aerobic, oxidase postive diplococci
Otitis externa is also called ____ and is usually caused by ____ or ____
Otitis externa is also called Swimmer’s ear and is usually caused by Pseudomonas aeruginosa or Staphyloccocus aureus
- Itchiness inside ear, redness and swelling of the ear, pain when the infected ear is tugged, purulent drainage from ear canal
- Prolonged water exposure and trauma to skin of ear canal
- Uncomplicated infection responds to topical antibiotics
Malignant otitis externa is typically seen in ____, caused by ____, and requires ____
Malignant otitis externa is typically seen in elderly diabetic patients, is caused by Pseudomonas aeruginosa, and requires systemic antibiotics
- Invasive infection of external auditory canal and skull base
Acute sinusitis is most commonly caused by ____ but may have superimposed ____
Acute sinusitis is most commonly caused by viral URIs but may have superimposed bacterial superinfection
- Treated with watchful waiting, initial antibiotic therapy has small clinical benefit
- Sinusitis may extend to bones and soft tissues of face and orbits
Preseptal cellulitis involves ____ and is treated with ____
Preseptal cellulitis involves infection in front of the eye and is treated with antibiotics
Orbital (postseptal) cellulitis involves ____ and is treated with ____
Orbital (postseptal) cellulitis involves infection within the orbit and is treated with surgery
Rhinocerebral mucormycosis is a ____ typically seen in ____
Rhinocerebral mucormycosis is a life-threatening infection typically seen in diabetics with diabetic ketoacidosis
This is ____ and is caused by ____
This is Lemierre syndrome and is caused by Fusobacterium necrophorum
This is ____ and is caused by ____
This is Ludwig angina and is caused by polymicrobial
Summarize head and neck microbiology
