Microbiology Flashcards
(15 cards)
Herpes simplex virus (HSV)?
- Type 1 acquired in childhood
- HSV1 is cause of oral lesions
- Transmitted via infected oral secretions during close contact
- Frequently asymptomatic
- Primary infection
- Lips, buccal mucosa, hard palate
Symptoms:
* Fever
* Local lymphadenopathy
* Aciclovir treatment-antiviral
Cold Sore?
- herpes is for ever
- Reactivation from nerves causes active infection of HSV
- Various stimuli e.g. anxiety, trauma
- Aciclovir therapy or suppression
- Not all reactivations are symptomatic
- Aciclovir does not prevent latency
- Multiple cycles of latency and active infection possible
- Only half of infected people get clinical recurrences
- Oral herpetic lesions usually HSV1
- Recurrent intra-oral lesions are rarely HSV
Herpetic whitlow?
- Infection of finger
- Often misdiagnosed as bacterial infection
- Occupational hazard of dentistry and anaesthetics
- Use of gloves essential in prevention
Herpangina?
- Vesicles/ulcers on soft palate
- Coxsackie viruses (not HSV)
enterovirus - Similar patient age range to 1ry HSV gingivostomatitis
- Diagnosis clinically or by PCR test of swab in viral transport medium
Primary syphilis?
- Painless indurated ulcer at site of entry of bacterium Treponema pallidum
- Most common site is genital, but oral and pharyngeal lesions can be the site of entry
- Left undiagnosed and untreated can progress to secondary and tertiary syphilis
Apthous ulcers (aphthae)?
- Non viral, self limiting
- Recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos
- Confined to mouth
- Absence of systemic disease
- Begin in childhood, tend to abate in 3rd decade
- Each ulcer lasts less than 3 weeks
Recurrent ulcers associated with systemic disease (non viral)?
- Behçet’s disease
Recurrent oral ulcers
Genital ulcers
Uveitis.
It can also involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems
Commonest in Middle East and Asia - Gluten-sensitive enteropathy or inflammatory bowel disease
Diarrhoea, weight loss - Reiter’s disease
Reactive arthritis - Drug reactions
- Skin diseases
lichen planus, pemphigus, or pemphigoid
Throat and pharynx?
Clinical Presentation:
Sore throat (symptom): Pain at the back of the mouth
Acute pharyngitis: inflammation of the part of the throat behind the soft palate (oropharynx)
Tonsillitis: inflammation of the tonsils
Microorganisms affecting the throat and pharynx?
Aetilogy of Sore throat?
If sore throat and lethargy persist into the second week, especially if the person is 15-25years of age, infectious mononucleosis/ glandular fever (caused by Ebstein Barr Virus ) should be suspected.
Consider HIV (especially seroconversion), gonococcal pharyngitis, and diphtheria according to the patient history
How to Dx sore throat?
History and clinical examination
Throat swabs **should not **be carried out routinely in primary care management
Associate complications with sore throat?
Otitis media (most common)
Peritonsillar abscess (quinsy)
Parapharyngeal abscess
Lemierre Syndrome (Suppurative thrombophlebitis of jugular vein)
REFER immediately: Stridor, breathing difficulty, clinical dehydration, systemically unwell
VAST MAJORITY (OVER TWO THIRDS) of Sore throats are VIRAL.
DO NOT NEED ANTIBIOTICS.
T/F
T
Mx of sore throat?
Self Care advice: analgesia, fluid intake, etc.
Prescribing antibiotics ONLY where appropriate
Identify and manage immunosuppressed people
Identifying those who need admission/referral
Throat cancer is suspected (persistent sore throat, especially if there is a neck mass)
Sore or painful throat lasts for 3 to 4 weeks. There is pain on swallowing or dysphagia for more than 3 weeks
Red, or red and white patches, or ulceration or swelling of the oral/pharyngeal mucosa persists for more than 3 weeks
Stridor / respiratory difficulty is an emergency
Bacterial Sore throat?
The most common BACTERIAL cause is Streptococcus pyogenes (also known as Group A streptococcus, or Group A Beta Haemolytic Strep)—>Gram positive cocci chains with Beta haemolysis
Clinical: acute follicular tonsillitis
Treatment: penicillin
