2: Viral Infections Flashcards
What does VZV cause
Children: chickenpox
Adults: shingles
How is VZV transmitted
Respiratory droplets
How does chickenpox present
Fever and prodrome for 1-2d, then pruritic erythematous rash with crusts
How does shingles present
Maculopapular rash in singre dermatome
What is herpes zoster opthalmicus
Herpes zoster affecting the ophthalmic division of the trigeminal nerve
how does herpes zoster opthalmicus present
- Vesicular rash in distribution of opthalmic branch that may or may not involve the eye
what sign strongly indicates ocular involvement
Hutchinson sign = rash on tip of the nose
why does hutchinson sign strongly indicate ocular involvement
Hutchinson sign indicates nasociliary involvement which is a strong predictor of ophthalmic involvement
how is herpes zoster opthalmicus managed
PO acyclovir
how soon should anti-virals for herpes zoster be started
72h
when is IV anti-virals given in herpes opthalmicus
Immunocompromised patient or severe infection
Aside from acyclovir, what is given in herpes opthalmicus
Topical Steroids - to reduce infection
If an individual has hutchinson sign what do they required and why
- Urgent ophthalmological review - as they likely have involvement of ocular nerve
What is herpes zoster oticus also known as
Ramsay Hunt Syndrome
what causes herpes zoster oticus
Re-activation Herpex soter virus in the geniculate nucleus of the seventh cranial nerve
what is the first clinical feature of Ramsay-hunt
ocular pain
how else does Ramsay-hunt present clinically
- vesicular rash inside the ear
- facial nerve palsy
- vertigo and tinnitus
how is Ramsay hunt syndrome managed
oral acyclovir and corticosteroids
how is VZV managed
oral acyclovir in 48h of symptom onset
who is VZV vaccine offered to
elderly people over-70
what is a complication of VZV
post-hepatic neuralgia = pain in region rash previously was
what is EBV also known as
HHV4
What two things can EBV cause
infectious mononucleosis
hairy leukoplakia
in which patients does infectious mononucleosis tend to occur in
adolescents
what is the triad of symptoms in EBV
- Sore throat
- Lymphadenopathy
- Pyrexia
what are other symptoms of EBV infection
- Splenomegaly
- Petechial rash
- Hepatitis
- Haemolytic anaemia secondary to cold agglutinins
how does hepatitis present
- Raised ALT
what will amoxicillin in 99% of people with EBV cause
maculo-papular rash
how is EBV diagnosed
- Hetrophil antibody test (Infectious monospot)
what will be seen on FBC
Leucocytosis
how is EBV managed
Rest
Fluid
Avoid alcohol
Analgesia
what should patients with EBV avoid doing and why
Contact sports for 8W due to risk of splenic rupture
what does EBV increase risk of
- Hodgkin lymphoma
- Burkitt lymphoma
- Nasopharyngeal cancer
- B cell lymphoma
- Gastric cancer
- Post transplantation lymphoma
what does HHV6 cause
Roseola infantum
what does HHV8 cause
Kaposi sarcoma
Primary effusion lymphoma
