Chapter 5: Bacterial Infections Flashcards
(133 cards)
1
Q
A
impetigo
2
Q
A
impetigo
3
Q
what bacteria is impetigo caused by?
A
streptococcus pyogenes and/or staphylococcus aureus
4
Q
what are the two forms of impetigo?
A
nonbullous and bullous
5
Q
cases of impetigo usually arise in ___ skin
A
damaged
6
Q
there is an increase prevalence of impetigo in what 3 populations?
A
HIV, type 2 DM, and dialysis
7
Q
which type of impetigo is more prevalent?
A
nonbullous
8
Q
nonbullous impetigo most frequently occurs where on the body?
A
legs
9
Q
nonbullous impetigo facial lesions are usually located where on the face?
A
around the nose and mouth
10
Q
nonbullous impetigo is seen in what age patient mostly?
A
school-aged children
11
Q
is impetigo contageous?
A
yes
12
Q
in nonbullous impetigo, ___ is common, and itching causes spreading of the infection
A
pruritis
13
Q
what is the treatment for nonbullous impetigo?
A
topical antibiotics
14
Q
bullous impetigo is seen more commonly in what aged patient?
A
infants
15
Q
untreated severe cases of bullous impetigo can lead to what 3 illnesses?
A
meningitis, pneumonia, and glomerulonephritis
16
Q
superficial vesicles of bullous impetigo rapidly enlarge to form what?
A
larger, flaccid bullae, which usually rupture and evelop a thin brown crust (“lacquer”)
17
Q
what is the treatment of bullous impetigo?
A
systemic oral antibiotics
18
Q
A
tonsillitis
19
Q
another name for tonsillitis/pharyngitis is ___
A
strep throat
20
Q
what is tonsillitis/pharyngitis caused by?
A
group A beta-hemolytic streptococci, influenza, and epstein-barr virus
majority is caused by virus
21
Q
the following are signs/symptoms of what infection?
sore throat, dysphagia, tonsillar hyperplasia, fever, headache, and other constitutional symptoms
A
tonsillitis and pharyngitis
22
Q
how is streptococcal pharyngitis and tonsillitis diagnosed?
A
throat culture
23
Q
what is the treatment for streptococcal pharyngitis and tonsillitis?
A
penicillin
24
Q
what are the four sequelae to streptococcal pharyngitis and tonsillitis?
A
- scarlet fever
- rheumatic fever
- rheumatic heart disease
- acute glomerulonephritis
25
scarlet fever
represents the first two days - white strawberry tongue
26
scarlet fever
represents 4-5 days into infection - red strawberry tongue
27
\_\_\_ is the result of disseminated group A beta-hemolytic streptococcal infection, with oral features including a white coating on the tongue with only fungiform papilla visible in the first two days, and an erythematous dorsal surface with hyperplastic fungiform papilla during days 4 and 5 of the infection
scarlet fever
first 2 days - white strawberry tongue
days 4-5 - red strawberry tongue
28
what are the dermatologic features of scarlet fever?
skin erythema (1 week) and desquamation (3-8 weeks)
pastia's lines - rash in areas of pressure and skin folds presenting as transverse red streaks
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scarlet fever
30
pastia's lines
scarlet fever
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what are the 5 possible complications of scarlet fever?
* abscess
* pneumonia
* acute rheumatic fever
* glomerulonephritis
* hepatitis
32
what is the treatment for scarlet fever?
oral penicillin or erythromycin
33
tonsilloliths
34
tonsillar concretions occur when ___ tonsillar crypts are filled with ___ and \_\_\_. secondarily, they become colonized with what bacteria?
* pharyngeal
* desquamated keratin and foreign material
* actinomyces spp.
35
what is the difference between a tonsillar concretion and tonsillolith?
* when the contents of invaginations become compacted, it's foul-smelling and termed a tonsillar concretion
* if it undergoes dystrophic calcification, it's termed a tonsillolith
36
what are the symptoms of tonsillar concretions/ tonsilloliths?
other than the foul smell of tonsillar concretions, they are asymptomatic
37
tonsillar concretions and tonsilloliths can promote recurrent \_\_\_
tonsillar infections
38
how are tonsilloliths discovered?
on panoramic radiograph as radio-opaque objects superimposed on the midportion of the mandibular ramus
39
what are the at home treatments for tonsillar concretions / tonsilloliths?
* gargle warm salt water
* use pulsating jets of water
40
what are the in-office treatments for tonsillar concretions / tonsilloliths?
