Bacterial Diseases of Oral Cavity & Sinusitis - 2.4 PDF

**[Bacterial diseases of the oral cavity including sinusitis - 2.4]** Odontogenic infection is the leading cause of acute orofacial swelling Abscess = swollen area of body tissue containing an accumulation of pus Cellulitis = inflammation of subcutaneous connective tissue Non specific bacterial...

**[Bacterial diseases of the oral cavity including sinusitis - 2.4]** Odontogenic infection is the leading cause of acute orofacial swelling Abscess = swollen area of body tissue containing an accumulation of pus Cellulitis = inflammation of subcutaneous connective tissue Non specific bacterial aetiology: - - - - Specific bacterial aetiology - - Risk factors for infection - - - - - - - - - - - - Symptoms of infection - - - - - Symptoms of severe infections - - - - - - - - - - Sepsis - - - - - - **NEWS 2** (national early warning score) Cumulative score of 5+ or a score of 3 in any single parameter = VERY poorly person  Dental abscess formation 1. 2. 3. 4. 5. Periodontal abscess - commonly on gingival margin and drains through pocket Periapical abscess - commonly drains through bone or apically through a buccal sinus Upper lateral teeth tend to drain palatally **First line management** - - - If pt is systemically well the dentist will treat infection Suppurative odontogenic infections may spread to potential fascial spaces - - - - Potential areas infection can spread: - - - **Fascial planes of neck + tongue** carotid sheath = ECA, ICA, IJV, CNX No horizontal barriers so pus can track into mediastinum (chest cavity around heart and lungs) Sublingual space - above mylohyoid Sub mental + sub mandibular spaces - below mylohyoid  Ludwig\'s angina = bilateral neck swellings, hot potato speech, drooling saliva **Bacteria of deep neck infections** Aerobic - - Anaerobic - - - Anaerobic bacteria more common in adults with dental infections and non diabetics Most spreading dental infections are mixed aerobic and anaerobic Enterococcus faecalis - in endodontic abscesses Staphylococcus aureus - normal skin and nasal flora Enterobacter cloacae - normal gut flora, infection in the immunocompromised Klebsiella pneumoniae + K. quasi pneumoniae - nosocomical infections, liver abscess, GI infections, antibiotic resistant **Other bacterial infections** Nosocomial - - - - Eg: - - - - - - - **Osteomyelitis** - - - - - - - - **Necrotic tumours** - - - - **Quinsy (tonsillar abscess)** Risk of airway obstruction Bacterial peritonsillar abscess - **Bacterial sinusitis** Can mimic toothache in upper posteriors **Odontogenic sinusitis** Up to 70% chronic unilateral maxillary sinusitis Bacterial maxillary sinus infection secondary to dental infection Symptoms - - Sinusitis complications - - - - - - - - - **Obstructive sialadenitis** Bacterial infection of salivary gland often due to stone **Acute ulcerative gingivitis + acute necrotising gingivitis** Looks like a crater like punched out ulceration of interdental papilla Ulcers covered in grey/green pseudomembrane Severe halitosis Hypersalivation Cervical lymphadenopathy Bacteria - - - - - Treatment - May result in noma Noma = Cancrum oris (gangrene of facial tissues) **Actinomycosis** Actinomycosis israeli Actinomycosis viscosus Actinomycosis naelundi Always a mixed infection May develop actinomycotic osteomyelitis Treatment - **Syphilis** Treponema palidum Symptoms - - - - Treatment - **Gonorrhoea** Neisseria gonorrhoea Symptoms - Treatment - - **Leprosy** Mycobacterium leprae 2 forms (dependant on immune response) 1. 2. - - - **TB** Mycobacterium tuberculosis 9% are asymptomatic (latent TB) Symptoms - - **Reiter syndrome** Unknown aetiology - - Symptoms - - - **Streptococcal pharyngitis + Scarlet fever** Primary = streptococcal pharyngitis Secondary = scarlet fever Treatment - **Lyme disease** Borrelia burgdorferi Symptoms - **Complications of bacterial infections** - - - - - - -