SKIN BACTERIAL INFECTIONS

Purpura
Skin bleeding lesion greater than 3 mm in
diameter. They are seen in Meningococcemia
patients.

Ecchymosis
Skin bleeding lesion with greater than 3 mm in
diameter. They are also known as “Black eye”
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 STAPHYLOCOCCUS AUREUS
- Gram-positive round-shaped bacterium
- usually arranged in grape-like clusters
- a usual member of the microbiota of the
body, frequently found in the upper
respiratory tract and on the skin
- the most dangerous of all of the many
common staphylococcal bacteria.
- Produces enzymes & toxins for its pathogenicity and
through direct invasion and destruction of tissues
MODE OF TRANSMISSION
Skin infections are transmitted through:
1. direct contact with person having purulent lesions
2. from hands of healthcare hospital workers
3. from fomites like bed linens, contaminated
equipment
o sudden onset of perioral erythema or BULLOUS (redness) that
covers the whole body within 2 days
o positive Nikolsky sign: when pressure is
applied in the skin, it causes displacement of
the skin (wrinkles tissue paper-like
appearance)
o Bullae and cutaneous blister
o DESQUAMATION
LABORATORY DIAGNOSIS
1. Microscopic examination of Gram-stained specimen
(gram positive cocci)
2. culture
- gray to golden colonies
3. qualities of the microorganism
- catalase positive: aerobic bacteria
- coagulase positive: clots plasma

CLINICAL FINDINGS
TREATMENT AND PREVENTION
FOLLICULITIS
- a pyogenic ( pus-producing) TREATMENT OF
infection involving the hair follicles CHOICE: BETA LACTAM PREVENTION
- common skin condition ANTIBIOTICS
- Characterized by:
Use Standard Precautions
o localized painful Develops resistance to
for skin, burn, and wound
inflammation penicillin derivatives like
infections if they are minor.
o heals rapidly after draining the pus methicillin and nafcillin
FURUNCLE Oxacillin is the only
- AKA Boils penicillin derivative Contact Precaution if
- an infection of several hair follicles antibiotic that has major SSSS
that has a small collection of pus remained active
(called an abscess) under the skin Standard Precautions for
- an extension of folliculitis infections caused by
- Characterized by: methicillin-resistant S.
o larger and painful nodules Incission and drainage
aureus (MRSA); add
with underlying collection of dead and necrotic ( I & D)
Contact Precautions if
tissue wounds cannot be
CARBUNCLE contained by dressing
- a red, swollen, and painful cluster of
boils that are connected to each other
under the skin.
- represents a coalase of furuncles that STAPHYLOCOCCUS EPIDERMIDIS
extends into the subcutaneous tissue - part of the normal flora of the skin
with multiple sinus tracts - associated with “stitch abscess”,
STY/HORDEOLUM UTI and endocarditis
- involves one or more of the small - it causes infections in individuals
glands near the base of the eyelids with prosthetic devices, cardiac
- it is red & painful, often filled with devices CNS shunts
pus STREPTOCOCCUS PYOGENES
- gram positive cocci arranged in
IMPETIGO pairs or chains
- infection common in young children - belongs to Groups A beta
and primarily involves the face and hemolytic
limbs - major virulence factor is M protein
- starts as macule which later which is anti-phagocytosis
becomes a pus filled vesicle that - produces enzymes and toxins responsible for the
ruptures and forms honey-colored crust pathogenicity
- can also be caused by Staphylococcus pyogens - some strains are encapsulated
STAPHYLOCOCCUS SCALDED SKIN SYNDROME - maybe associated with severe systemic infections
(SSSS) CLINICAL FINDINGS
- aka Ritter's Disease PYODERMA (IMPETIGO)
- primarily found in newborns and - a purulent skin infection that is
young children localized and commonly involves
- Manifestations of Staphylococcus the face, the upper and lower
Scalded Skin Syndrome: extremities
o Exfoliative toxin: responsible for the - starts as vesicles then progresses to
manifestations of the disease pustules
o only the outer layer of the skin is affected, - the lesion ruptures and forms
hence there will be no scarring honey-colored crusts
- there maybe enlargement of the regional lymph
nodes but no sign of systemic infection
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ERYSIPELAS - capable of water-soluble pigments (pyocyanin-blue)
- AKA St. Anthony’s fire - resistant to most antibiotics
- superficial form of cellulitis - virulence is attributed to adhesins (flagella, pili,
- follows a respiratory or skin LPS), toxins (exotoxin A, pigments) & enzyme
infection - infects extensive skin burns, which can be a source of
- affects the upper dermis and sepsis
extends into the superficial cutaneous lymphatics - it has been cultured from washbasins, respirator tubing,
- Manifestations: nursery cribs, and even antiseptic-containing bottles.
