Chapter 3.27 Herpesviridae Flashcards
What are 3 generalities of herpesviridae?
- Can develop a latent state
- Form multinucleated giant syncytial cells with intranuclear inclusion bodies
- Help at bay by cell-mediated immune responses
Where do primary viruses of herepesviridae migrate and reside?
sensory ganglia
*stay there until reactivation from stress and then they migrate to peripheral skin
What group of herpesviridae cause cell destruction?
alpha sub group viruses (herpes simplex virus 1 and 2 and varicella-zoster
*resulting in blisters
What virus is part of the beta subgroup of herpesviridae?
CMV
What virus is part of the gamma subgroup of herpesviridae?
Epstein-Barr virus
Who is more likely to suffer from herpesviridae?
patients with compromised cell-mediated immune status
How are Herpes Simplex Viruses 1 and 2 transmitted?
direct inoculation of muco-cutaneous surfaces
ex. orpharynx, cervix, conjunctivae, cracks in skin
What are some clinical manifestations of HSV 1 and 2?
Gingivostomatitis Genital Herpes Herpetic keratitis Neonatal Herpes Herpetic Whitlow Disseminated Herpes Encephalitis
What is the clinical presentation of Gingivostomatitis?
painful swollen gums and mucous membranes
fever and systemic symptoms
*resolve in about 2 weeks
What is the clinical presentation of Genital herpes?
Early signs- fever, headache, vaginal and urethral discharge, enlarged lymph nodes
Later signs- blisters and painful or painless ulcers
What is the clinical presentation of Herpetic keratitis?
corneal blindness
What is the clinical presentation of Neonatal herpes?
congenital defects or intrauterine death
What is the clinical presentation of Herpetic Whitlow?
HSV infection of the finger- painful, bright red, hot and swollen
What is the clinical presentation of Disseminated Herpes?
extensive mucocutaneous infections to liver, lung, GI tract in immune compromised patients
What is the clinical presentation of Encephalitis from HSV?
*HSV-1 is the most common cause of viral encephalitis in the US
sudden onset of fever and focal neurological abnormalities
What organisms can cross the blood-placental barrier?
TORCHES TO: TOxoplasmosis R: Rubella C: Cytomegalovirus HE: HErpes, HIV S: Syphilis
What diseases are caused by Varicella-Zoster Virus (VZV)?
varicella (chicken pox) and herpes zoster (shingles)
**chicken pox is not caused by pox viridae!
Who is varicella most common in?
children
*after resolution, virus remains latent and could get reactivated later in life
What organ system is affected in varicella?
respiratory tract and viral dissemination in the bloodstream (viremia)
What is the clinical presentation of a patient with varicella?
fever, malaise, headache followed by a rash
*Rash starts on face and trunk and spreads to the entire body
What is the appearance of the vesicles in varicella?
“dew on a rose petal”- red base with a fluid filled vesicle on top
fluid becomes cloudy, the vesicles rupture, and lesions scab over
What is the difference in lesions between chicken pox and smallpox?
Chicken Pox- superficial, not umbilicated, different stages, more common on trunk lesions
Smallpox- deep, hard, umbilicated, same stage, more common on extremities lesions
What is the clinical presentation of Zoster (Shingles)?
burning, painful skin lesions that develop over the area supplies by the sensory nerves
How is Zoster diagnosed?
patient develops a painful skin rah that overlays a specific sensory dermatome
What is the appearance of cytomegalovirus (CMV) cells?
swollen (cytomegaly), multinucleated giant cells, and intranuclear inclusion bodies
What are the 4 infectious states of CMV?
- Asymptomatic
- Congenital- one of the TORCHES that can cross the placenta
- Cytomegalovirus mononucleosis- causes mono in young adults
- Reactivation- in immunocompromised patients
What is the most common cause of viral mental retardation?
Congenital cytomegalovirus
What is the clinical presentation of a patient with congenital CMV?
mental retardation, microcephaly, deafness, seizures
What is the defining difference between EBV mononucleosis and CMV mononucleosis?
CMV mononucleosis will have “monospot negative mono”
What is the difference in CMV disease in AIDS patients vs bone marrow transplant patients?
AIDS patients- CMV viremia (in blood), CMV retinitis, and CMV colitis
Bone marrow transplant patients- develop CMV pneumonia
How can CMV be diagnosed?
- Buffy Coat- culture WBCs because thats where CMV invades
- Antigen- CMV antigen in blood
- PCR- CMV DNA in blood
What disease is caused by Epstein-Barr virus?
mononucleosis and certain cancers- Burkitt’s lymphoma and nasopharyngeal cancers
What does EBV infect in the body?
human B cells- causes uncontrolled growth
How can EBV infect immunosuppressed patients?
Latent EBV can reactivate and cause uncontrolled growth of B cell like
What is mononucleosis?
disease caused by EBV
“kissing disease”
Who is mononucleosis most common in?
young adults
What is the clinical presentation of a patient with mononucleosis?
fever, chills, sweats, headache, very painful pharyngitis, enlarged lymph nodes (from B cell proliferation), and enlarged spleens
What is shown in the blood work of a patient with mononucleosis?
- High WBC count with atypical lymphocytes* on a blood smear
- Heterophile antibody in blood- antibody against EBV
- Positive monospot test- detecting heterophile antibody
What herpesvirus causes Kaposi’s sarcoma?
HHV 8
