Infectious Diseases of the Oral Cavity and Gastrointestinal Tract

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What is the oral cavity?

the mouth

What lives in the oral cavity?

many microenvironments, 300+ species of bacteria(some aerobic and anaerobic), beneficial bacteria, and opportunisitc bacteria

What are viral infections of the oral cavity?

cold sores, fever blisters, superficial vesicles on an erythematous base

What is an example of a viral infection of the oral cavity?

Herpes simplex virus type 1 or type 2

Where are the viral infections of the oral cavity usually located?

face or lips

Why do the viral infections of the oral cavity reactivate?

stress, physiological change, fever, trauma

What patients usually have severe viral infections of the oral cavity?

immunosupressed patients

How do bacterial oral cavity infections occur?

biofilm formation, tarter(calculus), dental plaque, anaerobic bacteria

What is dental plaque?

masses of microorganisms attach to the tooth

What are dental caries?

tooth decay or cavities

How do dental caries occur?

start when enamel(external surface) is dissolved by organic acids produce by dental plaque. then enzymatic destruction of matrix, cavitation, and bacterial invasion

What is the cause of dental caries?

streptococcus mutans which ferment glucose and produce lactic acid

What is gingivitis?

inflammation of gingiva(gums)

What is periodontitis?

inflammation of tissues that support the teeth including the gingiva and supporting bones

What is periodontal diseases the result of?

dextran formation from sugars by streptococci, acid production by lactobacilli, depostition of calculus by actinomyces spp, secretion of endtoxins by bacteriodum spp

How do you prevent periodontal diseases?

good health and oral hygiene

What is colitis?

inflammation of the colon(large intestine)

What is diarrhea?

abnormally frequent discharge of semi-solid or fluid fecal matter

What is dysentery?

frequent watery stools accompanied by abdominal pain, fever, and dehydration. stool specimans may have mucous or blood

What is enteritis?

inflammation of intestines(usually small intestines)

What is gastritis?

inflammation of stomach

What is gastroenteritis?

inflammation of stomach and intestines

What is hepatitis?

inflammation of liver

What is viral gastroenteritis?

alot of viruses

What ages can get viral gastroenteritis?

all ages

What are the symptoms of viral gastroenteritis?

nasuea, diarrhea, vomitting, abdominal pain, myalgia, headache malaise, low-grade fever

Is viral gastroenteritis self-limiting?

most are,(24-48 hours), infatalities in infants, young chidren, rotavirus is main cause of most children, rapid antigen detection

What are the reserviors of gastroenteritis?

infected humans, contaminated water, food

How is viral gastroenteritis transmitted?

fecal-oral route, foodborne, waterborne, shelllfish

How is gastroenteritis transmitted in the hospital setting?

contact with contaminated fomites, airborne transmission

Type A viral hepatitis?

fecal, oral contamination(food)

Type B viral hepatitis?

kills healthcare wokers(needlestick), contact with infected humans

Type C viral hepatitis?

usually through blood transfusion, progresses but are symptomless until about 20 years later

Are there vaccines for HAV and HBV?

yes

Who is required to take the HBV vaccine?

healthcare workers exposed to blood

What is HBV immune globin?

It can be given to people who are unvaccinated who have been exposed to HBV

What causes bacterial gastritis and duodenal ulcers?

helicobacter pylori

What is helicobacter pylori?

curved, microaerophillic, capnophillic, gram-neg rod

Where does helicobacter pylori grow?

on stomcachs mucous-secreting cells

What does helicobacter pylori tolerate?

low acidity

What else is associated with helicobacter pylori?

gastric ulcers and adenocarcinoma

What are the reserviors for bacterial gastritis and ulcers?

infected humans

How is bacterial gastritis and ulcers transmitted?

oral-oral, fecal-oral

What is the diagnosis for bacterial gastritis and ulcer?

NH4 excretion test, urea breath test, culture of duodenal biopsy

What is NH4 excretion test?

patients consume urea containing NH4 and excrete it by urine

What is urea breath test?

patients ingest urea containing CO2 and 60 mins later breath in a tube

What causes campylobacter enteritis?

campylobacter jejuni, other C. spp

What is campylobacter jejuni?

spiral-, gull-winged-shaped, gram-negative rod, microaerophillic, capnophillic,

What degrees does campylobacter jejuni have optimum growth?

