[10.36a] Microbiology of Head and Neck Infections (Part 1) V2.3.pdf

Mouth, oral cavity, eye, and ear

What four areas are affected by head and neck infections according to the introduction?

Etiology

What is the primary focus of the head and neck infection lecture?

What the virus or bacteria looks like

What is the definition of morphology in the context of the introduction?

How the pathogens react with antibodies

What does the term antigenic properties refer to?

What makes the pathogen pathogenic

What is defined as the virulent determinant?

Acute rhinosinusitis and chronic sinusitis

What are the two types of sinus infections listed?

Acute pharyngitis and Lemierre's disease

What are the two infections of the pharynx discussed?

Oral thrush (Candidiasis), Vincent's angina, and Ludwig's angina

Name the three infections of the oral cavity mentioned.

Acute laryngitis, croup, and acute epiglottitis

Name the three infections of the larynx listed in the table of contents.

Blepharitis, dacryocystitis, conjunctivitis, keratitis, uveitis, and endophthalmitis

Name the six types of eye infections listed.

Otitis externa, otitis media, and mastoiditis

What are the three infections of the ear and mastoid mentioned?

Acute infective rhinitis, acute nasopharyngitis, acute coryza, and acute nasal catarrh

What are four other names for the common cold?

Non specific upper respiratory tract infection without anatomic localization

What is the clinical definition of the common cold?

Sinuses, pharynx, or lower airway

The common cold may affect which three anatomical areas?

Rhinorrhea, nasal congestion, and sore throat

What are three potential symptoms of the common cold?

Rare

Is fever common or rare in adults with the common cold?

Acute, mild, and self limited

What are the three descriptors for the presentation of the common cold?

Less than 1 week

If a common cold lasts more than how long, is it no longer considered the common cold?

Purely clinical

How is the diagnosis of the common cold made?

Symptomatic

What is the general treatment approach for the common cold?

Lessens the duration but does not treat the common cold

What is the effect of ascorbic acid found in studies?

Rhinovirus

What is the most common cause of the common cold?

30 to 40 percent

What percentage of common cold cases are caused by Rhinovirus?

More than 150

How many serotypes of Rhinovirus exist?

High number of serotypes and lack of a vaccine

Why is Rhinovirus difficult to treat despite having an established genome?

Adenovirus

Which common cold virus has 57 serotypes?

Coronavirus

Which common cold virus has 6 serotypes including SARS CoV 2?

Respiratory Syncytial Virus (RSV)

Which virus is the most common common cold etiology in pediatric and immunocompromised patients?

Rhinosinusitis

What is the inflammatory condition of the nasal sinuses called?

Maxillary sinus

What is the usual site of sinusitis?

Maxillary, ethmoid, frontal, and sphenoid

In what order of frequency are the sinuses typically affected?

Pseudostratified columnar epithelium with goblet cells

What type of epithelium lines the sinuses?

Normally no mucus

How much mucus is normally found in the sinuses if ciliary action is functioning?

Less than 4 weeks

What is the duration for acute rhinosinusitis?

Allergic, tumor, and altered mucous content

Name three non infectious causes of acute rhinosinusitis.

Present for more than 10 days

What is a distinguishing feature that suggests rhinosinusitis is bacterial?

Viral

If rhinosinusitis lasts less than 10 days, what is the likely etiology?

0.2 to 2 percent

What percentage of viral sinusitis cases become complicated into a bacterial infection?

A deep sample is needed

Why is culture no longer routinely done for rhinosinusitis?

S. pneumoniae and H. influenzae

What are the top two bacterial etiologies for acute bacterial rhinosinusitis?

50 to 60 percent

What percentage of acute bacterial rhinosinusitis cases are caused by S. pneumoniae and H. influenzae?

Moraxella spp

What organism accounts for 20 percent of acute bacterial rhinosinusitis etiologies?

Staphylococcus aureus

Which bacterium can cause rhinosinusitis and lead to MRSA?

Molar abscess

The presence of anaerobes in sinusitis should be suspected if there is what specific dental condition?

Damaged teeth, halitosis, and periauricular lymphadenopathy

What three signs should be checked for if an anaerobic sinus infection is suspected?

Chlamydia pneumoniae and Mycoplasma pneumoniae

What are two atypical agents of rhinosinusitis common in the Philippines?

Community acquired pneumonia

Atypical agents of rhinosinusitis are also etiologic agents for what other condition?

Klebsiella pneumoniae and Pseudomonas aeruginosa

Name two nosocomial agents of rhinosinusitis.

May be thick or purulent

How might nasal drainage appear even with a viral etiology?

Para akong sinisipon pero walang lumalabas

What Tagalog phrase describes the sensation of nasal drainage when little comes out?

