4: Microbiology - viral skin infections Flashcards
Which virus causes both chicken pox and shingles?
Varicella zoster virus
What is chicken pox also known as?
Varicella
What is shingles also known as?
Herpes zoster or zoster
What kind of virus is varicella zoster?
Part of the herpes family
When do patients typically get chicken pox?
Childhood
What is the presentation of chicken pox?
Distinctive red macular > papular > vesicular rash which then scabs over without scarring
After the first infection, varicella zoster virus becomes ___ within the body.
latent
When do patients typically develop shingles?
Why?
Late in life / immunosuppressed
Virus reactivates and immune system cannot deal with it
Where do varicella zoster viruses sit when they are latent?
What happens when they reactivate?
Dorsal sensory nerve
Same presentation as chicken pox in ONE DERMATOME only (i.e shingles)
Chicken pox rash is centripetal. What does this mean?
Primarily found on the trunk
What are other symptoms of chicken pox, apart from the rash?
Pruritus
Pain
What are some complications of chicken pox?
Secondary infection e.g pneumonia
Haemorrhage
Scarring
Encephalopathy (spread to the brain)
Why is shingles rash so distinctive?
Dermatomal, meaning it’s restricted to one or more dermatomes and is found on one side of the body usually
Who tends to develop shingles?
Elderly
Immunocompromised
What occurs in addition to the rash of shingles?
Tingly pain
If pain persists four weeks after a shingles infection, what is it called?
Post herpetic neuralgia
What are the three divisions of the trigeminal nerve (CN V)?
V1 - opthalmic division
V2 - maxillary division
V3 - mandibular division
If a patient has shingles affecting the opthalmic division of their trigeminal nerve, where will the rash be?
On the face (unilaterally), affecting the forehead and eye down to the bridge of the nose
Who should a patient with opthalmic zoster be referred to?
Opthalmologist
Why could children develop shingles?
Mother had chicken pox in utero
Immunocompromised
Adults tend to get herpes zoster in their ___ and ___ nerves.
Children tend to get herpes zoster in their ___ and ___ nerves.
(cervical, thoracic, lumbar, sacral)
thoracic , lumbar
cervical , sacral
What is Ramsay-Hunt syndrome?
What are the possible symptoms?
VSV in the 7th and 8th cranial nerves
Facial palsy, deafness, tinnitus
Which kind of vaccine is used to prevent chickenpox?
Live attenuated
alive, but less virulent
How is shingles vaccinated against?
The same live attenuated chicken pox vaccine