* enucleation
* local excision
* tonsillectomy is definitive
41
what is the bacteria responsible for diphtheria?
cornebacterium diphtheriae
42
\_\_\_ are the sole reservoir for diphtheria
humans
43
what tissues does diphtheria affect first?
mucosal tissues
44
what are the implications of diphtheria?
lethal exotoxin produced by the bacteria causes tissue necrosis and cardiac complications
45
syphilis is caused by \_\_\_
treponema pallidum
46
how is syphilis contracted?
primarily through sexual contact and from mother to fetus
47
syphilis is 6x more common in what populations?
men and african americans
48
how is primary syphilis characterized?
characterized by the chancre that develops at the site of inoculation (3-90 days after inoculation)
49
what are the most common sites of inoculation of syphilis?
anus and external genitalia
50
or lesions account for \_\_% of syphilis inoculation sites. describe the lesions.
* 2%
* most commonly seen on the lip
* primary syphilis is a painless ulceration
51
another term for secondary syphilis is \_\_\_
disseminated syphilis
52
secondary syphilis occurs ___ weeks after initial infection
4-10 weeks
53
what are the systemic symptoms of secondary syphilis?
* painless lymphadenopathy
* ALWAYS: diffuse, painless, maculopapular, cutaneous, widespread rash
54
diphtheria
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primary syphilis chancres
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primary syphilis chancre
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secondary syphilis
58
secondary syphilis
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tertiary syphilis
gumma
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after secondary syphilis, patients enter ___ syphilis and are free of ___ for ___ years
* latent
* lesions/symptoms
* 1-30 years
61
\_\_\_% of patients will progress from latent syphilis to tertiary syphilis
30%
62
what are the possible cardiac complications of tertiary syphilis?
* aneurysm of the ascending aorta
* congestive heart failure
* CNS involvement
* paralysis
* psychosis
* death
63
describe the lesions seen in tertiary syphilis
* ocular lesions
* tongue lesions (syphilitic glossitis)
* intraoral lesions usually affect the palate or tongue
* gumma - characteristic; scattered foci of granulomatous inflammation
64
what is hutchison's triad, and what is it associated with?
* hutchison's incisors
* ocular interstitial keratitis
* 8th nerve deafness
* occurs in congenital syphilis (however, not all people with congenital syphilis will have all of the features of hutchison's triad)
65
describe hutchison's incisors
* greatest mesiodistal width in the middle 1/3 of the crown
* incisal 1/3 tapers to the incisal edge - resembles a flat head screwdriver
* incisal edge has a central hypoplastic notch
66
what are the dental characteristics of congenital syphilis?
hutchison's incisors and mulberry molars
67
what are the ocular characteristics of congenital syphilis?
ocular keratitis, which results in blindness
68
what bacteria is responsible for gonorrhea?
neisseria gonnorhoeae
69
\_\_\_ is the most common reportable infectious disease in the US
gonorrhea
70
how is gonorrhea contracted?
sexual contact
71
what are the signs and symptoms of gonorrhea?
purulent discharge and dysuria
72
what bacteria is responsible for tuberculosis?
mycobacterium tuberculosis
acid fast bacillus
73
most patients that contract tuberculosis have an \_\_\_
immunodeficiency
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how does tuberculosis spread?
through airborne droplets
75
tuberculosis of the skin is called \_\_\_
lupus vulgaris
76
\_\_\_ is a form of myobacterial infection caused by drinking contaminated milk from an infected cow, and presents as an enlarged cervical lymph node
scrofula
77
intraorally, how does tuberculosis present?
tongue and palate as a painless, chronic ulceration
78
describe the histology of tuberculosis
granulomas with central areas of necrosis (caseating granulomatous inflammation)
79
what is the treatment for tuberculosis?
8-wk course of isoniazid, rifampin, and pyrazinamide, then 16-wk course isoniazid and rifampin
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congenital syphilis
hutchison's incisors
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congenital syphilis
mulberry molars
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gonorrhea
83
tuberculosis
84
tuberculosis
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tuberculosis, as indicated by a scrofula
86
leprosy is a chronic infectious disease produced by what bacteria?
mycobacterium leprae
87
is leprosy infectious?
it has a low infectivity (exposure rarely results in disease)
88
82% of all leprosy cases are found in what 5 places? what are the two endemic areas?
* brazil, india, indonesia, myanmar, and nigeria
* endemic areas are louisiana and texas
89
\_\_\_ is a host for leprosy
9-banded armadillo
90
what are the two main categories of leprosy, and what is the significance?
