BACTERIAL
DISEASES
Prepared by:
Dr. Rea Corpuz
Bacterial Diseases
(1) Syphillis
(2) Tuberculosis
(3) Leprosy
(4) Actinomycosis
(5) Cancrum Oris (NOMA)
(6) Gonorrhea
(1) Syphillis
sexually transmitted disease
caused by spirochete Treponema
Pallidum
acquired by sexual contact with
a partner with active lesions by:
transfusion of infected blood
transplacental inoculation
of fetus by infected mother
(1) Syphillis
Pathogenesis
when disease is spread
through direct contact
a hard ulcer, or chancre
forms at site of spirochete
later there is development
of painless, non-suppurative
regional lymphadenopathy
(1) Syphillis
Pathogenesis
chancre heals spontaneously
after several weeks without
treatment, leaving patient
with no apparent signs of
disease
(1) Syphillis
Pathogenesis
after a latent period of several
weeks, secondary syphilis
develops
patients infected via
transfusion bypass primary
stage & begin with
secondary syphilis
(1) Syphillis
Pathogenesis
secondary syphilis
fever
flulike symptoms
mucucutaneous lesions
lymphadenopathy
stage resolves spontaneously,
patient enters latency period
(1) Syphillis
Clinical Features
Primary Phase
Secondary Phase
Tertiary Phase
Congenital Phase
(1) Syphillis
Clinical Features
Primary Phase
does not produce exudate
location is usually on genitalia
lesions heals without therapy
in 3-12 weeks, with little or
no scarring
(1) Syphillis
Clinical Features
Primary Phase
Chancre, a chronic ulcer
at site of infection
(1) Syphillis
Clinical Features
Secondary Phase
if left untreated, begins
about 2-10 weeks
spirochetes are now
disseminated widely
inflammatory lessions may
occur in any organ during this phase
(1) Syphillis
Clinical Features
Secondary Phase
Oral mucous patches
condyloma latum
maculopapular rash
(1) Syphillis
Clinical Features
Tertiary Phase
manifestations take many
years to appear & can be
profound
there is predilection for
cardiovascular system
+ CNS
(1) Syphillis
Clinical Features
Tertiary Phase
Gummas (destructive ulcers)
central nervous system
cardiovascular diseases
(1) Syphillis
Clinical Features
Congenital Form
abnormal shape of molars/
incisors
deafness
ocular keratitis
skeletal defects
(1) Syphillis
Treatment
drug of choice for treating
all stages of syphillis
is penicillin
Treponema Pallidum is
sensitive to antibiotics such as:
Penicillin
Erythromycin
Tetracycline
(2) Tuberculosis
infects about 1/3 of worlds
population
kills approximately 3 million
people per year
most important cause of death
in the world
(2) Tuberculosis
caused by aerobic, non-spore
forming bacillus Mycobacterium
Tuberculosis
has thick, waxy coat
does not react with Gram stains
(2) Tuberculosis
Pathogenesis
spread is through small
airborne droplets
carry organism to
pulmonary air spaces
(2) Tuberculosis
Clinical Features
skin testing + chest radiograph
provide only indicators
of infection
(2) Tuberculosis
Clinical Features
in reactivated disease,
low-grade signs + symptoms
of fever
night sweats
malaise
weight loss
(2) Tuberculosis
Clinical Features
with progression,
cough
hemoptysis
chest pain (pleural involvement)
(2) Tuberculosis
Clinical Features
oral manifestations
follow implantation of M.
tuberculosis from infected
sputum may appear on
any mucosal surface
tongue + palate are favored
locations
(2) Tuberculosis
Clinical Features
oral manifestations
typical lesion is indurated
chronic, nonhealing ulcer
that is usually painful
bony involvement of maxilla
+ mandible may produce
tuberculosis osteomyelitis
(2) Tuberculosis
Treatment
First line drugs likely to
used fro treatment of TB
include
isoniazid
rifampin
pyrazinamide
exambuthol
(2) Tuberculosis
Treatment
drug combinations are often
used in 6, 9, or 12 month
treatment regimens
may be extended as long
as 2 years.
