黏膜医学教学（中山大学）感染性疾病七年制2017.pdfVIP

INFECTIOUS DISEASES OF ORAL MUCOSA Chen, Xiaobing Department of Oral Medicine Infection: The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body Common microbes of oral mucosal infection: Fungi, viruses, bacteria Herpes simplex M.tuberculosis •  Fungal-infection: Oral candidiasis •  Viral-infection: Herpetic stomatitis Herpes zoster Hand-foot-mouth disease Herpetic angina (疱疹性咽峡炎) •  Bacterial-infection: Coccigenic stomatitis Necrotic ulcerative gingivo-stomatitis Tuberculosis ORAL CANDIDIASIS ETIOLOGY •  Dysbacteriosis ➡ pathogenicity •  Over proliferation of fungus •  Four fungal organisms: Candida albicans, Candida tropicalis, Candida stellatoidea, and Candida pseudotropicalis •  Candida albicans is most common CLINICAL MANIFESTATION l Pseudomembrane(white) l Atrophy(red) pseudomembrane : White slightly elevated plaques mix of necrotic epithelium cell, inflammatory cell ,exudate can be wiped away leaving an erythmatous(red) base. Atrophy: thinnner of epithelium ➡ capillary is more clear ➡ erythematous PAS Stained Candida Albicans Hyphae Embedded in The Oral Mucosa pH 4～6 CLASSIFICATION (LEHNER 1966) •  pseudomembranous candidosis, thrush •  acute erythematous candidosis •  chronic erythematous candidosis •  chronic hyperplastic candidosis CLASSIFICATION (LOCATION) •  candidal stomatitis •  candidal cheilitis •  candidal angular cheilitis •  chronic mucocutanous candidiasis，CMCC MANIFESTATIONS OF CANDIDIASIS ACUTE PSEUDOMEMBRANOUS STOMATITIS •  Newborn, weak, immunodeficiency •  Buccal, tongue, lip, palate •  peudomembrane •  Rejecting foods •  Less systemic