DNA viruses Flashcards
HHV1
HSV 1: oral herpes labialis, gingivostomatitis, keratoconjunctivitis, temporal lobe encephalitis
less common- genital herpes
dormant in sensory neurons - Trigeminal ganglia
immune system keeps it in check
HHV2
HSV2: genital herpes
multiple painful vesicles
latent infections - sacral nerve root ganglia
sexual contact –> ANY mucosal surface
Infants: transmission via birth
- mom primary infection while pregnant - inutero or birth
- active infection –> c-section
HHV3
Varicella-Zoster Virus (VZV)
primary infection - chicken pox, encephalitis, pneumonia
-contact respiratory route
Reactivation - Herpes Zoster (shingles) - grouped vesicles in dermatomes, u/l. NEVER crosses midline
- direct contact w/ lesions
latent in dorsal ganglia after primary infection
Herpes Zoster ophthalmicus: V1 distribution
-cornea –> blindness
Disseminated Herpes needs isolation - can spread via ventilation system
Tzanck smear
scrape base of open vesicle –> slide w/ stain
multinucleated giant cells =+
Intranuclear eosinophilic inclusions - Type A cowdry body
HSV1, HSV2, VZV
Old test, use PCR now
EBV associated malignancies
Hodgkin lymphoma Burkitt lymphoma Nasopharyngeal carcinoma diffuse large B cell lymphoma Oral hairy cell leukoplakia lymphoproliferative disorders
HHV4
EBV –> infectious mononucleosis
oral secretions
latent in B cells
15-24 yo
Infect B cells –> large T cell response (CD8) –> atypical lymphocytosis
Downey cells - T cells with foamy appearance to cytoplasm
Mononucleosis
EBV
fever, sore throat, posterior cervical LAD
Exudative pharyngitis (like strep)
Splenomegaly
Amox –> maculopapular rash of trunk and extremities
can be pruritic
20% have strep too
-need other tx besides amox
Dx: monospot - detects heterophile Abs
- Ab against ag on horse, hseep, beef RBCs
- high sensitivity/specificity
Heterophile negative mono-like syndrome
CMV infection Acute HIV Acute toxoplasmosis Viral hepatitis Strep throat
HHV5
Cytomegalovirus - MC TORCH infection
Congenital spread
Infected body fluids- saliva, breask milk
Heterophile negative mono
life threatening pneumonia in bone marrow transplant patients
AIDS - retinitis, GI ulcerations
Intranuclear inclusion: Owl Eye
HHV6
Roseola in children less than 2 yo
“sixth dz”
Exanthem subitum
3-5 days of high fever over 102F
–> diffuse maculopapular rash
Complications: febrile seizure
latent infection
HHV7
most have it by age 5
causes roseola like infection
life long latent infection
HHV8
Kaposi sarcoma associated herpesvirus
only 5% of total US population is infected w/ virus
men who have sex with men- higher virus prevalence
Infect spindle cells coming from vascular and lymphatic endothelial tissue
causes high vascular tumors - purplish appearance on skin
Kaposi sarcoma tumors
Cutaneous tumors MC –> erythematous or violaceous skin lesions
can affect GI and lung (hemoptysis)
Tx:
HAART
Topical: vinblastine
Liposomal anthracyclines: daunorubicin, doxorubicin
Classic KS: slow growing tumor w/o potential of mets
Epidemic: HIV/AIDs pts
Immunocompromised: transplant pts
Aggressive need chemo
in AIDS/HIV aggressively treat HIV
Parvovirus
ssDNA
B19 infects humans
sickle cell patients –> aplastic crisis
Kids –> erythema infectious (5th dz)
-slapped cheek rash
Adult –> inflammatory arthritis - like RA
Inutero - TORCH
–> hydrous fettles and miscarriage
Human papillomavirus
HPV 1, -2: common warts of keratinized skin
HPV 6, -11: genital warts
HPV 16, 18: invasive cervical cancers, vulvovaginal, anal, penile, and head and neck cancers
