Bacterial Infections.pdf - GONORRHEA • Neisseria...

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GONORRHEA Neisseria gonorrhoeae bacteria causes this This is the most common reportable bacterial infection in the US 700,000-800,000 patient per year will become infected This has been declining since 1975 The US remains the highest rate of any industrialized country AA 19 x’s higher rate than white Sexually transmitted Most lesions are found in the genital area Can’t penetrate intact epithelium, so need a wound to enter the epithelium Once infected there is a 2-5 day incubation 10% of Males & 80 % of Females are asymptomatic Symptomatic =purulent discharge Oropharyngeal area most common for oral cavity involvement DIAGNOSIS Smear for a gram stain of purulent material F – gram stain of endicervical swab DNA or RNA type test Tx Fluroquinolones Ciprofloxacin Levofloxacin Resistant Intramuscular AB ASSESSMENT 1. The US remains the highest rate of gonorrhea than any industrialized country : T 2. Tx for Gonorrhea is: Fluoroquinones, Abx 3. When gonorrhea is found in the mouth is typically appears in the oropharynx : T TUBERCULOSIS This is caused by the Mycobacterium tuberculosis The infection is transmitted by airborne particles Approximately 1/3 world population is infected This infection accounts for about 2 million deaths annually In the US this infectin declined since 1800’s and flattened in 1980’s Primary Tb Infection of a previously unexposed patient Infection is asymptomatic The patient may have a lung nodule There is a progression from infection to disease in 5-10% of patients o More common secondary to immunosuppression Secondary Tb The bacteria will be reactivated after time Miliary TB can occur with vascular dissemination Patients will exhibit a cough Long term untreated TB can result in consumption – waste syndrome Patents may also show signs of Lupus vulgaris – Cutaneous Tb H&N Manifestation Cervical lymphadenopathy Scrofula from drinking contaminated milk Larynx, ear, nose, mouth may exhibit chronic painless ulcers Jaw radiolucency's may be present due to calcified lymph nodes Calcified lymph nodes Tb - Oral Cancer
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HISTOLOGY Necrotizing granulomatous inflammation “Caseous ” necrosis Tubercle is the granuloma Stains of the tissue biopsy's are not 100% diagnostic, need to culture the bacteria or perform PCR PPD – tuberculin or Mantoux test 5-10% of the population will be positive from exposure without disease Tx Multi agent therapy due to resistance from genetic mutations Patient have to take 2 or more drugs for months to years Course of treatment includes: 8 weeks of isoniazid, rifampin and pyrazinamide followed by 16 weeks of isoniazid & rifampin BCG vaccine are given in other countries ASSESSMENT 1. Tx for Tb is: multi-agent therapy 2. Tb is caused by Treponema: F – Mycobacterium tuberculosis 3. Primary Tb symptoms include: none – infection is asymptomatic 4. Long-term untreated 2ndary Tb can cause:
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