Bacteria & Herpetic Gingivostomatitis

Terms in this set (22)

The 7 classic Gram + bacteria that cause disease in humans

-Streptococcus (strips)
-Enterococcus (strips)
-Staphylococcus (clusters)
-Spore-formers: Bacillus, Clostridium
-Non spore-formers: Corynebacterium, Listeria

Examples of gram -

ENTERICS - live in the GI tract:

-E. Coli -Bacteriodes (anaerobic)
-Shigella -Serratia
-Salmonella -Vibrio
-Yersinia -Campylobacter
-Klebsiella -Helicobacter
-Proteus -Pseudomonas
-Enterobacter

Others:
-Haemophilus
-Bordatella
-Legionella
-Yersinia
-Francisella
-Brucella
-Pasteurella
-Gardnerella

What bacteria is the exception/not really gram + or -?

Why and what does it cause?

Mycoplasma:
-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

-Fever
-Myocarditis (heart inflammation)
-Arthritis
-Chorea
-Subcutaneous nodules under the skin
-Rash (erythema marginatum)

Know it can cause major heart disease!

Inflammation of gingiva and oral mucosa?

Herpetic Gingivostomatitis

Etiology of Herpetic gingivostomatitis?

Herpes viral infection-contagious
HSV-1

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)
Pain
Irritability
Anorexia
Dysphagia

Fever
Perioral pinpoint vesicular lesions
Shallow ulcers (after vesicles rupture)
Drooling
Lymphadenopathy

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?

Clinical!

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

F, ST, malaise, anorexia, irritability, rash on hands, feet, mouth lesions

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?

Clinical

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.

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