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)