The document discusses 6 bacterial diseases: syphilis, tuberculosis, leprosy, actinomycosis, cancrum oris (noma), and gonorrhea. It provides details on the causative bacteria, pathogenesis, clinical features, and treatment for each disease. Syphilis is caused by Treponema pallidum and has primary, secondary, tertiary, and congenital stages. Tuberculosis is caused by Mycobacterium tuberculosis and can cause oral lesions. Leprosy is caused by Mycobacterium leprae and has a spectrum of manifestations. Actinomycosis is caused by Actinomyces israelii and usually follows trauma. Cancrum oris

1. BACTERIAL
DISEASES
Prepared by:
Dr. Rea Corpuz

2. Bacterial Diseases
 (1) Syphillis
 (2) Tuberculosis
 (3) Leprosy
 (4) Actinomycosis
 (5) Cancrum Oris (NOMA)
 (6) Gonorrhea

3. (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

4. (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

5. (1) Syphillis
 Pathogenesis
 chancre heals spontaneously
after several weeks without
treatment, leaving patient
with no apparent signs of
disease

6. (1) Syphillis
 Pathogenesis
 after a latent period of several
weeks, secondary syphilis
develops
• patients infected via
transfusion bypass primary
stage & begin with
secondary syphilis

7. (1) Syphillis
 Pathogenesis
 secondary syphilis
• fever
• flulike symptoms
• mucucutaneous lesions
• lymphadenopathy
• stage resolves spontaneously,
• patient enters latency period

8. (1) Syphillis
 Clinical Features
 Primary Phase
 Secondary Phase
 Tertiary Phase
 Congenital Phase

9. (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

10. (1) Syphillis
 Clinical Features
 Primary Phase
• Chancre, a chronic ulcer
at site of infection

11. (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

12. (1) Syphillis
 Clinical Features
 Secondary Phase
• Oral mucous patches
• condyloma latum
• maculopapular rash

13. (1) Syphillis
 Clinical Features
 Tertiary Phase
• manifestations take many
years to appear & can be
profound
• there is predilection for
cardiovascular system
+ CNS

14. (1) Syphillis
 Clinical Features
 Tertiary Phase
• Gummas (destructive ulcers)
• central nervous system
• cardiovascular diseases

15. (1) Syphillis
 Clinical Features
 Congenital Form
• abnormal shape of molars/
incisors
• deafness
• ocular keratitis
• skeletal defects

16. (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

17. (2) Tuberculosis
 infects about 1/3 of world’s
population
 kills approximately 3 million
people per year
 most important cause of death
in the world

18. (2) Tuberculosis
 caused by aerobic, non-spore
forming bacillus Mycobacterium
Tuberculosis
 has thick, waxy coat
 does not react with Gram stains

19. (2) Tuberculosis
 Pathogenesis
 spread is through small
airborne droplets
• carry organism to
pulmonary air spaces

20. (2) Tuberculosis
 Clinical Features
 skin testing + chest radiograph
• provide only indicators
of infection

21. (2) Tuberculosis
 Clinical Features
 in reactivated disease,
• low-grade signs + symptoms
of fever
• night sweats
• malaise
• weight loss

22. (2) Tuberculosis
 Clinical Features
 with progression,
• cough
• hemoptysis
• chest pain (pleural involvement)

23. (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

24. (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

25. (2) Tuberculosis
 Treatment
 First line drugs likely to
used fro treatment of TB
include
• isoniazid
• rifampin
• pyrazinamide
• exambuthol

26. (2) Tuberculosis
 Treatment
 drug combinations are often
used in 6, 9, or 12 month
treatment regimens
 may be extended as long
as 2 years.

27. (2) Tuberculosis
 Treatment
 Bacille Calmette Guerin
(BCG) vaccine is effective
in controlling childhood TB,
 but loses efficacy in adulthood

28. (3) Leprosy
 also known as Hansen’s disease
 chronic infectious disease
 caused by acid-fast bacillus,
Mycobacterium leprae
 moderately contagious

29. (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

30. (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

31. (3) Leprosy
 Clinical Features
 skin + peripheral nerves
are affected
 organism grows best in
temperatures less than core
body temp of 37C

32. (3) Leprosy
 Clinical Features
 cutaneous lesions appear
as erythematous plaques
or nodules
• represents granulomatous
response to organism
 similar lesions may occur
intraorally or intranasally

