Aani Micro: Herpes Flashcards
Where is VZV stored as a latent infection?
Dorsal Root ganglia
What are the symptoms of shingles?
Painful rash in specific dermatone
What is the treatment of shingles?
800mg Acyclovir 5 times a day OR 250mg Famciclovir TDS OR 1000mg Valacyclovir TDS
What is the spread of Herpes infection HSV1/2?
Mucocutaneous
What is the spread of VZV?
Droplet infection
Describe the genetic make up of Herpes?
double stranded DNA
Which Herpes strain most commonly causes herpes encephalitis?
HSV1
Which Herpes strain most commonly causes Mollaret’s Meningitis?
HSV2
What is another differential for Cold sores?
Could be Herpangina (hand foot and mouth in adults- caused by Coxsackie A)
What genital symptoms do you get from Herpes Simplex?
Pain
Rash
Sacral Radiculomyelitis (urinary retention)
What eye symptoms can you get from HSV if you are immunocompromised?
PORN
Progressive Outer Retinal Necrosis
Which trimester is associated with transmission of HSV to foetuses?
Third
What treatment do you give if a mother has HSV and is pregnant
TO MOTHERS. Give oral or IV Acyclovir 6weeks before EDD
What will you see in CSF if someone has Herpes enceph or molarett’s meningitis?
Raised protein
Treatment of Herpes Enceph/Molarett’s meningitis?
STAT IV Acyclovir 10mg/kg
THEN
Oral Acyclovir for 2-3 weeks
What are scrum pox?
Herpes Simplex skin lesions on the face caused by skin contact e.g. scrumming in Rugby
What other skin lesions can you get from Herpes Simplex?
Red painful finger (Whitlow)
Erythema Multiforme
Eczema Herpeticum
Which strain of herpes is in the Varicella Zoster vaccine?
Oka Strain
Describe the skin rash in VZV?
Vesicles - droplet (raindrops on roses_)
What cells will be present in VZV infection?
Multinucleated giant cells i.e. Tzanck Cells
What symptoms can a baby get if they have congenital varicella syndrome?
Cataracts
Psychomotor Retardation
Hypoplastic limbs
Who should you treat for VZV? and How?
Adults neonates Immunocompromised People with painful symptoms People with eye-involvement
Treat with 800mg Acyclocvir PO TDS 1 week
What are the 3 broad categories of Herpes Virus? And the viruses within them?
Alpha- HS1, HS2 and VZV
Beta- CMV, HH6 and HH7
Gamma- HH8 and EBV
What do HH6 and 7 cause?
Roseola Infantum i.e. 6th disease i.e. Exanthum Subitum
What can HH8 cause?
Castleman’s Syndrome (benign LN growth)
or
Kaposi’s Sacrcoma
Which cells will you see in Kaposi Sarcoma?
Spindle Cells
AND
Kaposi Sarcoma Herpes Virus Cells (KSHV)
What can EBV become?
In immunocomp when T cells cannot keep B cells in check, there is uncontrolled B cell prolif and you can get Post Transplant Lymphoprolif disease (PTLD) or Burkitt’s Lymphoma
What is the Tx of EBV?
In immunocomp: Rituximab for Lymphoma and PTLD
What type of infection is EBV?
Mononucleosis
Tx of HH8?
Ganciclovir
2nd line: Foscarnet or cidofovir
Tx of HH6/7?
Ganciclovir
2nd line: Foscarnet or cidofovir
Which of the alpha Herpes Virus is most/least sensitive?
Most: HSV1
Least: VZV (high medication dose needed)
Which cells do you get in CMV?
Owl Eye Inclusion bodies
Monocucleosis
Swollen large cells hence ‘megalovirus’
What symptoms can you get in CMV if you are immunocompetent?
80% asymptomatic
Fever, SOB, penumonia
What symptoms can you get in CMV if you are immunosuppressed?
Retinitis (haemorrhagic exudate changes)
Tx of CMV?
1st: ganciclovir or valganciclovir
2nd: foscarnet or cidofovir
Investigations for CMV?
Blood- owl eye inclusion bodies
Paul Bunnel Ab test- clumping of sheep RBCs
Which conditions does Paul Bunnell Test identify? (positive clumping of sheep RBC)
EBC and CMV
Which cells do CMV stay latent in?
B Lymphocytes
Which cells do HH6 and HH7 Stay latent in?
Monocytes/T cells/ epithelial cells
Which people get Burkitt’s lumphoma? What do they look like?
African kids with big jaw
Treatment of Burkitt’s Lymphoma?
Rituximab
Which virus can cause Burkitt’s Lymphoma?
EBV
