Viral/Fungal Infections

Question 1

4 examples of viruses which can affect the oral mucosa

Answer 1

• HSV
• VZV
• Epstein Barr Virus
• Cytomegalovirus
• Coxsackie Virus
• Paramyxoviruses
• HPV

Question 2

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

Answer 2

Primary Herpetic Gingivostomatitis

(Common in children 6 montsh to 6 years)

HSV1 or HSV2

Question 3

Tx for Primary Herpetic Gingivostomatitis

Answer 3

• Control of infection
• Supportive care - fluids, anti-pyretic
  *

Question 4

Most common location for recurrent herpes infection:

Answer 4

Lips

Herpes Labialis

Question 5

Oral manifestation of Infectious Mononucleosis (Epstein Barr virus)

Answer 5

Petechiae on palate

Question 7

What is Ramsay Hunt Syndrome

Answer 7

When a shingles recurrence affets the trigeminal nerve, causing paralysis of the facial nerve resulting in a palsy.

Question 8

An irregular, corrugated white lesion most commonly occurring on the lateral border of the tongue. EBV considered to be the causative agent.

Answer 8

Hairy Leukoplakia

Question 9

List some conditions or factors other than age, which can cause candida infection (7)

Answer 9

1. Diabetes
2. Cushing Syndrome
3. Broad spectrum antibiotics
4. Immunosuppressant
5. HIV
6. Nutritional deficiency (iron, folate, b12)
7. Tobacco smoking

Question 10

Why does Xerostomia cause candida?

Answer 10

Lack of flushing mechanism

Question 11

List the different presentations of candida

Answer 11

1. Pseudomembranous Candidosis
2. Erythematous candidosi (denture induced, median rhomboid glossitis)
3. Chronic hyperplastic candidosis
4. Angular Cheilitis

Question 12

Which type of candida is considered pre-mlaignant

Answer 12

Chronic hyperplastic

Question 13

Bacteria associated with Angular Cheilitis

Answer 13

Staph Aureus

Question 14

Management of Candida

Answer 14

• Remove pre-disposing factors
• Topical antifungal

Question 15

List 3 types of antifungals

Answer 15

• Nystatin (polyene)
• Amphotericin B (polyene)
• Miconazole (Azole)

Question 17

What do you use to treat chronic hyperplastic candidosis

Answer 17

Fluconazole 50mg once daily 2+ weeks

Question 18

Normal oral carriage rate of candida:

Answer 18

40-80%

Question 19

List 3 primary oral candidosis presentations

Answer 19

• Pseudomembranous candidosis
• Erythematous candidosis
• Chronic hyperplastic candidosis

Question 20

List 4 candida-associated lesions

Answer 20

1. Median rhomboid glossitis
2. Angular cheilitis
3. Denture associated stomatitis
4. Linear gingival erythema

Question 21

Linear gingival erythema is comon in people with:

Answer 21

HIV

Question 22

Clincal presentaiton of denture associated stomatitis:

Answer 22

Usually painlesa nd asymptomatic. Appearance is red and swollen sometimes with pin point haemorrhage

Question 23

Erythematous candidosis usually occurs in people who have:

Answer 23

• Steroid tx
• Broad spectrum AB
• HIV

Question 24

Example of a mouthwash with anti-candida activity:

Answer 24

Chlorhexidine Gluconate

Question 25

3 main topical antifungals

Answer 25

• Nystatin
• Amphotericin B
• Miconazole