o localized raised areas associate with pain - causes corneal keratitis in wearers of contact lenses,
o erythema endocarditis and osteomyelitis in intravenous drug
o warmth abusers, external otitis (swimmer's ear) in healthy
o lymphadenopathy individuals, and severe external otitis in diabetics
o systemic manifestations A: aerobic
CELLULITIS E: Exotoxin A
- involves the skin and SC tissue R: Rod/ resistance
- the infected skin and the normal U: UTI, burns, injuries G:
skin are not clearly differentiated green-blue dressing I:
- local inflammation with systemic iron-containing lesions N:
signs negative gram
NECROTIZING FASCITIS O: odor of grapes
- AKA 'flesh-eating” infection or S: slime capsule sometimes
streptococcal gangrene A: Adherin pili
- involves deep SC tissue
MODE OF TRANSMISSION
- starts as cellulitis then becomes
- colonization or previously injured skin
bullous and gangrenous
- it spreads to the fascia then the
muscle and fat CLINICAL FINDINGS
- it may become systemic and cause multi-organ -blue-green pus that exudes a sweet grape-like odor
failure to death -other skin infections are foliculitis and secondary
infections in individuals with acne and nail infections
resulting from immersion in contaminated water
COMPLICATIONS OSTEOCHONDRITIS
ACUTE GLUMEROLOUS NEPHRITIS - most common cause of inflammation of the bone and
- commonly associated with skin infections a cartilage of the foot following a penetrating injury
RHEUMATIC FEVER
- associated with throat infections
- non-supporative, immune mediated complications
SCARLET FEVER/SCARLATINA
- develops in some people who have strep throat.
- manifested by Strawberry tongue, bright red rash that
covers most of the body, sore throat and fever
LABORATORY DIAGNOSIS
LABORATORY DIAGNOSIS 1. Gram stain
1. Microscopy - gram negative bacilli arrange individually and in
- gram stain of samples of infected tissue will show pairs
gram-positive cocci in pairs and chains associated with 2. Culture
leukocytes - flat colonies with green pigmentation
2. Culture 3. Oxidase test is positive
- positive beta hemolysis in blood agar - aerobic and can use oxygen as a terminal electron
3. Bacitracin test acceptor in respiration.
- antibiotic TREATMENT AND PREVENTION
- susceptibility test with posituve zone of inhibition of TREATMENT OF CHOICE PREVENTION
growth around the Bacitracin disc
preventive measures must be
done and focused on
TREATMENT AND DIAGNOSIS Pseudomonas Aeruginosa is
preventing contamination of
resistant to most antibiotic
sterile hospital equipment and
hence C&S must be done
instruments and cross-
TREATMENT OF CHOICE: PENICILLIN contamination of patients
by hospital personnel
in case of penicillin allergy, CLOSTRIDIUM PERFRINGES
macrolides (erythromycin, - (formerly known as C. welchii, or Bacillus
azithromycin) or cephalosporins are - welchii)
alternate drugs - gram positive bacilli
- anaerobic and rarely produce endospores
the drainage of pus and thorough - produces 4 lethal toxin: alpha, beta, iota, epsilon
debridement of infected tissues toxin ( alpha: most lethal)
- toxins cause massive hemolysis, bleeding and
tissue destruction
PSEUDOMONAS AERUGINOSA - associated with soil and water, also associated with feces
- an opportunistic aerobic gram-negative bacillus that is
frequent & common cause of nosocomial infection
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 MODE OF TRANSMISSION - Disease of herbivores: strikes primarily grazing
- colonization of the skin following physical trauma mammals, such as cattle and sheep
and surgery - People at risk are those who handle animals, hides,
wool, and other animals products
CLINICAL FINDINGS - There are three forms of anthrax disease:
CELLULITIS CUTANEOUS ANTHRAX
- involves the skin and SC tissue - is the most common form of
- the infected skin and the normal skin are not clearly anthrax infection, and it is also
differentiated considered to be the least
- local inflammation with systemic signs dangerous.
