Common Viral Diseases

Question 1

Class I - double stranded DNA

Answer 1

Papovavirus (warts, cervical cancer)
Adenovirus (respiratory diseases)
Herpesvirus (cold sores, genital herpes, chicken pox, mononucleosis)
Poxvirus (smallpox, cowpox)

Question 2

Viral exanthematous diseases

Answer 2

Chickenpox/Herpes zoster
Infectious mononucleosis
Roseola infantum (Sixth Disease or Erythema subitum)
Fifth disease (Erythema infectiosum)
Measles
Rubella
Enteroviral exanthems:
Coxsackievirus
Echovirus

Question 3

Herpes simplex Clinical Presentation

Answer 3

Dew-drop on rose petal
Oral-facial lesions
Primary infections: Gingivostomatitis and pharyngitis most frequent
children and young adults
Fever, malaise, myalgias, inability to eat
Recurrence: Herpes labialis (“Cold Sores”)

Question 4

Herpes simplex Diagnostics

Answer 4

The diagnosis can be made by viral culture, polymerase chain reaction (PCR), direct fluorescence antibody, Tzanck preparation, and type-specific serologic tests

Question 5

CMV Clinical Presentation

Answer 5

Congenital CMV (Cytomegalic inclusion disease)
Ranges from inapparent infection (most) to severe/disseminated (~5%)
Petechiae, hepatosplenomegaly, jaundice common (60-80%)
Microcephaly, growth retardation, prematurity (30-50%)
Perinatal CMV
CMV Mononucleosis

Question 6

Fifth Disease (Erythema infectiosum)

Answer 6

Human Parvovirus B19

Classic “slapped face” lesion: indurated, confluent erythema of the cheeks, fiery red

Question 7

Roseola (infantum)

Answer 7

HHV6 – b-cell lymphotropic virus
Major cause of infantile febrile seizures
Rash appears several hours after sudden drop in temperature

Question 8

Measles (Rubeola) Clinical Presentation

Answer 8

Acute febrile eruption following 9-11 days incubation (2 weeks until rash eruption)
Prodromal (lasts 1-8 days; average 3-4d): malaise, irritability, fever (up to 105F), conjunctivitis with increased lacrimation, edema of eyelids, photophobia, hacking cough, rhinorrhea
KOPLIK SPOTS
Brick red, irregular maculopapular rash

Question 9

Rubella (German Measles; 3-day Measles)

Answer 9

Caused by Togavirus
Rash appears 14-21 days after exposure and follows same pattern as rubeola
Lymphadenopathy
IMMUNIZE PREGNANT MOM

Question 10

Mumps

Answer 10

A paramyxovirus
Parotitis: parotid swelling (salivary adenitis) is first indication of illness and usually occurs suddenly
Epididymoorchitis

Question 11

Viral respiratory infections

Answer 11

Common cold viruses: Rhinovirus, Coronavirus, Adenovirus
Influenza-like illnesses: , Influenza A virus, Influenza B virus
Brochiolitis: Respiratory syncytial virus (RSV)
Croup: Parainfluenza virus

Question 12

Major antigenic shifts occurs regularly:

Answer 12

Type A viruses about every 3 years

Type B viruses about every 5 years

Question 13

Bronchiolitis (RSV)

Answer 13

Commonly presents as rhinorrhea, low-grade fever, cough, wheezing, mild systemic symptoms

Question 14

Croup

Answer 14

Caused by the parainfluenza viruses: 4 major serotypes
a “barking” cough.
Croup is much worse at night

Question 15

Croup Management

Answer 15

Cool or moist air can bring relief. 
bring child into a steamy bathroom or outside into the cool night air.
Tylenol
ER treatment:
Aerosolized Racemic Epinephrene
Predisone in ER and to go (oral)

Question 16

Variola Versus Varicella: Differential Diagnosis

Answer 16

Variola:
Rash starts face
Lesions same stage
Deep lesions
Often palms/soles

Varicella:
Rash starts trunk
Lesions in crops
Superficial lesions
Never palms/soles