Bacteria & Herpetic Gingivostomatitis
Terms in this set (22)
The 7 classic Gram + bacteria that cause disease in humans
-Spore-formers: Bacillus, Clostridium
-Non spore-formers: Corynebacterium, Listeria
Examples of gram -
ENTERICS - live in the GI tract:
-E. Coli -Bacteriodes (anaerobic)
What bacteria is the exception/not really gram + or -?
Why and what does it cause?
-NO cell wall
-Only a simple cell membrane
-Therefore-neither Gm+ or Gm-
Mycloplasma pneumoniae "walking pneumonia"
-F, dry, non-productive, hacking cough
-Tx of choice: Azithromycin, Doxy, or FQ
What is the difference between extotoxins and endotoxins? Give some examples of each
Exotoxins: proteins released by some Gm+ and some Gm- bacteria!:
o Neurotoxins: act on nerves paralysis i.e.-Tetanus, Botulinum
o Enterotoxins: act on GI tract diarrhea
o i.e.-Vibrio, E. Coli, Campylobacter, Shigella
o Pyrogenic: lead to rash, F, and toxic shock
o i.e.-Staph aureus, Strep pyogenes
Tissue evasive: allow bacteria to destroy tissues
Endotoxins: Lipid A
o Normal part of outer membrane that sheds off, NOT a protein
o Gm- bacteria only
bacteria in the BLOODSTREAM = ?
bacteremia systemic immune response to the infection (F, leukocytosis, tachycardia etc.)
sepsis hypotension and organ dysfunction
-Common, deadly response to both Gm+ and Gm- infections
-High mortality rate despite ICU and Abx tx
Major illness that may occur if step throat is not treated? What are the major manifestations of this?
Acute Rheumatic Fever (ARF):
-Uncommon since advent of PCN
-MC in children ages 5-15 yrs old
-Myocarditis (heart inflammation)
-Subcutaneous nodules under the skin
-Rash (erythema marginatum)
Know it can cause major heart disease!
Inflammation of gingiva and oral mucosa?
Etiology of Herpetic gingivostomatitis?
Herpes viral infection-contagious
Where is the most common location for Herpetic Gingivostomatitis?
Gums, cheeks, palate, tongue, border b/w lip and skin
Can occur anywhere throughout oropharynx
Who is most likely to get Herpetic Gingivostomatitis?
Young children (<3 yrs old)
Typically primary exposure
Adult family member w/cold sore
What are the sx and PE findings of Herpetic Gingivostomatitis?
Fever (1-2 days before onset-lesions)
Perioral pinpoint vesicular lesions
Shallow ulcers (after vesicles rupture)
What is the diagnosis and treatment of Herpetic Gingivostomatitis?
Typically clinical but can perform Tzanck smear to confirm!
Spotanteous resolution in 1-2 weeks but can use topical lidocaine with caution for tx.
What is the etiology of Herpangina? When is it most frequently seen?
Group A Coxsackie viruses
Infants and children, summer season
What are the sx and PE findings of Herpangina?
Sudden onset of F w/ST, HA, anorexia
w/in 2 days small grey spots in oropharynx shallow ulcers
Vesicles/ulcers on posterior oropharynx-tonsillar pillars*, uvula, soft palate, tongue
IMPORTANT TO REMEMBER THAT LESIONS ARE ON THE POSTERIOR OROPHARYNX!
Diagnosis and tx of Herpangina?
Spontaneously resolve w/in 5-7 days, +/-topicals
Etiology of hand foot and mouth? Who and when is it seen?
Group A Coxsackie Viruses
Children in daycare (<10 yrs old), summer and fall
Sx of HFM?
F, ST, malaise, anorexia, irritability, rash on hands, feet, mouth lesions
PE of HFM?
Painful, red, blister-like lesions on anterior tongue, gums, inside of cheek. REMEMBER THAT LESIONS ARE ON THE ANTERIOR TONGUE.
Red (non-itchy) rash on palms and soles
How would you make the diagnosis/tx for HFM?
Spontaneous resolution 7-10 days, +/-topical
When are you no longer contagious with HFM?
After the lesions in the mouth are gone. Lesions can remain on hands and feet without being contagious.