Class: Herpes Virus: CMV, EBV, HHV6-8 Flashcards
How is EBV associated infectious mononucleosis transmitted?
saliva
What is incubation time for EBV associated infectious mononucleosis
30-50 days
What are the 3 major sxs of EBV associated infectious mononucleosis
Triad for IM-lymphadenopathy, fever, pharyngitis
major complications of EBV associated infectious mononucleosis (4)
i. Hemolytic anemia- dt auto-antibodies
ii. Thrombocytopenia- unclear etiology
iii. Neutropenia- mild, self-limiting
4. Neurologic complications <1% (85% recover completely)
What happens to 80-90% of IM patients who take ampicillin for EBV IM?
rash from a hypersensitivity reaction
X-linked lymphoproliferative disease is marked by increased what?
abnormally high numbers B cells, T cells and macrophages
What can be result of X-linked lymphoproliferative disease (2)
fulminant hepatitis, or develop hemophagocytic lymphohistiocytosis.
What causes X-linked lymphoproliferative disease?
inability of the body to effectively control EBV replication
How is EBV IM diagnosed?
monospot test
What does the monospot test detect?
heterophile antibodies
If monospot test is negative what is the cuase of IM
CMV
WHat oral infx is caused by EBV
oral hairy leukoplakia
What distinguishes Oral Hairy Leukoplakia from candidiasis
OHL can’t be scraped off tongue
how is CMV is transmitted
Saliva, urine, semen, cervical secretions breast milk trasnplants Stem cells sexual
What disease doe CMV cause in normal immune people
heterophile (-) infectious mononucleosis
how is congenital CMV is transmitted.
32% risk of congenital transmission if there is a primary infection of CMV during pregnancy
if already seropositive - 1% risk of congenital infection
How it cCMV diagnosed and in what time frame? (2 ways)
Saliva (1 hour after nursing) and/or urine PCR test within 3 weeks of life.
What percent of cCMV infants show symptoms at birth?
10%
common sx of cCMV? (5)
petechiae jaundice hepatosplenomegaly microcephaly hearing loss
if symptomatic at birth, what are sequelae (3)
higher risk of long term sequelae
1) Sensorineural hearing loss = #1 sequelae
2) Cognitive defect/intellectual defect
3) Vision loss
if symptomatic at birth, what are sequelae (3)
1) Sensorineural hearing loss = #1 sequelae
2) Cognitive defect/intellectual defect
3) Vision loss
What is the most serious complication of CMV infx in SOT and HSCT pts?
Pneumonitis - has a very high mortality (84%) rate
How to manage CMV infx in highly susceptible groups
Prophylaxis -ganciclovir or valganciclovir
What are two things serology detects in CMV test and problem with one of them
IgA - can last several months so can’t show acute infx
IgM