Frontal and retro orbital

In what two locations is facial pain commonly felt in sinusitis?

Heavier when prone

When is facial pain/pressure typically heavier for the patient?

Leaning forward and pressing on sinuses

What physical movement elicits pain during a maxillary or frontal sinus assessment?

Orbital cellulitis

What condition involves swelling around the eye as a symptom of acute rhinosinusitis?

Decongestants or saline lavage

What two treatments are used for the alleviation of symptoms in rhinosinusitis?

Amoxicillin or co amoxiclav

What two antibiotics are mentioned for bacterial rhinosinusitis?

More than 10 days

After how many days of symptoms are antibiotics typically given?

Rhinocerebral mucormycosis

What is another name for acute fungal rhinosinusitis?

Order Mucorales

From which order does the term Mucor originate?

Rhizopus, Rhizomucor, Mucor, Lichtheimia, and Cunninghamella

Name the five genera listed under the Order Mucorales.

Aspergillus and Fusarium

Name two other fungi besides the Mucorales order that cause fungal rhinosinusitis.

Diabetic with ketoacidosis, transplant patients, and hematologic malignancies

What are three types of immunocompromised patients at risk for fungal rhinosinusitis?

Complete restriction of movement in the right eye

What advanced symptom did the patient in Case #1 develop regarding her eye?

Broad aseptate hyaline hyphae branching at acute angles

What was revealed in the direct microscopy of the scrapings in Case #1?

MRI

What was the actual radiological modality used for Case #1 according to the journal?

More than 12 weeks

What is the duration for chronic sinusitis?

Endoscopy

What diagnostic tool provides direct visualization and allows tissue culture collection in chronic cases?

Aspergillus

Which fungus is associated with noninvasive chronic fungal sinusitis?

Curvularia or Bipolaris

Which two fungi are associated with invasive chronic fungal sinusitis?

Mycetoma

What is the term for a fungus ball in the sinus?

Hyperdensities

How do mycetomas appear in ethmoid and maxillary sinuses on a coronal CT scan?

Physiologic impairment rather than bacterial invasion

Chronic bacterial sinusitis is characterized by what rather than invasion?

Cystic fibrosis or polyps

Name two underlying conditions that cause inept mucociliary clearance in chronic sinusitis.

Staphylococcus aureus

Which specific bacterium may be involved in chronic sinusitis?

Sore throat

What is the primary symptom of infections of the pharynx?

Pharyngitis due to the common cold

What is the most common cause of pharyngeal infections?

Rhinovirus

Which RNA virus accounts for 20 percent of acute pharyngitis cases?

Coronavirus

Which RNA virus accounts for 5 percent of acute pharyngitis cases?

Influenza, Parainfluenza, and Coxsackie A

Name three other RNA viruses that cause pharyngitis.

Adenovirus, HSV 1 and 2, CMV, and EBV

Name four DNA viruses that cause pharyngitis.

Herpesviridae

To which family of enveloped double stranded DNA viruses do EBV, HSV, and CMV belong?

Adenovirus

Which family of DNA viruses is unenveloped and double stranded?

Picornaviridae

To which virus family do Polio, Rhino, and Coxsackie belong?

PERCH on a peak

What is the mnemonic for Picornaviridae?

Poliovirus, Enterovirus, Rhinovirus, Coxsackie, and Hepatitis A

What viruses are in the PERCH mnemonic?

Rare

Are fever and cervical lymphadenopathy common or rare in Coronavirus and Rhinovirus pharyngitis?

Myalgia

What systemic symptom is severe in Influenza but not Coronavirus?

Pharyngoconjunctival fever

What condition is caused by Adenovirus?

Conjunctivitis

What ocular symptom is usually paired with pharyngeal exudate in Adenoviral pharyngitis?

Herpangina

What condition is characterized by painful inflammation of the tonsils and pharynx from Coxsackievirus?

Pain

What does the prefix herp mean in herpangina?

Inflammation of the tonsils and pharynx

What does the term angina mean in this context?

Vesicles and small ulcers

What type of lesions are seen at the posterior palate, pharynx, and tonsils in herpangina?

Gingivostomatitis

What is the term for vesicles and large ulcers in the gingiva and buccal mucosa caused by HSV 1?

Singaw

What Filipino term do patients use to describe oral ulcers?

Infectious Mononucleosis

What is the disease associated with EBV, also known as the kissing disease?

Heterophile positive mononucleosis

How is EBV mononucleosis classified based on heterophile status?

Fever, sore throat, lymphadenopathy, and atypical lymphocytosis

What are four signs and symptoms of EBV infection?

Heterophile negative mononucleosis

How is CMV mononucleosis classified compared to EBV?

Summer and fall

In which two seasons is Coxsackievirus usually seen?