33. (3) Leprosy
 Clinical Features
 in time, severe maxillofacial
deformaties can appear
• producing classic destruction
of anterior maxilla
• facies leprosa

34. (3) Leprosy
 Treatment
 chemotherapeutic approach
in which, several drugs are
used for protracted period,
typically years

35. (3) Leprosy
 Treatment
 commonly used drugs:
• dapsone
• rifampin
• clofazimine
• minocycline
• teratogen thalidomide
 useful to manage complications
of leprosy therapy

36. (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

37. (4) Actinomycosis
 infections usually appear after
 trauma
 surgery
 previous infection

38. (4) Actinomycosis
 Clinical Features
 most infections are seen:
• thorax usually preceded
• abdomen by trauma or direct
• head + neck extension of contagious
infectiom

39. (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

40. (4) Actinomycosis
 Radiographic Feature
 radiolucency
 irregular + ill-defined margins

41. (4) Actinomycosis
 Treatment
 Long-term, high-dose
penicillin
 For sever cases, intravenous
penicillin followed by oral
penicillin
 Tetracycline + Erythromycin
can be used

42. (4) Actinomycosis
 Treatment
 drainage of abscess
 surgical excison of scar +
sinus tracts
• to enhance penetration
of antibiotics

43. (5) Cancrum Oris
(Noma)
 also known as gangrenous
stomatitis
 devastating disease of
malnourished children
 destructive process of orofacial
tissues

44. (5) Cancrum Oris
(Noma)
 results from oral contamination
by heavy infestation of
Bacteroidaceae
 particularly Fusobacterium
necrophorum

45. (5) Cancrum Oris
(Noma)
 consortium of other
microorganisms:
 Borrelia vincentii
 Staphylococcus aureus
 Prevotella intermedia

46. (5) Cancrum Oris
(Noma)
 these opportunistic pathogens
invade oral tissues whose
defense are weakened by:
 malnutrition
 acute necrotizing gingivitis
 debilitating conditions

47. (5) Cancrum Oris
(Noma)
 these opportunistic pathogens
invade oral tissues whose
defense are weakened by:
 trauma
 other oral mucosal ulcers

48. (5) Cancrum Oris
(Noma)
 Clinical Features
 typically affects children
 related disorder, noma
neonatorum, oocurs in low-
birth-weight infants
 who suffer from debilitating
diseases

49. (5) Cancrum Oris
(Noma)
 Clinical Features
 initial lesion is a painful
ulceration
 usually gingiva or
buccal mucosa
 spreads rapidly + eventually
becomes necrotic

50. (5) Cancrum Oris
(Noma)
 Clinical Features
 denudation of involved bone
may follow
 leading to necrosis +
sequestration

51. (5) Cancrum Oris
(Noma)
 Clinical Features
 teeth in affected area may
become loose + exfoliate
 penetration of organisms
into
• cheek
• lip
• palate

52. (5) Cancrum Oris
(Noma)
 Treatment
 fluids
 electrolytes
 general nutrition are
restored
 along with antibiotics
• clindamycin
• piperacillin
• aminoglycoside gentamicin

53. (5) Cancrum Oris
(Noma)
 Treatment
 fluids
 electrolytes
 general nutrition are
restored
 along with antibiotics
• clindamycin
• piperacillin
• aminoglycoside gentamicin

54. (5) Cancrum Oris
(Noma)
 Treatment
 debridement of necrotic
tissue may also be
beneficial if destruction
is extensive

55. (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

56. (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

57. (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

58. (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

59. (6) Gonorrhea
 Clinical Features
 no specific clinical signs
have been consistently
associated with oral
gonorrhea
 multiple ulcerations
 generalized erythema

60. (6) Gonorrhea
 Clinical Features
 in the more common
pharyngeal gonococcal
infection, presenting signs
are usally
• general erythema
• associated ulcers
• cervical lymphadenopathy

61. (6) Gonorrhea
 Clinical Features
 chief complaint may be
sore throat,
 although many patients
are asymptomatic

62. (6) Gonorrhea
 Treatment
 uncomplicated gonorrhea
responds to single dose
of appropriately selected
antibiotic

63. References:
 Books
Neville, et. al: Oral and Maxillofacial Pathology
3rd Edition
• (pages 24-32)