15.1

Question 1

herpes simplex 1 and 2

Answer 1

typically produce lesions of the skin and mucous membranes
blistering
ulceration
painful, itchy
primary infections are more severe than reactivations and more extensive

Question 2

latency of herpes simplex 1 and 2 is usually established n

Answer 2

trigeminal or cervical ganglia or sacral nerve root ganglia (dorsal root sensory ganglia)

Question 3

reactivations of herpes simplex 1 and 2

Answer 3

virus travel down the nerve to produce lesions within nerve’s sensory distribution
unpredictable timing
usually less severe
HSV-1 typically orofacial
HSV-2 typically genital
lesions may occur at any location on the skin surface

Question 4

4 serious forms of herpes simplex disease

Answer 4

1. ocular - blephiritis, keratitis, conjunctivitis
2. encephalitis
3. neonatal
4. in the immuncompromised host

Question 5

3 forms of serious herpes smplex occular disease

Answer 5

blepharitis, ketatitis, conjunctivitis

Question 6

herpes encephalitis

Answer 6

commonest cause of sporadic encephalits in the developed world
70% untreated mortality
19% treated mortality

Question 7

morbidity of herpes encephalitis

Answer 7

moderate-severe neurological defects in 50% of survivors

Question 8

herpes neonatorum

Answer 8

acquision of virus from mother’s birth acanal at delivery
multi organ neonatal infection +- encephalitis
mortality 65%

Question 9

HSV in immunocompromised hosts

Answer 9

cancer chemotherary, organ transplant recipients
may experence sevee reactivations
severe mucocutaneous lesions +- dissemination to internal organs

Question 10

varicella zoster virus

Answer 10

primary infection is the cause of chldhood disease varicella
reactivation causes zoster

Question 11

chickenpox symptoms

Answer 11

mild illness with a widespread rash which progresses from small fluid filled vesicles through to pustules and crusty scabs

Question 12

shingles symptoms

Answer 12

may occur when the immune system becomes less effective at containing the virus at its site of latency (dorsal root ganglion)
viruses travel down the corresponding sensory nerve to produce a very painful eruption in the corresponding dermatome

Question 13

3 forms of serious varicella zoster diseae

Answer 13

chickenpox in adults
chickpox in pregnancy
chickpox and shingles in immunocompromised hosts

Question 14

chickenpox in adults

Answer 14

primary chicken pox is more severe in adults and carries a greater risk of complications

• varicella pneumonitis
• varicella encephalitis

Question 15

chickenpox in pregnancy

Answer 15

a non immune pregnant women may acquire chickenpox from

• someone with chickenpox
• someone with shingles

Question 16

risk to foetus/neonate for chickenpox in pregnancy

Answer 16

risks to the foetus/neonate dopend on the stage of pregnancy at which the mother becomes infected, and include

• early foetal loss
• foetal varicella syndrome
• in utero chickenpox
• in utero shingles with skin scarring
• filmunant neonatal chickenpox, high mortality
• neonatal chickenpox, recovery
• shingles in infancy

Question 17

foetal varicella syndrome

Answer 17

severe foetal abnormalities

• dermatomal scarring
• limb hypoplasia
• eye defects (microopthalmia, cateracts, chorioretinitits)
• neurological abnormalities (mental retardation, microcephaly)

Question 18

chickenpox and shingles in immunocompromised hosts

Answer 18

chickenpox is more severe and prolonged
may spread to visceral organs - lungs (pneumonitis), liver (hepatitis), CNS (encephalitis), significant mortality
shingles is also more severe and prolonged, chronic form may develop, particularly in aids