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Periodontics · patient case question

All of the following bacteria are seen in this condition EXCEPT:

Patient case: ANUG — blunted papillae and fetid odour

Scenario: A clinical photograph of ANUG showing BLUNTED PAPILLAE and FETID ODOUR.

  1. Porphyromonas gingivalis
  2. Prevotella intermedia
  3. Streptococcus viridans
  4. Tannerella forsythia
Show answer and explanation

Correct answer: C. Streptococcus viridans

  • A. Porphyromonas gingivalis is a gram-negative anaerobe and a red complex pathogen found in necrotizing and chronic periodontal disease.
  • B. Prevotella intermedia is a hallmark organism in ANUG and is characteristically elevated, along with spirochetes and fusiform bacteria.
  • C. Correct — this is the EXCEPTION. Streptococcus viridans is a facultative GRAM-POSITIVE aerobe and a normal commensal of the oral cavity. It is the organism of concern for INFECTIVE ENDOCARDITIS after bacteraemia, not a component of the necrotizing periodontal disease flora.
  • D. Tannerella forsythia is another red complex gram-negative anaerobe recovered in periodontal disease.

Note: The classic ANUG flora is the FUSOSPIROCHETAL complex — fusiform bacteria (Fusobacterium) plus SPIROCHETES (Treponema) — with Prevotella intermedia. The clinical triad is PAIN, punched-out/CRATERED interdental papillae, and BLEEDING, with fetid halitosis and a grey pseudomembrane.

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