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Microbiology II > Adenovirus and Herpes Family (Dustin) > Flashcards

Adenovirus and Herpes Family (Dustin) Flashcards

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Biology 101 flashcards
1
Q

Adenovirus:

  • Morphology, Characteristics
  • Pathogenesis
  • Transmission
  • Diseases
A
  • dsDNA, icosahedral, non-enveloped (“naked”). 49 serotypes.
  • Has penton fiber to attach to cells and agglutinate RBCs (haemagglutinin)
  • Respiratory droplets, contact (towels), fecal-oral
  • Diseases:
    1. Respiratory (pharyngoconjunctival fever, ARDS, pertussis-like syndrome, pneumonia)
    2. Eye infection (epidemic keratoconjunctivitis)
    3. Enteric infection (gastroenteritis, diarrhea. serotypes 40, 41)
    4. Infections in immunosuppressed patients (hepatitis, pneumonia)
    5. Acute hemorrhagic cystititis: dysuria, hematuria occurs in boys
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2
Q

Adenovirus:

  • Diagnosis
  • Vaccine?
  • Treatment
  • Any other special features
A
  • Diagnosis: cultivation: HeLa cell culture, cytopathic effect (CPE). Serology, ELISA.
  • Vaccine: live, attenuated vaccination. Only for US military.
  • Treatment: none
  • Special feature: used in gene therapy, recombinant adenovirus
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3
Q

HSV-1 and HSV-2:

  • Morphology, Characteristics
  • Pathogenesis
  • Transmission
  • Clinical picture
A
  • dsDNA, icosahedral capsid. Enveloped. 150nm.
  • Enters through skin or mucosa. Cytolytic virus, local inflammation. Acute infection -> latency -> recurrence. Reactivation due to stress, pregnancy, UV-light.
  • Transmission: HSV-1: Saliva. HSV-2: Vaginal secretions, vesicle fluid. Autoinoculation in eye.
  • Painful, clear vesicle on erythematous base (“dew drop on rose”). Pustular crusted lesions. Recurrent attack usually less severe. Disseminated in immunocompromised
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4
Q

HSV-1 Diseases

or at least ones that are primarily in HSV-1; many of them can be in HSV-2 too

A
  • Herpes labialis / cold sore (also HSV-2)
  • Herpetic gingivostomatitis
  • Herpes pharyngitis
  • Herpetic keratitis, keratoconjunctivitis
  • Herpetic whitlow (on fingers) - more common in dentists
  • Herpes simplex encephalitis (HSE)
  • Erythema multiform: appears 1-2 weeks after infection
  • Herpes gladiatorum: occurs in wrestlers; herpes sores on skin in general
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5
Q

HSV-2 Diseases:

A
  • Genital herpes
  • Neonatal herpes after infection during delivery. Sores become dessiminated.
  • Aseptic meningitis in neonates
  • Most of the same ones in HSV-1 card
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6
Q

HSV-1 and HSV-2:

  • Diagnosis
  • Treatment
A
  • Diagnosis: 1. DFA (Direct fluorescent antibody). 2. Tzanck smear to see multinucleated giant cells. 3. CPE test with HeLa, Hep-2 cells: become enlarged with ballooning cytoplasm
  • Treatment: acyclovir, valacylovir. These are nucleoside analogues that alter base recognition and pairing, terminating the viral DNA chain elongation
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7
Q

Epstein-Barr Virus (EBV):

  • Morphology, Characteristics
  • Pathogenesis
  • Transmission
  • Diseases (just the names. Details in other cards)
A
  • dsDNA, icosahedral capsid. Enveloped. Herpes family.
  • Pathogenesis: infects nasopharyngeal epithelial cells, salivary glands, and B cells. B cell effect: Binds CD-21, stimulates growth of and immortalizes B cells, altered B cells induce atypical Tc cells (Downey cells)
  • Transmission: Saliva

-Diseases: Infectious mononucleosis (“mono”), Burkitt lymphoma (Africa), nasopharyngeal carcinoma (Asia), Hodgkin B cell lymphoma.
Hairy leukoplakia may be seen in immunodeficient patients (NOT precancerous).

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8
Q

Infectious mononucleosis:

  • Causes
  • Population affected
  • Symptoms
  • Diagnosis
  • Treatment
A
  • Causes: EBV or CMV
  • Occurs in young adults
  • Symptoms: Exudative pharyngitis, fever, fatigue, lymphadenopathy, hepatosplenomegaly. Lymphocytosis occurs - must distinguish from leukemia. “Ampicillin rash” on 8th day: occurs if mistakenly taking antibiotic
  • Diagnosis: Paul-Bunnell antigen on sheep RBC test: EBV is heterophile-antibody positive (causes agglutination), while CMV is negative.
  • Treatment: just reduce symptoms. Avoid contact sports because of risk of splenic rupture.
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9
Q

Role of EBV in Burkitt lymphoma

A

t(8;14) translocation that activates c-myc oncogene

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10
Q

HHV-6:

  • Morphology, Characteristics
  • Transmission
  • Pathogenesis
  • Diseases
  • Diagnosis
  • Treatment
A
  • Human Herpes Virus 6, Roseola. linear dsDNA, icosahedral capsid. Enveloped, derived from nuclear membrane. Contains intranuclear inclusion Cowdry bodies.
  • Transmission: respiratory droplets
  • Pathogenesis: infects peripheral mononuclear cells, mainly Th.

