Inflammatory Disease Part I Infections
Bacterial, Fungal and Viral Infections of the Head and Neck
Sexually Transmitted Diseases Lomaki, Middle Mesa Petroglyphs Northern Arizona Herpesviruses I, II Clamydia Treponema Gonococci Papillomavirus HIV Hepatitis B, C
Bacterial Infections Pulpitis, periapical infections, spread of infection Space infections, osteomyelitis Periodontitis Sialadenitis Specific infections Syphilis (Treponema) Tuberculosis (Mycobacterium) Actinomycosis (Actinomycetes) Cat Scratch fever (Rochinella) Rhinoscleroma (Klebsiella)
SYPHILIS PRIMARY Chancre 2-4 weeks SECONDARY Maculopapular rash, Mucous patches Split papules TERTIARY Gummatous necrosis, Neurosyphilis, Aneurysm
SYPHILIS Treponema pallidum Diagnostic Tests VDRL FTA TPI
Primary Syphilis - Chancre
Secondary Syphilis
Tertiary Syphilis
CONGENITAL SYPHILIS Saddle Nose Mental Retardation Blindness Short Stature Saber Shins
Saber Shins
HUTCHINSON S TRIAD DENTAL DEFECTS Notched Screwdriver Centrals Pegged Laterals Mulberry Molars BLINDNESS DEAFNESS
Congenital Syphilis Notched Centrals, Mulberry Molars
TUBERCULOSIS Mycobacterium tuberculosum Primary, Secondary, Miliary Metastatic, Scrofula, Lupus vulgaris Mycobacterium aviium intracellulare HIV nonpulmonary infection
Tuberculosis Scrofula Oral Granuloma
ACTINOMYCOSIS Actinomycetes, elongated rods Sulfur Granules aggregated colonies Cervicofacial form Osteomyelitis of the mandible Soft tissue abscess Periapical abscess
Actinomycosis PAS stain
CAT SCRATCH FEVER Feline Claws Rochinella bergdorfdi Lymphadenitis Necrotizing Granuloma
Cat Scratch Fever Necrotizing granuloma
Fungal Infections Superficial Candidiasis Geotrichosis Invasive Histoplasmosis Coccidioidomycosis Blastomycosis Mucormycosis Asperigillosis Rhinosporidiosis Allergic fungal sinusitis (Bipolaris fungi)
CANDIDIASIS Pseudomembranous Erythematous Angular Cheilitis Median Rhomboid Glossitis
Pseudomembranous Candidiasis
Erythematous Candidiasis
Angular Cheilitis
Median Rhomboid Glossitis Multinodular mass Midline posterior tongue Adult onset Surface colonized by Candida
MYCELIA PAS STAIN Parakeratin layer, biospy Cytologic smear
Antifungals Nystatin Pastilles or Vaginal Tabs Nystatin Cream or ointment Chlotrimazole (Mycelex) Troches Ketaconazole (Nizoral) 100 mg
DEEP INVASIVE FUNGI Granulomatous Inflammation Special Stains (PAS, GMS) Microorganisms Histoplasmosis* Coccidioidomycosis* Blastomycosis* Cryptococcosis Tissue Tropism Pulmonary* and nonpulmonary
DEEP INVASIVE FUNGI Clinical Giant Cells with Fungus
Histoplasmosis
MUCORMYCOSIS Zygomycosis, Phycomycosis Large Mycelia Antral Involvement Vascular Invasion and Ischemic Necrosis Debilitation Brittle IDDM Immunosuppression
Mucormycosis Radiograph Fungal organisms GMS PAS
ALLERGIC FUNGAL SINUSITIS Bipolaris Pleomorphic Fungi Aspergillosis may show similar features Sinusitis, Expansion, Bone Resorption Lesion due to Allergy not organism Eosinophilic Infiltrate Brown Sludge in Antrum
Allergic Fungal Sinusitis Radiograph Bipolaris Fungi
Viral Infections Human Papillomavirus Herpesvirus types I and II Varicella zoster Epstein Barr Enteroviruses Coxsackieviruses Mumps virus HIV and oral opportunists
Benign HPV Oral Papillary Tumors Verruca vulgaris - HPV 2,4 Squamous papilloma - HPV 6,11 solitary Condyloma acuminatum - HPV 6,11 multiple
Verruca vulgaris Clinical Histopath and DNA
Clinical, Gross Squamous Papilloma Histopathology
Condyloma Acuminatum Clinical Histopath & DNA HPV 6
Condyloma
Focal Epithelial Hyperplasia HPV 13 and 32 are viruses with a restricted tropism for oral mucosa Lesions evolve as multiple papules then progress to flattened nodules of the lips and buccal mucosa Children (more often seen in Amerindians) and HIV infected subjects Lesions persist for 6-12 months, then spontaneously regress Microscopic: Focal parakeratosis and nodular acanthosis, mitosoid bodies resembling mitotic figures are found in the mid spinous layer.
Focal Epithelial Hyperplasia HPV 13,32
Heck Disease (FEH) in HIV+ Patients
HERPES SIMPLEX 1,2 LYTIC INFECTION Keratinocytes LATENT INFECTION Ganglia
Primary Herpetic Gingivostomatitis
Herpes Labialis
Recurrent Intraoral Herpes
HSV Vesicle and Antigen
BALLOONING DEGENERATION
HERPETIC WHITLOW
Primary Varicella-Zoster (Chicken Pox)
Secondary VZV (Shingles)
Infectious Mononucleosis Epstein Barr Virus Malaise Lymphadenopathy Palatal Petechia Atypical Lymphocytes in Blood Other EBV associated diseases Oral Hairy Leukoplakia Burkitt s Lymphoma Nasopharyngeal Carcinoma
ENTEROVIRUSES ENTEROVIRUSES ECHOVIRUSES COXSACKIEVIRUSES POLIOVIRUSES
Hand, Foot & Mouth Disease
Herpangina
Lymphonodular Pharyngitis
Koplik Spots -Rubeola-
ENDEMIC PAROTITIS (MUMPS) Mumps virus Bilateral Painful Parotid Enlargement Pain on Salivation Fever Ten Day Course Orchitis Complication
MUMPS
HIV CD4 Lymphocyte Target CD4 and CCR5 Chemokine Receptor Latency of 2-10+ years AIDS = <200 CD4 Lymphocytes/mm3
HIV ASSOCIATED DISEASES Opportunistic Infections Pneumocystis pneumonia HSV, VZV, CMV Toxoplasmosis, Cryptosporidium Mycobacterium Aviium Intracellulare Candida, Histoplasmosis Neoplasms Kaposi s Sarcoma Malignant Lymphoma
HIV ORAL LESIONS CANDIDIASIS HAIRY LEUKOPLAKIA PAPILLOMAVIRUS LESIONS HIV GINGIVITIS HIV PERIODONTITIS HISTOPLASMOSIS, OTHER DEEP FUNGI KAPOSI S SARCOMA NON-HODGKIN S LYMPHOMA
Oral Opportunistic Infections Candidiasis Pneumocystis Herpes
Oral Hairy Leukoplakia EBV DNA
EBV virions Keratinocyte nucleus ultrastructure
HIV - Kaposi s Sarcoma Herpesvirus type 8
Epstein Barr Virus HIV - Lymphoma
HIV Periodontal Lesions HIV Gingivitis HIV Periodontitis