SUPPURATIVE MYOSITIS - Contact with material
- an acute intramuscular infection - Infection usually develops from 1
that develops secondary to to 7 days after exposure.
hematogenous microorganism - When anthrax spores get into
spread into the body of skeletal the skin, usually through a cut or scrape, a person can
muscle, manifested by abscess develop cutaneous anthrax.
formation of large muscle groups INHALATION (PULMONARY) ANTHRAX
CLOSTRIDIAL MYONECROSIS (GAS GANGRENE) - starts primarily in the lymph
- is a life-threatening infection nodes in the chest before
following trauma or surgery spreading throughout the rest
- characterized by of the body, ultimately
o massive tissue necrosis causing severe breathing
with gas formation, problems and shock.
shock, renal failure, and - Without treatment, inhalation
death within 2 days of anthrax is almost always fatal.
onset However, with
aggressive treatment, about 55% of patients survive.
GASTROINTESTINAL ANTHRAX
LABORATORY FINDINGS - When a person eats raw or
1. Microscopic detection of gram-positive bacilli and undercooked meat from an
culture under an anaerobic conditions animal infected with anthrax,
they can develop
TREATMENT AND PREVENTIONS gastrointestinal anthrax.
- Once ingested, anthrax spores can
TREATMENT OF CHOICE PREVENTION affect the upper
Surgical wound debridement gastrointestinal tract (throat and esophagus), stomach,
Patient care: Use standard and intestines, causing a wide variety of symptoms.
high-dose penicillin therapy precautions

BACILLUS ANTHRACIS
- a gram-positive bacterium
- spore-forming rod: bamboo rod or medusa head
appearance
- produces anthrax toxin resulting in an ulcer with a
black eschar.
- deadly disease to livestock and, occasionally, to
humans.
- It is the only permanent (obligate) pathogen within the
genus Bacillus.
- grows slowly in soil types that meet specific
moisture conditions.
- Endospores survive in soil tests for up to 60 years

PROTECTIVE ANTIGEN EXOTOXIN

Edema Toxin
local edema (swelling) and
interferes with
a cell receptor–binding
phagocytosis by
protein binds the toxins
macrophages
to
Lethal Toxin
target cells and permits
targets and kills
their entry
macrophages, which
disables an essential
defense of the host

ANTHRAX DISEASE
- bacterial disease caused by bacillus anthracis that can MODE OF TRANSMISSION
affect skin, lungs, or gastrointestinal tract depending - inoculation into the open skin from either the soil or
on the portal of entry of the etiologic agent. infected animal products
- ingestion of infected meat or milk
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- inhalation of aerosolized spores

 LABORATORY FINDINGS BACTERIAL CONJUNCTIVITIS
1. blood test detects both inhalational and cutaneous - AKA “PINKEYE”
cases of anthrax within an hour. - inflammation/infection of
2. The peripheral blood contains a large number of B. conjunctiva
anthracis which is easily seen on gram-stain. - involves irritation,
3. Spores can be done using Dorner stain or Wirtz reddening of conjunctiva;
Conklin edema of eyelids,
mucopurulent discharge, sensitivity to light; highly
WIRTZ CONKLIN STAINING METHOD contagious
- Heat helps open the spore's membrane so the dye can - Pathogens
enter. o Haemophilus influenzae subspecie
- The main purpose of this stain is to show aegyptius
germination of bacterial spores. o Streptococcus pneumoniae
- If the process of germination is taking place, then the o Other bacteria
spore will turn green in color due to malachite green - Patient Care
and the surrounding cell will be red from the safranin. o Standard Precaution
- Reservoirs and Mode of Transmission
o Infected humans.
TREATMENT AND PREVENTION
o Human-to-human transmission occurs via
- Antibiotics like penicillin or doxycycline are the contact
drugs of choice.
- Vaccination of livestock in endemic areas; single - known as the Koch-WeeksINFLUENZAE
HAEMOPHILUS
dose of live, attenuated vaccine is used, which is bacillus
unsafe for use in humans. BIOGROUP AEGYPTIUS
- Gram-negative bacterium;
- Vaccine approved for humans: contains inactivated form - rod shape (coccobacillus)
of antigen toxin to prevent entry of 2 toxins into the - causative agent of acute and
host’s cells often purulent conjunctivitis;
- For people who have been exposed to B. anthracis: 3 - caused worldwide seasonal
doses of the vaccine over 4 weeks, along with antibiotic epidemics (summer)
treatment, are recommended - virulence - pili
- Transmission – mechanical
PATIENT CARE - Sulfunamide and gentamycin effective
- Standard Precautions
- Add Contact Precautions for cutaneous anthrax STREPTOCOCCUS PNEUMONIAE
patient if there is a large amount of uncontained - gram-positive, facultatively
drainage. anaerobic pathogen, in pairs,
- Use soap, water for handwashing; alcohol does not have encapsulated.