42 degrees celcius

What is campylobacter enteritis?

acute disease, asymptomatic to severe

What is campylobacter enteritis the major cause of in the U.S.?

diarrhea

What are the symptoms of campylobacter enteritis?

diarrhea, vommiting, nausea, fever, malaise, abdominal pain

Is campylobacter enteritis self-limiting?

yes, its usually self-limiting lasting 2-5 days

What are in the stools if you have campylobacter enteritis?

gross or occult blood, mucous, WBCs

What are the reserviors for campylobacter enteritis?

animals, raw poultry

How is campylobacter enteritis transmitted?

contaminated food, water, animals, cutting boards

What is the diagnosis for campylobacter enteritis?

culture on a selective agar; micraerophillic atmosphere increased CO2 at 42 degrees celcius

What is the cause of salmonellosis?

salmonella spp. which is gram-neg bacilli, invade intestinal cells, produce toxins

What are the symptoms of salmonellosis?

sudden onset headache, abdominal pain, nausea, sometimes vomitting

What are the reservoirs of salmonellosis?

domestic, wild animals

How is salmonellosis transmitted?

contaminated food and water, fecal-oral route

What is the diagnosis of salmonellosis?

selective/differential agar

What causes typhoid fever(enteric fever)?

salmonella typi, salmonella paratypi

What is typhoid fever?

systemic disease; if untreated 10% mortality

What are symptoms of typhoid fever?

fever, sever headache, malaise, anorexia, rash on trunk, nonproductive cough, constipation

What are complications of typhoid fever?

meningitis, endocarditis, gall bladder, liver, bone infection, pneumonia, bacteremia

What are the reserviors for typhoid fever?

infected humans, carriers

How is typhoid fever transmitted?

fecal-oral route, contaminated food, water, shellfish, flies

What is the diagnosis for typhoid fever?

culture from clinical specimen

What causes cholora?

vibrio cholorae serogroup 01 which are curved, gram-neg bacillus, halophillic, and in marine envir.

What is cholora?

an acute disease

What are symptoms of cholora?

profuse watery stools, occasional vomitting, rapid dehydration

If cholora is untreated, what happens?

circulatory collapse, renal failure, death may occur, 50% mortality

What are the reservoirs for cholora?

infected humans, aquatic zooplankton

How is cholora transmitted?

fecal-fecal, contact with feces, vomitus of infected, contaminated water and food

What is the diagnosis for cholora?

culture on selective media

What is another name for exterotoxigenic e. coli?

travelers diarrhea

What are symptoms of enterotoxigenic e. coli?

profuse, water diarrhea, mucous or blood, vomitting, abdominal cramping, dehydration, low-grade fever

How is exterotoxigenix e. coli transmitted?

fecal-oral, contaminated foos and water

What is the reservior for exterotoxigenix e. coli?

infected humans

What is the diagnosis for exterotoxigenic e. coli?

culture, usually not performed

What causes enterohemorrhagic e. coli(EHEC)?

e. coli O157:H7 most common serotype

What does enterohemorrhagic e. coli produce?

shiga-like toxins(shiga toxins)

What are the symptoms for enterohemorrhagic e. coli?

hemorrhagic, watery diarrhea, abdominal cramping, mild or no fever

What can enterohemorrhagic e. coli progress to?

hemolytic-uremic syndrome

What is hemolytic-uremic syndrome?

anemia, low platelet count, kidney failure *5%progress to this

What is the reservoirs for enterohemorrhagic e. coli?

cattle, infected humans

How is enterhemorrhagic e. coli transmitted?

fecal-oral, contaminated undercooked beef, food and drinks

What is the diagnosis for enterhemorrhagic e. coli?

culture of e. coli O157:H7 using selective/differential media, or enzyme immunoassay for shiga toxin

Do you use treatment for enterohemorrhagic e. coli/

NO!!! trying to give antimicrobial created more HUS

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