Bacteroides

Fusobacteria
Spirochetes
Leptotrichia buccalis
Rickettsiae
Bacteroides
• Anaerobic bacterial pathogens
• Non-spore forming
• Gram negative bacteria
• Represents 2/3 of the anaerobic colonic flora
• Bacteroides fragilis is the major human pathogen of the genus
bacteroides.
• It produces abscesses in a variety of organs.
Bacteroides fragilis

Major virulence factor is the capsular polysaccharides, which

may cause abscess formation.
 Dental infections
• periodontal disease,
• gingivitis,
• pulpitis,
• acute necrotizing ulcerative gingivitis,
• localized juvenile periodontitis,
• adult periodontitis,
• pericoronitis,
• endodontitis,
• periapical and dental abscesses,
• postextraction infection
Fusobacteria
• Fusobacterium is a genus of anaerobic, Gram-negative
bacteria, similar to Bacteroides.
• Individual cells are rod-shaped bacilli with pointed ends.
Mode of transmission
• By contact of mucous membrane

• By surgical/accidental trauma,

• accidental inoculation.
• Strains of Fusobacterium contribute to several human
diseases, including :
periodontal diseases
Lemierre's syndrome
topical skin ulcers.

• Although older resources have stated that Fusobacterium is a

common occurrence in the human oropharynx,
• Recently Fusobacterium should always be treated as a
pathogen.
Spirochetes
• The general term spirochetes is used to include genus
Treponema & organisms of a similar spiral morphology
belonging to genera Borrelia & Leptospira.
SYPHILIS
• Treponema pallidum is the causative organism
• A small slender delicate spiral filament with 6-12 coils .
• They are actively motile by means of endoflagella .
• They have cork-screw like motility with characteristic bending
movement.
• Treponema pallidum, the agent of syphilis, is a sexually
transmitted organism
Oral Infections
• Endodontics infections
• Periodontal diseases (Treponema denticola)
• Fusospirochetes causes acute necrotizing ulcerative gingivitis.
• Lip ulcers.
Laboratory Diagnosis

Each stage of syphilis requires certain laboratory investigations.

Primary stage:

Specimens:
Exudate from a chancre.
• Any suspected penile or female genital syphilitic lesion
(chancre) should be squeezed gently using the gloved hand to
obtain a serous exudate.
• Bleeding should be avoided because RBCs may mask the
spirochetes as they are of almost the same size.
Detection of Treponema:
1. A dark ground microscopy is used to demonstrate typical
motile Treponema pallidum.
• 2. Exudate is spread on a slide, air dried, fixed and stained with
fluorescein-labeled anti-treponemal serum then examined by
means of immunofluorescence microscopy for typical
fluorescent spirochetes.

• 3. Nucleic acid probe and PCR techniques

 • Serology:
Cardiolipin antibodies (reagin) may be negative in early primary
syphilis because they can only be detected after appearance of the
chancre by about 10-14 days,
but fluorescent treponemal (FTA) test may be positive earlier
because it can detect IgM anti-treponemal antibodies

Rapid Plasma
Reagin test
(RPR)
Secondary stage:

• Specimens:

Exudate from skin lesions, mucous patches or condyloma lata

should be examined for the presence of Treponema pallidum:
dark ground microscopy
immunofluorescent microscopy
PCR techniques

• Serology:

Both groups of antibody tests, cardiolipin and antitreponemal,

usually show strongly positive results in secondary syphilis
Latent syphilis:
• Serum samples: All serological tests are characteristically
positive although the patient appears well.

Late syphilis:
Serological tests for syphilis are almost always positive but the
cardiolipin antibody tests may be negative in patients with old
syphilis or partially treated syphilis while the treponemal antibody
tests remain positive.
Leptotrichia buccalis

• Anaerobic, gram-negative rod.

• It is a constituent of normal oral
flora.
• Leptotrichia species are normally
found in human dental plaque.
• Leptotrichia buccalis infection
occurred in patients with
neutropenia
• The genus may be implicated in a
wide range of inflammatory
disorders including endocarditis
and cellulitis.
•Leptotrichia has been isolated
from blood cultures of patients
with lesions in the oral
mucosa,
RICKETTSIAE
• Rickettsia is a genus of non-motile,
• Gram-negative,
• non-spore forming bacteria.
• They are obligate intracellular
parasites---- insects bits
• They are smaller in size.
• They are highly pleomorphic bacteria
that can present as cocci , rods or
thread-like .
• They are susceptible to antibiotics of
the tetracycline group.
 Clinical picture

• Fever, Chills, Generalized

Lymph-adenopathy
• ESCHAR – A punched out
ulcer covered with a
blackened scab which
indicates the location of
the mite bite.
Oral Consideration
In Rocky Mountain Spotted Fever
• Swollen and dry with prominent papilla in buccal mucosa,
throat and tongue
• Thrombosis of small blood vessel
• Necrosis of soft palate as a
complication

In Typhus
• Lesions found on tongue, soft palate and pharynx
Laboratory diagnosis
• Specimens
Blood, skin biopsies
• Direct demonstration:
direct immunoflourescence
• Isolation:
patient blood is injected into guinea pigs for isolation
• Serological tests:
Latex agglutination
ELISA
Complement fixation test
• PCR
Treatment
• Tetracycline
• Doxycycline

Prevention
• Avoid living in areas with fleas or lice
• Bathing
• Infected clothes can be boiled
• Using insecticides