sporicidal activity. - alpha hemolytic if aerobic; beta
hemolytic if anerobic
OCULAR BACTERIAL INFECTIONS - lancet-shaped
- virulence : adhesin, capsule.
toxin, pneumolysin and IgA

CHLAMYDIA TRACHOMATIS
- Gram-negative bacterium and
obligate intracellular pathogen;
cell with high lipid.
- susceptible to sulfonamides
- associated with eye infections
such as:
o conjunctivitis
o inclusion conjunctivitis
o trachoma
- Chlamydia trachomatis bacterium is most commonly
spread through vaginal, oral and anal sex.
-
CLINICAL FINDINGS
LATE ONSET NEONATAL CONJUNCTIVITIS
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CONJUNCTIVITIS DUE TO CHLAMYDIA TRACHOMATIS
FOODBORNE DISEASES
- AKA “swimming pool
GASTRITIS
conjunctivitis”
- inflammation of the gastric lining
- Transmission:
ENTERITIS
o Acquired in
- inflammationof the small intestine
non/poor
COLITIS
chlorinated
- inflammation of the inner lining of the colon
swimming pool
GASTROENTERITIS
- In adults, occur with non-gonococcal urethritis or
- involves the stomach and intestines
cervicitis (genital to eyes transfer)
HEPATITIS
- there is mucopurulent eye dischargeoccurs with
- inflammation of the liver
pneumonia or chlamydial nasopharyngitis.
DYSENTERY
CHLAMYDIAL CONJUNCTIVITIS
- inflammation of the intestines that causes bloody or
- AKA; Inclusion
mucoidal diarrhea
conjunctivitis/Paratrachoma
- Caused by
o serotypes D to K GASTRITIS AND GASTRIC ULCERS
- In adults, associated with - Signs and symptoms
genital infection o sharp or burning pain emanating from the
- In newborn acquired upon abdomen
passage in birth canal o severe ulcers can be accompanied by
- Signs and symptoms bloody stools, vomiting, or both
o swelling of eyelids with mucopurulent o worst at night, after eating, or under
keratitis psychological stress
o corneal infiltrates - Causative agent
o corneal vascularization o Helicobater Pylori
CHLAMYDIA KERATOCONJUNCTIVITIS ULCERATIVE COLITIS
- AKA Trachoma/chronic - is an immune-mediated disease that affects the
keratoconjunctivitis. entire large intestine or colon
- Cause: GASTROENTERITIS
o serotypes A,B & C - is a very common condition that causes diarrhoea and
- Transmission: vomiting.
o eye-to-eye by - It's usually caused by a bacterial or viral tummy
droplets bug.
o fomites & eye-seeking flies - It affects people of all ages, but is particularly
o In poor living conditions common in young children.
- Signs and symptoms - Most cases in children are caused by a virus called
o follicular conjunctivitis with diffuse rotavirus.
inflammation involving entire conjunctiva - Signs and symptoms in adults:
o progress to conjunctiva scarring producing in- o Abdominal cramps and pain
turned eyelids o Watery diarrhea
o In-turned eyelids causes constant abrasion of o Nausea, vomiting, or both
cornea o Occasional muscle aches or headache
o ulceration o Low-grade fever
o scarring HEPATITIS A
o invasion of vessels into cornea - Is a liver disease which spreads when faecal matter
o loss of vision (frequent cause of blindness) enters the mouth.
- May last for several weeks but most of the people
NEISSERIA GONORRHEAE recover completely
- Signs and symptoms
- a kidney bean–shaped, Gram-
negative diplococcus o Abdominal pain
- Also called as gonococcus o Vomiting
- Common cause of STI in o Yellowing of Skin and Eyes
- Spread by
neonates
o Direct contact
o “Ophthalmia
Neonatorum” o Food and beverages
- In adults, transmitted o Poor sanitation
through finger-to eye - Prevention
contact involving infectious genital secretions o Hygienic food & water, Clean bathrooms,
proper hand washing
- Signs and symptoms
o redness & swelling of conjunctiva
o with purulent eye discharge ESTABLISHMENT OF INFECTIOUS DISEASE IN
o If untreated – leads to corneal ulceration, THE DIGESTIVE SYSTEM
perforation & blindness PHARMACOLOGIC ACTION
- Prevention - Some bacteria may alter normal intestinal function
o (neonate): 1% silver nitrate (Crede’s without causing lasting damage to their cells
prophylaxis) after birth o vibrio cholerae: produces voluminous,
o 1% tetracycline eye ointments watery diarrhea due to its ability to induce
o 0.5% erythromycin eye ointments increased electrolytes into the intestines
LOCAL INFLAMMATION
- Invasion of the alimentary tract by microbes can
lead to inflammation
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 - Invasion is usually limited to the epithelial layer but
CLOSTRIDIUM DIFFICILE
may spread to the deeper tissues
- Gram-positive species of spore-forming bacteria.
