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| Infectious Diseases Contributed by:
Mary Cassatt
University of Medicine and Dentistry of New Jersey
Notes by: Ashley Quinn, Donna Lawson, and Mary Cassatt Disclaimer: These notes were copied and pasted from files sent to me by Mary. They have not been reviewed for errors. You are responsible for checking out the information to verify the accuracy. This site, Amy Nieves, Ashley Quinn, Donna Lawson, and Mary Cassatt are not responsible for typographical errors.Chapter 4 I. Introduction Microorganisms are divided into those who cause disease: Pathogenic Those that do not: Nonpathogenic ( sometimes they do ) = opportunistic infection Can be caused by immunosupression diseases To cause disease the organism must gain access to the body, accommodate to growth in the human environment and avoid multiple host defenses. BACTERIAL INFECTIONSIMPETIGO Not an oral Lesion, Skin infectionFace or extremitiesYOUNG CHILDRENBacteria : Streptococcus pyogenes and Staphylcoccus aureusStart off as Vesicles that rupture, then they crust,Usually occur when they is already skin trauma: dermatitis MAY RESEMBLE : Herpes Simplex InfectionClinical Presentation is important unless cultures were taken bacteria can be identified,Treatment: topical and systemic AntibioticsTonsilitis and PharyngitisMany different Bacteria casues this: streptococci, adenoviruses, influenza viruses and Epstien barr virusAppearance - white patches on tonsilsStreptococcal tonsillitis and pharyngitis is a common bacteria infection : spread by contact with nasal or oral secretionsAntibiotics are used to treat Streptococcal infectionScarlet fever : USUALLY IN CHILDRENBreak out in rash, strawberry tongueThroat culture helpful Rheumatic fever : effects the heart , joints and nervous systemPeople recovering or who have this usually require : premedTUBERCULOSIS – ( bacteria)“CHRONIC INFECTIION” MYCOBACTERIUM TUBERCULOSIS Primary infection of the - LUNG Fever chills fatigue malaise weight loss cough Disease is WALLED OFF in the ling Hard to treat Chronic Granulomatous inflammatory lesions Areas of necrosis surrounded by macrophages, multinucleated giant cells and lymphocytes Treatment: multiple antibiotic regimens Tongue and palate most common sites ( oral lesions not common)Painful non healing slowly enlarging ulcers, Reactivate: immuno depression Identifeid : Biopsy and microscopic examination of the tissuePPD test - Type IV hypersensitivity reactionCell mediated immune response will activate if positive reaction Chest radiograph must be done if result is positiveMeds Used: isoniazid ( INH) and Rifampin,Treatment lasts months to 2 years, Counsel patient on ongoing treatmentACTINOMYCOSIS Normal flora found in mouth, plaque , sulcus, perio pocket Bacteria : Actinomyces isrealiiMost common from : abscesses, tend to drain by the Sinus tractsPus tiny BRIGHT YELLOW GRAINS - don’t see in any other diseaseSulfur Granules - due to their color Microscopic exam The infection is preceded by : Tooth extraction or abrasion of the mucosaIdentifying the colonies for diagnosisTreated with: long term high doses of antibiotics Smells bad, SYPHILIS page 164Bacteria : Spirochete Treponema pallidumDirect contact You need some kind of break in the skin to invade through Can die when exposed to the air PRIMARY 2) CHANCRE forms at the site of anoculation 1) Spirochete enters body, accompanied by LYMPHADNAPATHYthis heals by itself, then it enters latent periodSECONDARY STAGE = MUCOUS PATCH 6 weeks later eruptions in the skin and mucous membranesMultiple , painless, grayish white plaques covering ulcerative mucosa Most infectious stageTertiary Lesions Years later Involves cardiovascular systems and CNS GUMMA : noninfectiousHole in palate : not treat ableFirm mass, then turns to ulcer Tongue and palate: most common Destructive lesion: perforation of palatal bone may occur CoNGENITAL SYPHILIS Infected MOTHER TO FETUSCan casue serious facial and dental abnormalitiesDIAGNOSIS : microscopic techniqueTWO BLOOD TEST ARE ASLO NEEDED (VDRL) and Fluorescent treponemal antibody absorption ( FTA-ABS) Generally treated by PENICILLIANDETECTED BY TITER NECROTIZING ULCERATIVE GINGIVITIS ( NUG) Page 166-167 Painful erythemous gingivitis with necrosis of the interdental papillaBASTERIA: fusiform bacillus and spirochete ( borelia vincentii) decreased resistance to infectionFOUL ODOR, metallic taste Cratering of interdental areaPsuedomembrane over tiisues, sloughs offClinical features determine anug from acute marginal gingivitis and gingival componet of acute primary herpes simplexChlorhexadine rinses : treatmentHost response is neededPERICORONITIS Page 78-79 Inflammation of the mucousa around the crown of a partially erupted tooth, or impacted Most common mand. 3rd molarsResult of am infection from bacteria part of normal flora Proliferate in tissue b/t soft tissue and crown Compromised host defenses are associated with this Trauma from opposing molar usuallt the casue and removal of this trauma is the treatment Food impaction also may be a cause DIAGNOSIS : clinical presentaion, swollen, erythemous and painfulTREATMENT: Mechanical debribment, irrigation of pocket and systemic antibiotics, Extraction of impacted molar to prevent reoccurance ACUTE OSTEOMYELITIS Acute inflammation of bone and bone marrowJaws: most commonResult of extension of periapical abscessIt may follow Fracture of bone or surgery and may also result from bacteremiaDiagnosis: culture results, or treatment to antibiotic sensitivity testingMicroscopic you will see: non viable bone, necrotic debris, acute inflammation and bacterial colonies in marrow spacesDisease needs to be present for more then 1 week to see change in radiographsTreatment: drainage of the area, and use of proper antibioticsCHRONIC OSTEOMYELITIS Hard to treat Body walls off area Sickle cell disease, pagets disease, bone irradation, Involved bone is PAINFUL, SWOLLEN Radiographically: diffuse and irregular radiolucency it will eventually become radioopaque Radio Opaque = chronic sclerosing osteomyelitisDiagnosis: biopsy results and histological examTreatment: debribment and administration of systemic antibioticsSome patients may need hyperbaric oxygen to successfully treat this FUNGAL INFECTIONS CANDIDIASIS AKA : Moniliasis and THRUSH Overgrowth of a yeast like fungus : Candida AlbicansMOST COMMON ORAL INFECTION Normal flora : this particularly in those who wear denture Can be casued by: Antibiotic therapy Cancer chemotherapy Corticosteriod therapy DENTURES DIABETES MELLITUS Hiv INFECTION Hypoparathroidism Infancy Multiple myeloma Primary T-Lymphocytes Xerostomia Most common associated with immunodeficiency Easily identified by a white plaque that wipes offMany types Pseudomembranous White curdlike material: mucosa surface Underlying mucosa is erythemous Burning sensation is felt Metallic taste also may be present ERYTHEMATOUS CANDIDIASIS
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