* tuberculoid leprosy (paucibacillary)
* lepromatous leprosy (multibacillary)
* treatment will be different depending on the category
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lepromatous leprosy
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lepromatous leprosy
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which type of leprosy is this?
tuberculoid leprosy
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which type of leprosy is this?
lepromatous leprosy
95
which type of leprosy is this?
lepromatous leprosy
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describe paucibacillary leprosy
* tuberculoid pattern
* small number of skin lesions
* rare oral lesions
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describe multibacillary leprosy
* lepromatous pattern
* loss of hair
* facial skin enlargements = leonine facies
* collapse of bridge of the nose = pathognomonic
98
lepromatous leprosy (multibacillary leprosy)
99
\_\_\_ is a rapidly progressive, polymicrobial, opportunistic infection that is most frequently preceded by measles
noma
100
what are the two types of bacteria responsible for noma?
fusobacterium necrophorum and prevotella intermedia
101
noma frequently begins as \_\_\_
NUG
102
noma most frequently develops in ___ in children of what age?
* africa
* ages 1-7
* nutrition from breastfeeding = carbs and unsafe water
103
in noma, how do the zones of necrosis present?
* develop in gingiva or soft tissue
* necrosis spreads, but does not follow tissue planes and spreads through anatomic barriers (like muscle)
* necrotic areas are well-defined and unilateral
104
what is the treatment for noma?
* antibiotics and correct nutrition
* conservative debridement of gross necrotic areas
* aggressive removal is contraindicated (it compounds reconstruction problems - reconstruction is delayed 1 year to ensure complete recovery)
* leave necrotic bone to hold facial form; remove if it sequestrates
105
what are the mortality rates of noma?
* 95% mortality if untreated
* 10% mortality if treated in the US
106
necrotizing ulcerative mucositis, which is characteristic of **noma**
107
noma
108
actinomycosis
109
actinomycosis is a bacterial infection caused by what bacteria?
actinomyces israelii
110
where can actinomyces israelii colonization occur in healthy patients?
tonsillar crypts, plaque, and/or carious dentin
111
55% of cases of actinomycosis are diagnosed in the ___ region
cervicofacial
112
what is the treatment for actinomycosis?
long-term high dose antibiotics
113
what bacterial infection can result in a suppurative reaction of the infection that may discharge a yellow material? what does the yellow material represent?
* actinomycosis
* represents colonies of bacteria (actinomyces israelii), termed sulfur granules
114
what bacteria causes cat-scratch disease?
bartonella henselae
115
cat-scratch disease is the most common cause of ___ in children
chronic regional lymphadenopathy
116
cat-scratch disease begins in the \_\_\_, and classically spreads to \_\_\_
* skin
* adjacent lymph nodes
117
cat-scratch disease arises after contact with what?
* a domestic cat or kitten
* scratches, licks, bites
118
80% of cat scratch disease cases occur in patients younger than \_\_\_
20
119
what can happen in cases of cat-scratch fever where primary lesions are adjacent to the eye?
can result in a conjunctival granuloma with preauricular lymphadenopathy (= oculoglandular syndrome of parinaud)
120
how is cat-scratch fever diagnosed?
serologic tests
121
what is the treatment for cat-scratch fever?
* it is a self-limiting condition
* palliative treatment only unless severely involved, then antibiotics are appropriate
* resolves in 4 months
122
cat scratch disease
123
cat scratch disease
124
\_\_\_ is one of the most common health complaints in the US
sinusitis
125
sinusitis is usually caused by a blockage of the \_\_\_
ostiomeatal complex (therefore disruptive normal drainage)
126
what are the most common predisposing factors of sinusitis?
* allergic rhinitis
* upper respiratory tract viral infection
127
if not corrected, acute sinusitis can become \_\_\_
* chronic
* defined as recurring episodes of acute sinusitis/symptomatic sinus disease lasting longer than 3 months
128
in chronic sinusitis, calcification can occur, which is termed a \_\_\_
antrolith
129
describe pain of maxillary sinusitis
* increased pain when head is upright
* decreased pain when patient is supine
* a sinus infection should be strongly considered when patients complain of pain from several teeth
130
\_\_\_ helps diagnose chronic sinusitis
radiographic imaging
sinus is cloudy with increased density
131
what is the treatment for **acute** sinusitis?
no treatment; disease is self-limiting
132
what is the treatment of **chronic** sinusitis?
* if unresponsive, surgical correction to enlarge the ostial openings
* surgery should try to be avoided in children
* decreased distance between orbit and brain
133
sinusitis
cloudy right maxillary antrum
