43. Specific Chronic Granulomatous Diseases Flashcards
Clinical presentation of chronic actinomycosis in the maxillofacial region
- Indurated swelling around the mandible =>
- Near third molar and mandibular angle
- Initial symptoms=> suppurative infection=>
- Tumor-like masses, trismus=>
- Masticatory muscle involvement, and abscess formation with multiple fistulae=>
- Drain small amounts of pus containing sulfur granules
- Painless w/ minimal fever
can persist or recur over weeks to years.
Factors that contribute to development of actinomycosis in the maxillofacial region
- Poor dental hygiene, oral surgery, trauma, odontogenic infections=>
- Allow Actinomyces species invade deeper tissues by breaching mucosal barriers
Actinomyces species are normally low-virulence, anaerobic Gram-positive bacilli,
Primary causative organisms of actinomycosis
- Primary=> Actinomyces israelii
- Other species => Actinomyces naeslundii, Actinomyces viscosus
Diagnostic features of actinomycosis
- Clinical signs and symptoms
- Patient history
- Presence of sulfur granules in exudate
- Microbiologic findings
Standard treatment protocol for actinomycosis
- Intravenous penicillin G (10–20 million U per day) for 3–14 days=>
- Followed by at least 3 months of oral antibiotics
- Surgery => incision, drainage, and excision of fistulae=>
- Ensure antibiotic delivery and reduce bacterial load
Antibiotics-erythromycin, cephalosporins, tetracycline, clindamycin, or imipenem.
How tuberculosis (TB) transmitted and pathogen that causes it
- Mycobacterium tuberculosis=>
- Spreads via droplets from the sputum
- Affect the lungs, CNS, lymphatic system, circulatory system, bones, joints, skin, and oral mucosa
Common manifestations of tuberculosis in the oral and maxillofacial region
- Ulcers on the dorsal tongue =>irregular raised borders=>
- Can appear on the skin of the face as lupus vulgaris=>
- Painful reddish-brown nodules=> ulcerate and scar
- Cervical lymph nodes swell painlessly
- Fistulae=>advanced cases can develop
-ulcers can develop on other sites in the mouth
Diagnostic methods for tuberculosis in the MF region
- Mucosal biopsy => granulomatous inflammation, Langerhans giant cells, and necrosis
Treatment approach for tuberculosis in the MF region
- Chemotherapy with antibiotics
- Duration => 6–9 months
Antibiotiics used
How syphilis transmitted and what causes it
- Treponema pallidum
- Sexual contact or congenitally from mother to child
- Iatrogenically through exposed wounds or needles
Stages and symptoms of syphilis in the oral and maxillofacial region
- Primary stage=» Chancre
- Cervical lymph nodes enlarged and rubbery
- Secondary stage=>macular rash, systemic symptoms, and oral “snail track” ulcers or mucous patches
- Latent stage=>Asymptomatic
- Tertiary stage=> severe organ damage
Chancre=>a firm nodule that ulcerates with indurated margins
Syphilis diagnosis
- Dark-field microscopy of primary or secondary lesions =>
- Detect T. pallidum spirochetes
Treatment regimen for syphilis
- Intramuscular procaine penicillin
- Patients monitored and undergo serologic examinations for 2 years
- Alternative antibiotics=> erythromycin and tetracycline
