Oral Cavity Infections and Their Management

Study Notes

Infections of the Oral Cavity and Salivary Glands

Common infections include oral thrush (candidiasis), herpes gingivo-stomatitis, herpangina, hand-foot-and-mouth disease, Vincent’s angina, and dentoalveolar infections.

Oral Candidiasis (Oral Thrush)

Caused by opportunistic infection from Candida species; prevalent in individuals with compromised immunity (e.g., diabetes, HIV, steroid therapy, newborns, denture wearers).
Clinical features: White adherent patches on buccal mucosa or hard palate, red, sore surrounding mucosa, potential for confluent curd-like pseudomembrane.
Diagnosis: Scrapings/swabs from lesions, Gram stain, and culture on Sabouraud's agar.
Treatment involves topical antifungal agents like nystatin, miconazole lozenges, and clotrimazole.

Herpes Gingivo-Stomatitis

Caused by Herpes simplex virus (commonly HSV-1, rarely HSV-2); primarily affects children aged 6 months to 6 years.
Clinical features: Abrupt onset with high fever, headache, malaise, irritability, bilateral lymphadenopathy, and oral lesions that appear as coalescing vesicles leading to painful ulcers.
New lesions may develop for 3-5 days; ulcers typically heal within 10-14 days.
Pathogenesis involves targeting epithelial cells, resulting in vesicle formation, ulceration, and potential latency of the virus.

Herpangina

Acute febrile illness characterized by small vesicular lesions in the posterior oropharyngeal area, caused by Coxsackievirus A.
Common symptoms: Abrupt fever, sore throat, anorexia, dysphagia, vomiting; vesicles on the fauces, uvula, tonsils, and tongue.
Mainly occurs in small children; transmitted via fecal-oral, respiratory droplets, and direct contact.
Diagnosis includes clinical history, stool specimens, and swabs; treatment focuses on symptomatic relief.

Hand-Foot-and-Mouth Disease

Caused by Enterovirus 71 and Coxsackievirus A16; highly contagious among infants and young children, particularly in nursery settings.
Initial symptoms resemble common illnesses: fever, headache, malaise; leads to painful red blisters in the oral cavity (throat, tongue, gums) and on palms, hands, and soles.
Clinical progression includes development of oral ulcers, potential CNS involvement, and abdominal discomfort.
Prevention emphasizes good hygiene practices like hand washing.

Description

This quiz covers common infections of the oral cavity and salivary glands, including oral thrush and herpes gingivo-stomatitis. It explores their causes, clinical features, diagnosis, and treatment options. Ideal for medical students and healthcare professionals.