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Applied Oral Pathology through Interactive Learning Infectious Diseases Rachel S. Ennis MDH707 Spring 2011 Infectious Diseases Chapter 4 Objectives Inflammatory and immune response Causes of opportunistic infection Organisms involved in specific infectious diseases Oral candidiasis; five forms Herpes labialis; clinical features Recurrent intraoral herpes simplex infection; clinical features Minor aphthous ulcers; clinical features Objectives continued: Herpes Zoster; clinical characteristics Epstein-Barr Virus; four associated diseases Coxsackie virus and oral manifestations Oral manifestations of HIV infection; clinical appearance Any ideas? ? ? ? ? Acute Necrotizing Ulcerative Gingivitis Edematous and erythematous gingiva Cratered or “punched out” interdental papillae Painful Foul odor Metallic Taste Associated with decreased resistance Caused by Fusiform bacilli, and spirochetes Inflammatory and Immune Response Inflammatory response: body’s first line of defense against tissue injury and disease-producing microorganisms Immune response: defends body against injury, remembers past instances of injury Opportunistic Infection Alteration in the oral micro flora Organisms that are normally nonpathogenic are able to cause disease Opportunistic infections of the oral cavity Dental caries Periodontal disease Infectious Diseases and the organisms involved Impetigo: Staph Aureus, Staph pyogenes. Tonsillitis and Pharyngitis: Streptococci, Adenoviruses, Influenza, and Epstein-Barr virus Tuberculosis: Mycobacterium tuberculosis Actinomycosis: Actinomyces israelii Syphilis: Treponima pallidum Veruca vulgaris: Human papilloma virus Condyloma acuminatum: Human papilloma virus Primary herpetic gingivostomatitis: Herpes simplex virus Acute Necrotizing Ulcerative Gingivitis: Borrelia vincentii fusiform bacillus, and spirochete Impetigo Adult male with impetigo on chin Child with impetigo on chin Syphilis chancre Dorsal surface of tongue Actinomycosis Left mandible Condyloma acuminatum Lower lip Oral Candidiasis (thrush) Pseudomembranous Erythematous Denture stomatitis (chronic atrophic candidiasis) Chronic hyperplastic candidiasis Angular cheilitis Angular cheilitis Commissure of lips Pseudomembranous candidiasis Hard palate Herpes Labialis Caused by herpes simplex virus Also called “cold sore or fever blister” Vermillion of lips Herpes Labialis Vesicles on lips and vermillion boarder Herpes Labialis Lower lip Recurrent intraoral herpes simplex infection Herpes simplex virus Keratinized mucosa (hard palate, and gingiva May be caused by sunlight, menstruation,fatigue,fever,stress Painful, focal crops of vesicles Prodromal symptoms: pain,burning,tingling Primary Herpes Simplex Infection Dorsal surface of tongue Minor aphthous ulcers Nonkeratinized mucosa One to several ulcers present No vesicle preceding ulcer Pain <1cm Round to oval Can recur Minor aphthous ulcer Floor of mouth Major Aphthous Ulcer Soft palate Herpes Zoster Shingles Unilateral, painful eruption of vesicles along sensory nerve May affect three branches of trigeminal nerve Prodromal symptoms: pain, burning,paresthesia May last several weeks Herpes Zoster Shingles Varicella Zoster Lips and palate Epstein-Barr Virus Infectious Mononucleosis Palatal petichiae kissing disease Nasopharyngeal carcinoma Burkitt lympoma Hairy Leukoplakia usually on lateral border of tongue Hairy Leukoplakia Lateral boarder of tongue Coxsackievirus Discovered in Coxsackie, NY Transmission by fecal-oral contamination, saliva, respiratory droplets May cause: Herpangina Hand-Foot-and Mouth Disease Acute Lymphonodular Pharyngitis Coxsackie virus Sores on dorsal surface of tongue and palate HIV and Oral Lesions Candidiasis Herpes simplex infection Herpes Zoster Hairy Leukoplakia Human papilloma virus lesions Atypical gingivitis and periodontitis Kaposi sarcoma Non-Hodgkin lymphoma Aphthous ulcers Mucosal pigmentation Bacterial salivary gland enlargement and xerostomia Spontaneous gingival bleeding resulting from thrombocytopenia HIV associated thrush Soft palate Papilloma Papilloma on soft palate Papilloma Lateral boarder of tongue Papilloma Buccal Mucosa Kaposi sarcoma HIV infection ! References Ibsen, O., Phelan, J.A. (2009). Oral pathology for the dental hygienist, 5thed. St. Louis, MO: Saunders Elsevier. Langlais, R. P. , Miller, C.S. , Nield-Gehrig, J. S. (2009) Color atlas of common oral diseases, 4thed. Philadelphia, PA: Lippincott Williams and Wilkins.
