Viral/Fungal Infections Flashcards
4 examples of viruses which can affect the oral mucosa
- HSV
- VZV
- Epstein Barr Virus
- Cytomegalovirus
- Coxsackie Virus
- Paramyxoviruses
- HPV
Child presents with:
- Painful, erythematous, red bleeding gingiva with multiple tiny vesicles on perioral skin, vermillion border of lips and oral mucosa
- Vesciles progress to form ulcers
- Pt may have systemic symptoms - fever, malaise, cervical lymphadenopathy
Primary Herpetic Gingivostomatitis
(Common in children 6 montsh to 6 years)
HSV1 or HSV2
Tx for Primary Herpetic Gingivostomatitis
- Control of infection
- Supportive care - fluids, anti-pyretic
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Most common location for recurrent herpes infection:
Lips
Herpes Labialis
Oral manifestation of Infectious Mononucleosis (Epstein Barr virus)
Petechiae on palate
What is Ramsay Hunt Syndrome
When a shingles recurrence affets the trigeminal nerve, causing paralysis of the facial nerve resulting in a palsy.
An irregular, corrugated white lesion most commonly occurring on the lateral border of the tongue. EBV considered to be the causative agent.
Hairy Leukoplakia
List some conditions or factors other than age, which can cause candida infection (7)
- Diabetes
- Cushing Syndrome
- Broad spectrum antibiotics
- Immunosuppressant
- HIV
- Nutritional deficiency (iron, folate, b12)
- Tobacco smoking
Why does Xerostomia cause candida?
Lack of flushing mechanism
List the different presentations of candida
- Pseudomembranous Candidosis
- Erythematous candidosi (denture induced, median rhomboid glossitis)
- Chronic hyperplastic candidosis
- Angular Cheilitis
Which type of candida is considered pre-mlaignant
Chronic hyperplastic
Bacteria associated with Angular Cheilitis
Staph Aureus
Management of Candida
- Remove pre-disposing factors
- Topical antifungal
List 3 types of antifungals
- Nystatin (polyene)
- Amphotericin B (polyene)
- Miconazole (Azole)
What do you use to treat chronic hyperplastic candidosis
Fluconazole 50mg once daily 2+ weeks
Normal oral carriage rate of candida:
40-80%
List 3 primary oral candidosis presentations
- Pseudomembranous candidosis
- Erythematous candidosis
- Chronic hyperplastic candidosis
List 4 candida-associated lesions
- Median rhomboid glossitis
- Angular cheilitis
- Denture associated stomatitis
- Linear gingival erythema
Linear gingival erythema is comon in people with:
HIV
Clincal presentaiton of denture associated stomatitis:
Usually painlesa nd asymptomatic. Appearance is red and swollen sometimes with pin point haemorrhage
Erythematous candidosis usually occurs in people who have:
- Steroid tx
- Broad spectrum AB
- HIV
Example of a mouthwash with anti-candida activity:
Chlorhexidine Gluconate
3 main topical antifungals
- Nystatin
- Amphotericin B
- Miconazole
