selected infectious diseases Flashcards Preview

Oral Path > selected infectious diseases > Flashcards

Flashcards in selected infectious diseases Deck (49)
Loading flashcards...
1

what is lupus vulgaris

mucocutaneous lesions of secondary tuberculosis; hematogenous or lymphatic spread of disease. Nose and cheeks are most common sites of involvement. May be ulcerative and destructive; healing may result in scarring and deformity.

2

WHAT IS SCROFULA

Cervical lymph node involvement by Mycobacteria. Periparotid, periauricular, and submental LNs possible, but usually high cervical lymph nodes in the submandibular gland region. Usually presents as a unilateral neck mass; patients are afebrile. May be TB or MOTT (Mycobacteria Other Than Tuberculosis). Enlarged, firm LN(s). Overlying skin ulceration possible.

3

CERVICOFACIAL ACTINOMYCES

ACTINOMYCOSIS • Filamentous, branching, gram-positive anaerobic bacteria • Normal part of oral flora • Tonsillar crypts (tonsilloliths), caries, perio pockets; immunocompetent people • “Infection” (overgrowth) may be acute or chronic; immunocompromised patients • Over 50% of all cases are cervicofacial

4

What is the suppurative reaction of actinomycosis

• Sulfur granules – large yellow flecks • Spreads via direct extension through soft tissue; not along fascial planes or lymphatic/vascular: sinus tract • Classic: wooden, indurated fibrosis with central soft area of abscess

5

What is the tx for actinomycosis

• Chronic fibrosing cases • Prolonged high dose antibiotics – 6 months (penicillin/amoxicillin) • Abscess drainage • Excision of sinus tracts • Acute cases • Localized removal of infected tissue

6

which form of candidiasis is associated tiwh invasion of tissues

hyphen form (yeast form is innocuous)

7

What factors determined clinical evidence of infection

• Host immune status • Oral environment • C. albicans strain

8

what are the four clinical patterns of candidiasis

• Pseudomembranous • Erythematous • Chronic hyperplastic • Mucocutaneous

9

PSEUDOMEMBRANOUS CANDIDIASIS

• Best recognized form of candidiasis • Aka “thrush” • White mucosal plaques (cottage cheese) • Plaques can be removed, usually revealing red, irritated tissue

10

Where are the most common sites for pseudomembranous candida

• Most common sites are buccal mucosa, dorsum of tongue, and palate

11

what are symptoms of pseudomembranous candidiasis

Symptoms may include mild chronic burning, bad taste (salty, bitter), “blisters”

12

What are the predisposing factors for candidiasis

Pre-disposing factors • Recent history of broad spectrum antibiotic • Immune dysfunction (HIV, leukemia) • Infants (underdeveloped immune system

13

what are the subtypes of erythematous candida

• Acute atrophic candidiasis • Median rhomboid glossitis • Chronic multifocal candidiasis • Angular cheilitis • Denture stomatitis

14

Acute atrophic candidiasis

• “Antibiotic sore mouth” – recent course of broad spectrum antibiotics • Burning, scalded sensation • Red, bald tongue due to diffuse loss of filiform papillae

15

Median rhomboid glossitis

• Aka central papillary atrophy • Found in adults, consistently associated with c. albicans • Well-outlined erythema in midline of posterior dorsal tongue • Loss of filiform papillae; may be smooth or lobulated • Often asymptomatic, may resolve with antifungal therapy

16

Chronic multifocal candidiasis

Involvement of dorsal tongue as well as other areas, usually junction of hard and soft palate (“kissing lesion”) and corners of the mouth

17

Angular cheilitis

• Red, fissured, scaling lesions at the mouth corners • Common patient: older, with reduced vertical dimension

18

what bacteria is usually connected with angular chelitis

s. aureus

19

Cheilocandidiasis

type of angular chelitis Involvement of perioral region, often due to lip or thumb sucking

20

Denture stomatitis

• Aka chronic atrophic candidiasis • Denture-bearing areas under maxillary removable prosthesis • The fungus shows very little invasion into tissue, and lesion is usually asymptomatic • Heavier fungal colonization on denture than tissue

21

CHRONIC HYPERPLASTIC CANDIDIASIS

• Aka candidal leukoplakia • White patch cannot be removed by rubbing • May represent secondary candidal infection of a leukoplakic lesion

22

location of chronic hyper plastic candidiasis and description

• Usually located on anterior buccal mucosa • May be speckled red and white • Hyphae are present • Diagnosis is confirmed by lesion resolution after antifungal therapy

23

MUCOCUTANEOUS CANDIDIASIS

• Seen within a rare group of immune disorders, usually sporadic or autosomal recessive • Candidiasis of mouth, nails, skin, etc from a young age • Thick white, foul-smelling plaques cannot be rubbed off, but can be controlled throughout life by anti-fungals

24

which candida may be associated with iron deficiency anemia

MUCOCUTANEOUS CANDIDIASIS

25

Endocrine-candidiasis syndrome:

• Hypothyroidism • Hypoparathyroidism • Hypoadrenocorticism (Addison’s) • Diabetes mellitus

26

CANDIDIASIS DIAGNOSIS • Combination of?

Clinical presentation • Exfoliative cytology • Biopsy • Level of response to anti-fungal treatment

27

CANDIDIASIS TREATMENT • Mucosal Tissue:

• Mycelex troches, 5x/day for 10 days. One in morning, then 30 minutes after each meal, and one more before bed.

28

treatment for candida on Complete dentures:

• 1 cup of water plus 1 teaspoon bleach, soak denture overnight

29

tx of candida on partials

• NO bleach. Use Nystatin elixir, 480 mL; place cup in refrigerator and instruct the patient to drop FPD’s in cup each night

30

ASPERGILLUS

• Fungus, member of the Monilaceae family, class Hyphomycetes, phylum Deuteromycota. Abundant in soil and decaying matter; mode of transmission is inhalation. Often see pulmonary or sinonasal cases.