BACTERIAL DISEASES

Impetigo Contagiosa

due to Staphylococcus pyogenes affects epidermis

Clinical manifestations

vesiculo-bulbous lesions that rupture and then covered with a crust affects mostly children highly contagious

occurs around the oral cavity, in perioral region

labial commissure vemillion border of the lips

fever

Treatment

Remove crusts twice daily and wash well with soap Apply sulfur locally to enhance the effectiveness of antibiotics Systemic antibiotics

ACUTE DEEP FOLLICULITIS

(Furuncle)

FURUNCLE

affects deep areas: entire hair follicle and surrounding tissues causes necrosis and leukocytic liquefaction

Predisposing factors

oily skin, dark complexion, history of acne and dandruff poor hygiene diet rich in sugars and fats diabetes local skin trauma from friction of clothing macertion in obese individuals

Clinical manifestations

Produces a bulge, swelling or abscess externally pain fever center of lesion has sequestration or necrotic tissue

Not a pimple!
nausea fever swelling becomes enlarged and prominent sometimes eye swells, cant close drowsiness paralysis

ERYSEPELAS

Clinical manifestations

portal of entry is usually a break in the skin: abrasion, wound, crack in the angle of the nostrils or mouth

Symptoms

fever severe pain and swelling marked redness in area, producing fingerlike projection similar to Lupus erythematosus butterfly projection of face lymphadenopathy

PERTUSSIS

(Whooping cough)

Etiology

Bordatella pertussis strictly a childhood disease

Clinical manifestations

continuous cough, with the tendency to extend tongue forward (laceration of lingual frenum) pale and puffy face ecchymosis of conjunctiva petecchiae in neck area

TUBERCULOSIS

Description

ETIOLOGY
Mycobacterium tuberculosis

Highly contagious disease that could spread through droplet infection

Diagnosis

radiographs of lungs tuberculin test sputum test

Types

Gohns nodules lupus vulgaris ulcerative miliary tuberculosis scrofula

Gohns nodules

Occurs in bronchopulmona ry tree post cervical lymph node enlargement discharge of necrotic material

weight loss late afternoon fever chills anorexia bloody sputum (hemoptysis) night sweat

Lupus vulgaris

affects 1st - 2nd decade of life affects skin and mucosa small reddish brown macule ears and nose may be sometimes affected (cartilage)
Primary complex: 1 yr old, with skin nodules

Ulcerative miliary tuberculosis

fissured tongue increased possibility of bacterial retention ulcers are covered with yellow exudate with numerous bacteria may also affect hard palate and commissure of lips

Scrofula

most common form of cutaneous TB affects dermis, subcutaneous tissue and lymph nodes predilection for submandibular and cervical lymph nodes

begins as painless bluish nodules that increase in size and are cold abscesses sometimes nodules calcify

Gonorrhea

Etiology: Neisseria Gonorrhea, G(-) diplococci

Clinical features

sexual transmission more severe in males, than in females, occuring in

anterior urethra epididymis prostate seminal vesicles

in females, can start through the cervix to the fallopian tube

can produce Gonococcemia: massive entrance of microorganisms within the body and can spread through the lymphatics or through a hematogenous route

Oral manifestations

affects pharynx: Gonococcal stomatitis

diffuse erythema non-adherent pseudomembrane that produces a bleeding surface when scraped

Clinical features

fever fetid odor dryness increased salivation lymphadenopathy

SYPHILLIS

Etiology: Treponema pallidium

Stages

1o syphillis CHANCRE 2o syphillis MUCOUS PATCH 3o syphillis GUMMA

Chancre

seen 2 - 3 weeks after exposure lesion begins as a small papule with surface erosion and ulceration usually covered with hemorrhagic pus, containing T. pallidum

Mucous patch

occurs 6 - 8 weeks after exposure painless, raised lesion with central erosion and covered with grayish plaque may remain for several months or years highly infectious

Gumma

affects skin, mucous membrane, bone and nerves represents end result of hypersensitivity of body: granulomatous lesions with central zone of necrosis

Tertiary syphillis with gumma of the leg

Oral manifestations

glossitis tongue appears lobulated or fissured atropy of papilla: bald tongue gummatous lesion in the palate

Types

Acquired Congenital
Peg-shaped incisors Hutchinsons incisors mulberry molars perioral fissures or syphillitic rhagades seen at the corner of mouth

Laboratory findings

dark field illumination rapid plasma reagin: Ab like substance produced when T. pallidum is present serologic test for syphillis

Tabes dorsalis

patient dances even without music widespread syphillis, including spinal cord even motor and muscular tissues are affected

Treatment

parenteral use of penicillin