-Disease: Roseola (exanthema subitum). High fever for 3-5 days (“3 day fever”), followed by generalized maculopopular rash that spares the face. Can involve seizures. Primarily 6 months - 2 years old.
Diagnosis based on symptoms, treatment is supportive

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11
Q

HHV-7:

  • Morphology, Characteristics
  • Transmission
  • Pathogenesis
  • Diseases
A
  • Herpes family, roseola genus. dsDNA, icosahedral capsid. Enveloped.
  • Transmission: saliva
  • Pathogenesis: replicates in CD4+ T cells, uses CD4 receptor. Can reactivate latent HHV-6 genome.
  • Diseases: Most importantly can cause or help HHV-6 in Roseola infantum / exanthema subitum. Other syndromes: Pityriasis rosea (“herald patch”), Gloves-and-Socks Syndrome (papular purpura)
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12
Q

HHV-8:

  • Morphology, Characteristics
  • Transmission
  • Pathogenesis
  • Diseases
  • Diagnosis
  • Treatment
A
  • Herpes family, dsDNA, icosahedral capsid. Enveloped
  • Transmission: sexual contact, saliva, vertical transmission
  • Pathogenesis: gene activates VEGF, causing excessive angiogenesis seen in Kaposi sarcoma
  • Diseases:
    1. Kaposi Sarcoma: erythematous violet lesions on nose, extremities, mucous membranes (esp. hard palate). Plaques, patches, macuoles or nodules. Note: distinguish it from Bacillary Angiomatosis. Common in AIDS/ immunosuppresed, but also some elderly Eastern European/ Mediterranean/ African men
    2. Primary Effusion B cell Lymphoma (less important)
  • Diagnosis: clinical signs, PCR, serology.
  • No treatment
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13
Q

VZV: Varicella-Zoster Virus

  • Morphology, Characteristics
  • Transmission
  • Pathogenesis
A
  • Herpes family, linear dsDNA, icosahedral capsid. Enveloped.
  • Transmission: respiratory droplets, vertical
  • Pathogenesis: Enters resp tract -> replicates in lymph nodes -> enters primary viremia and goes to spleen and liver -> enters secondary viremia and goes to skin to create typical rash. Remains latent in dorsal root ganglia, reactivated in stress or immunocompromised state.
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14
Q

VZV: Varicella-Zoster Virus:

4 Diseases

A
  1. Chickenpox: in children causes itchy rash, fever, pharyngitis, malaise, rhinitis. In adults causes pneumonia and encephalitis.
  2. Shingles/Herpes Zoster: 50-60 y/o or immunocompromised: painful vesicles similar to HSV but confined to one dermatome
  3. Herpes Zoster Opthalmicus: CN V1 is affected
  4. Congenital Varicella: limb hypoplasia, cutaneous dermatological scarring, and blindness
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15
Q

VZV: Varicella-Zoster Virus:

  • Diagnosis
  • Treatment
  • Prevention
A
  • Diagnosis: Tzanck smear: Cowdry type A, giant cells. PCR
  • Treatment: Acyclovir for shingles. Do not give children with chickenpox aspirin because of risk of Reye’s syndrome
  • Prevention: Live attenuated vaccine for children and seniors. Seniors get booster shot. VZIg available for immunocompromised
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16
Q

CMV: Cytomegalovirus

  • Morphology, Characteristics
  • Transmission
  • Pathogenesis
A
  • Herpes family, linear dsDNA, icosahedral capsid. Enveloped.
  • Transmission: saliva, sexual partners, organ transplants, blood, in utero (vertical)
  • Pathogenesis: Infects salivary gland epithelial cells, establishing persistent infection. Latency established in mononuclear leukocytes (B and T cells, macrophages)
17
Q

CMV: Cytomegalovirus

3 Diseases

A
  1. Immunocompetent: causes infectious mononucleosis (like EBV), but heterophile antibody neg with the Paul-Bunnel test
  2. Immunosuppressed patient: severe infection with pneumonitis, retinitis, colitis, esophagitis
  3. Congenital infection (C in TORCH): liver problems (hepatosplenomegaly, jaundice), microcephaly, intracerebral calcifications, hearing loss. It’s a major risk if mother is having primary infection during her pregnancy
18
Q

CMV: Cytomegalovirus:

  • Diagnosis
  • Treatment
  • Prevention
A
  • Diagnosis: Cell culture CPE: “owl eye” intranuclear inclusion body. PCR. Antigen detection: IF.
  • Treatment: Ganciclovir
  • Prevention: no vaccine yet. Most people are infected.

Microbiology II (8 decks)

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