(2) Herpes, and Poxvirus Flashcards
Cytomegalovirus (CMV)
Official name
Human Herpesvirus 5
Cytomegalovirus (CMV)
Most common cause of
iral congenital infection (Infection of the newborn babies)
can lead to severe abnormalities
Cytomegalovirus (CMV)
nfection is common during?
during childhood and adolescence
Cytomegalovirus (CMV)
infections are typically?
asymptomatic
(severe infections can occur in immunocompromised patients)
Cytomegalovirus (CMV)
Mode of transmission
transplacental, oral, sexual and by blood and tissue transplant
CMV: Pathogenesis
what happen when the virus is acquired from the blood, tissue or other body fluids
CMV cause a productive infection of the epithelial cells
CMV: Pathogenesis
In immunoncompromised patients, reactivating CMV diseases develops?
severe presentation
CMV: Pathogenesis
Site of latency
T-cells, macrophages, monocytes, and renal tubules
CMV: Clinical Manifestation (findings)
Enumerate the disease involve:
- Congenital Infection
- Postnatal Infection
- pneumonitis, gastrointestinal infection and encepalopathy
CMV: Clinical Manifestation (findings)
Can result in death of the fetus in utero
Congenital Infection
CMV: Clinical Manifestation (findings)
for congenical infection, the Cytomegalic inclusion disease of newborns Characterized by
involvement Of the central nervous system and reticuloendothelial systems
CMV: Clinical Manifestation (findings)
clinical findigns under the congenital infection
- ntrauterine growth
- retardation
- jaundice
- hepatosplenomegaly
- thrombocytopenia
- microcephaly
- retinitis
CMV: Clinical Manifestation (findings)
infections mononucleosis like illness (heterophil antibody negative)
Postnatal infection
main distinction from IM of the EBV
CMV: Clinical Manifestation (findings)
TOF
Signs and symtoms are alike with IM of the EBV
T - heterophil antibody negative yung main difference
CMV: Clinical Manifestation (findings)
pneumonitis, gastrointestinal infection and encepalopathy
Immunocompromised Patients
Lab Diagnosis: CMV
enumerate
- Isolation of Virus
- Direct Microscopy Examination
- Serology
- Molecular Assay
- Antigemia Test- Rapid test in serology
Lab Diagnosis: CMV (isolation)
what should be isolated from the virus?
Human Diploid Fibroblast (HDF) cell
Lab Diagnosis: CMV (isolation)
appearance of cytologic changes occurs after 2-3 weeks
Human Diploid Fibroblast (HDF) cel
Lab Diagnosis: CMV (isolation)
Cytopathic effect?
SWOLLEN TRANSLUCENT CELLS WITH LARGE INTRANUCLEAR INCLUSION
Lab Diagnosis: CMV (isolation)
For rapid method
DEAFF TEST (Detection of early antigen fluorescent foci)
Lab Diagnosis: CMV (isolation)
process of DEAFF Test
Specimen is inoculated into cell culture and examined after 24 hours by immunofluorescence for expressed CMV encoded early proteins (this is what looked for)
Viral proteins fluoresce
Lab Diagnosis: CMV (Direct microscopic)
what are the specimen for GIEMSA Stain
Urine or tissue
Lab Diagnosis: CMV (Direct microscopic)
what inclusion should be seen from PAP or Giems stain (Urine/tissue)
“OWL EYE” inclusion
Lab Diagnosis: CMV (Serology)
ANtibody tests
serology
Lab Diagnosis: CMV (Serology)
present infection and also found in patients with reactivation
CMV IgM
Lab Diagnosis: CMV (Serology)
past infection
CMV IgG
Lab Diagnosis: CMV
what molecular assay technique can be used
PCR - can provide quantitativeviral load in the blood, CSF, and urine
Lab Diagnosis: CMV
Antigemia Test- Rapid test in serology, what should be detected
CMV PP65
Lab Diagnosis: CMV (antifemia)
CMV PP65 should be detected in?
Detected in nuclei or peripheral blood neutrophils
CMV: Treatment, Prevention and Control
TOF
Screening of transplant donors and recipients for CMV antibody may prevent some transmissions of primary CMV
True
CMV: Treatment, Prevention and Control
immunocompromised patient can take what medicine?
ganciclovir, forscarne, and cidofovir
antiviral drugs
Human Herpes Virus 6 (HHV-6)
first recognized in what year?
1986
Human Herpes Virus 6 (HHV-6)
Genome of the virus resembles that of ?
human CMV
Human Herpes Virus 6 (HHV-6)
Mode Of transmission
Oral secretions
HHV-6: Pathogenesis
When the virus is present in the saliva, it causes an infection in the
oropharynx
HHV-6: Pathogenesis
The virus will grow well in the
CD4 T - lymphocytes
HHV-6: Pathogenesis
The virus will grow well in the CD4 T - lymphocytes and can also replicate in
- B-cells
- cells of glial
- fibroblastoid
- megakaryocyte origin
HHV-6: Pathogenesis
important cellular receptor
HUMAN CD46
HHV-6: Clinical Manifestation
Roseola infantum, or “sixth disease” of childhood
Exanthem Subitum
HHV-6: Clinical Manifestation
exanthem subitum are mild common childhood disaese characterizeed by?
high fever and skin rash
HHV-6: Clinical Manifestation
reactivation is common in?
transplant patients and during pregnancy
HHV-6: Clinical Manifestation
reactivation is common in transplant patients and during pregnancy and may cause
encephalitis, pneumonitis, or chorioretinitis
Lab Diagnosis: HHV-6
basis for diagnosis?
Clinical findings
Lab Diagnosis: HHV-6
TOF
Culture- practical
F (not practical)
Lab Diagnosis: HHV-6
Lab Diagnosis: HHV-6
TOF
kantology — IgM (present infection) and IgG (past infection)
F (serology)