- In the mouth, the gums are usually affected causing
- Clostridioides spp. are anaerobic, motile bacteria,
periodontitis.
ubiquitous in nature and especially prevalent in soil.
- In the intestines, infections can cause inflammation that
- Its vegetative cells are rod-shaped, pleomorphic,
can result to dysentery
occur in pairs or short chains.
DEEP TISSUE INVASION
CLOSTRIDIUM DIFFICILE INFECTION
- Certain organisms are able to spread to adjacent
- C. Difficile contains endospores that can survive the
tissues and enter the blood stream.
acidity of the stomach and reach the large intestine
o Strongyloides: is capable of burrowing
- C. Difficile flourishes within the colon
through the intestinal wall; The parasite is
- Toxins A and B cause mucosal damage
often colonized by GUT bacteria and as a
- Most common infectious cause of nosocomial
result, infection by this worm can lead to
diarrhea
polymicrobial septicemia
- The normal gut flora is altered by broad-spectrum
PERFORATION
antibiotics, most notably clindamycin, cephalosporins,
- When the mucosal epithelium is perforated, the
ampicillin, amoxicillin, and fluoroquinolones
normal flora spills into sterile areas and invades
o Pseudomembranous Colitis: Yellowish
deep tissues, often with serious consequence.
plaques form over damaged epithelium
o perforation of an inflammed appendix can
- Signs and symptoms
lead to peritonitis
o Fever
o Crampy abdominal pain
BACTERIAL INFECTIONS OF THE GIT o Diarrhea
BACTERIAL ENTEROCOLITIS (FOOD POISONING)
SALMONELLA
- an illness caused by the consumption of food
- a genus of rod-shaped Gram-negative flagellated
contaminated with bacteria or bacterial toxins
facultatively anaerobic bacilli of the family
- Causes:
Enterobacteriaceae
o Bacillus cereus
- most frequently reported cause of food-related
o Staphylococcus aureus
illness
o Clostridium perfringes
- Salmonella bacteria typically live in animal and
o Vibrio parahemolyticus
human intestines and are shed through feces.
GASTROENTERITIS
SALMONELLOSIS
- Diarrhea
- AKA salmonella poisoning
THREE MECHANISMS OF FOOD POISONING - Humans become infected most frequently through
INGESTION OF PREFORMED TOXIN contaminated water or food
- present in contaminated food - Incubation period: ½ - 48 hours
- Signs and symptoms - Manifestations:
o developed in few hours consisting of o Typhoid Fever
explosive diarrhea o Gastroenteritis
o abdominal pain - Signs and symptoms
- Causes: o Abrupt onset of severe diarrhea and
o Staphylococcus aureus abdominal cramps
o Vibrio cholerae o Stools are offensive and putrefactive at first,
o Clostridium Botulinum later becoming watery, greenish and bloody
INFECTION BY TOXIGENIC ORGANISMS o tenesmus (straining at stool)
- involve secretory enterotoxin, dysentery o Concurrent nausea and vomiting
INFECTION BY ENTEROINVASIVE ORGANISMS o abdominal tenderness
- proliferate, invade, destroy epithelial cells o slight fever
dysentery. - Management and prevention:
- Causes: o proper canning, preservation and
o Escherichia coli refrigeration of foods
o Salmonella sp - Treatment:
o Shigella sp o Medical care: Fluid and electrolytes;
o Yersinia enterocolitica Potassium replacement is a life-saving
o Vibrio cholera measure; Treatment of shock if present;
o Clostridium perfringes Antibiotics
o Clostridium difficile o Nursing care: CBR and comfort measures
o Bacillus anthracis
o Mycobacterium tuberculosis SHIGELLA DYSENTERIAE
o Clostridium Botulinum
- a species of the rod-shaped bacterial genus
CLOSTRIDIUM PERFRINGES Shigella
- occurs when foods are prepared in large quantities and - Gram-negative, non-spore-forming, facultatively
kept warm for a long time before serving anaerobic, nonmotile bacteria
- develop diarrhea and abdominal cramps within 6 to 24 - release toxins that irritate the intestines.