(2) Tuberculosis
Treatment
Bacille Calmette Guerin
(BCG) vaccine is effective
in controlling childhood TB,
but loses efficacy in adulthood
(3) Leprosy
also known as Hansens disease
chronic infectious disease
caused by acid-fast bacillus,
Mycobacterium leprae
moderately contagious
(3) Leprosy
transmission of disease
requires frequent direct contact
with an infected individual
for a long period
inoculation through respiratory
tract is also believed to be
a potential mode of transmission
(3) Leprosy
Clinical Features
there is clinical spectrum
of disease that ranges from
a limited form (tuberculoid
leprosy) to a generalized
form (lepromatous leprosy)
latter has a more seriously
damaging course
(3) Leprosy
Clinical Features
skin + peripheral nerves
are affected
organism grows best in
temperatures less than core
body temp of 37C
(3) Leprosy
Clinical Features
cutaneous lesions appear
as erythematous plaques
or nodules
represents granulomatous
response to organism
similar lesions may occur
intraorally or intranasally
(3) Leprosy
Clinical Features
in time, severe maxillofacial
deformaties can appear
producing classic destruction
of anterior maxilla
facies leprosa
(3) Leprosy
Treatment
chemotherapeutic approach
in which, several drugs are
used for protracted period,
typically years
(3) Leprosy
Treatment
commonly used drugs:
dapsone
rifampin
clofazimine
minocycline
teratogen thalidomide
useful to manage complications
of leprosy therapy
(4) Actinomycosis
chronic bacterial disease
exhibits some clinical + microscopic
features that are fungilike
caused by Actinomyces israelii
an anaerobic or microaerophilic
gram-positive bacterium
not regarded as contagious because
infection cannot be transmitted from
one individual to another
(4) Actinomycosis
infections usually appear after
trauma
surgery
previous infection
(4) Actinomycosis
Clinical Features
most infections are seen:
thorax usually preceded
abdomen by trauma or direct
head + neck extension of contagious
infectiom
(4) Actinomycosis
Clinical Features
when it occurs in head + neck
condition is usually designated
cervicofacial actinomycosis
swelling of mandible
skin lesion are indurated
having woody hard consistency
results to osteomyelitis that
may drain through gingiva
(4) Actinomycosis
Radiographic Feature
radiolucency
irregular + ill-defined margins
(4) Actinomycosis
Treatment
Long-term, high-dose
penicillin
For sever cases, intravenous
penicillin followed by oral
penicillin
Tetracycline + Erythromycin
can be used
(4) Actinomycosis
Treatment
drainage of abscess
surgical excison of scar +
sinus tracts
to enhance penetration
of antibiotics
(5) Cancrum Oris
(Noma)
also known as gangrenous
stomatitis
devastating disease of
malnourished children
destructive process of orofacial
tissues
(5) Cancrum Oris
(Noma)
results from oral contamination
by heavy infestation of
Bacteroidaceae
particularly Fusobacterium
necrophorum
(5) Cancrum Oris
(Noma)
consortium of other
microorganisms:
Borrelia vincentii
Staphylococcus aureus
Prevotella intermedia
(5) Cancrum Oris
(Noma)
these opportunistic pathogens
invade oral tissues whose
defense are weakened by:
malnutrition
acute necrotizing gingivitis
debilitating conditions
(5) Cancrum Oris
(Noma)
these opportunistic pathogens
invade oral tissues whose
defense are weakened by:
trauma
other oral mucosal ulcers
(5) Cancrum Oris
(Noma)
Clinical Features
typically affects children
related disorder, noma
neonatorum, oocurs in low-
birth-weight infants
who suffer from debilitating
diseases
(5) Cancrum Oris
(Noma)
Clinical Features
initial lesion is a painful
ulceration
usually gingiva or
buccal mucosa
spreads rapidly + eventually
becomes necrotic
(5) Cancrum Oris
(Noma)
Clinical Features
denudation of involved bone
may follow
leading to necrosis +
sequestration
(5) Cancrum Oris
(Noma)
Clinical Features
teeth in affected area may
become loose + exfoliate
penetration of organisms
into
cheek
lip
palate
(5) Cancrum Oris
(Noma)
Treatment
fluids
electrolytes
general nutrition are
restored
along with antibiotics
clindamycin
piperacillin
aminoglycoside gentamicin
(5) Cancrum Oris
(Noma)
Treatment
fluids
electrolytes
general nutrition are
restored
along with antibiotics
clindamycin
piperacillin
aminoglycoside gentamicin
(5) Cancrum Oris
(Noma)
Treatment
debridement of necrotic
tissue may also be
beneficial if destruction
is extensive
(6) Gonorrhea
one of the most prevalent
bacterial disease in humans
caused by gram-negative
diplococcus Neisseria
gonorrhoeae
infects columnar epithelium of
lower genital tract
rectum
pharynx
eyes
(6) Gonorrhea
transmitted by direct sexual
contact with an infected
partner
short incubation period of less
than 7 days
absence of symptoms in many
individuals, especially females
(6) Gonorrhea
genital infections may be
transmitted to oral or
pharyngeal mucous membranes
through orogenital contact
transmission from an infected
patient to dental personnel
is regarded as highly unlikely
(6) Gonorrhea
organism is very sensitive
to drying
requires break in skin or
mucosa to establish an
infection
gloves provide
protective eyewear adequate protection
mask from accidental
transmission
(6) Gonorrhea
Clinical Features
no specific clinical signs
have been consistently
associated with oral
gonorrhea
multiple ulcerations
generalized erythema
(6) Gonorrhea
Clinical Features
in the more common
pharyngeal gonococcal
infection, presenting signs
are usally
general erythema
associated ulcers
cervical lymphadenopathy
(6) Gonorrhea
Clinical Features
chief complaint may be
sore throat,
although many patients
are asymptomatic
(6) Gonorrhea
Treatment
uncomplicated gonorrhea
responds to single dose
of appropriately selected
antibiotic
References:
Books
Neville, et. al: Oral and Maxillofacial Pathology
3rd Edition
(pages 24-32)