hours (typically 8 to 12 hours) - invades villus of large intestine
- usually begins suddenly and lasts for less than 24 o can perforate intestine or invade blood
hours - enters Peyer’s patches & instigates inflammatory
- People infected with C. perfringes usually do not response
have fever or vomiting o endotoxin
- Common source: o exotoxins
o Beef
o poultry
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o gravies
o dried or pre-cooked foods
SHIGELLOSIS (BACILLARY DYSENTERY)
- AKA Bloody Flux
- infectious disease caused by a group of bacteria
called Shigella BOTULISM
- the most severe form of dysentery
- Signs and symptoms
o Ushered in by chills followed by fever
o Nausea & vomiting, abdominal pain
o tenesmus
o Severe diarrhea at first mucoid and later
bloody, alternating with constipation, there is
stomach cramps starting a day or two after
exposure to the bacteria
o Bowel movements may be 30-40 times or
more in 24 hours
o Extreme thirst and rapid dehydration
- Management:
o antibiotics and fluid and electrolytes
replacement
DENTAL CARIES
VIBRIO CHOLERAE
- curved (comma-shaped), facultative anaerobe,
Gram-negative bacilli.
- It is widely distributed in aquatic environments,
where it is a natural, free-living organism
- naturally lives in brackish or saltwater where they PERIODONTITIS/GINGIVITIS
attach themselves easily to the chitin-containing
shells of crabs, shrimps, and other shellfish.
CHOLERA
- AKA El Tor
- an acute diarrheal infection caused by ingestion of food
or water contaminated with the bacterium Vibrio
cholerae ACUTE NECROTIZING ULCERATIVE GINGIVITIS
- causes severe watery diarrhea, which can lead to
dehydration and even death if untreated
- Signs and symptoms
o Starts with acute colicky pains in the
abdomen, a profuse watery diarrhea,
yellowish becoming grayish- white
sometimes described as "rice-water
stools," vomiting
o rapid heart rate,
o low blood pressure
o loss of skin elasticity
o dry mucous membranes
o Marked mental depression
o Headache
o Vomiting
o Fever may or may not be present.
o Extreme thirst, thickly furred tongue,
severe or violent cramps in the legs and feet
o Face appears shrivered
o Eyes sunken
o Skin an ash-gray color
o Washerwoman’s hands: because of rapid
dehydration
- Management:
o antibiotics
- produced only under anaerobic conditions and in
alkaline or neutral nonacid foods
- Easily destroyed by boiling
- It’s a paralytic illness caused by a nerve toxin that is
produced by the bacterium Clostridium botulinum
- It is the severe form of food poisoning when the
toxin containing food are ingested.
- Sign and Symptoms:
o Extreme weakness
o dizziness
o Difficulty in breathing, swallowing and
speaking
o Marked vertigo
o disturbances of vision
- Treatment:
o Antitoxin
MOUTH INFECTIONS
- Involves the dissolution of solid tooth
surface due to the metabolic action of
bacteria
- Cause:
o Streptococcus mutans
- means inflammation of the gums, or
gingiva.
commonly occurs because a film of
plaque, or bacteria, accumulates on the
teeth
- Treponema denticola and Porphyromonas gingivalis
- AKA Vincent’s disease or Trench
mouth
- has a sudden onset with gingiva
showing punched-out crater-like
ulcerations, covered with a whitish
pseudomembrane, surrounded by a demarcated zone of
erythema.
- Any area of the mouth can be affected.
- There is spontaneous bleeding and breath has fetid odor
- Causative agent:
o Prevotella intermedia
- Treatment:
o Metronidazole

CLOSTRIDIUM BOTULINUM
- anaerobic, rod-shape, endospore-forming bacterium that
produces a protein with characteristic neurotoxicity
- Under certain conditions like low oxygen conditions
these organisms may grow in foods producing
dangerous toxin:
o botulinum toxin
BOTULINUM TOXINS
- are one of the most lethal substances known.
- Botulinum toxins block nerve functions and can lead to
respiratory and muscular paralysis.
- grow in inadequately sterilized canned foods
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