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
Adenovirus
dsDNA virus
URI followed by conjunctivitis febrile pharyngitis acute hemorrhagic cystitis pneumonia diarrhea
Small pox
enveloped variola virus
Cow pox
vaccinia pox virus
“milk maid blisters”
provides immunity to small pox
Molluscum contagiosum
flesh colored dome shaped lesions w/ umbilication (central dimple)
benign
resolves less than 1 yr in immunocompetent
AIDS: outbreaks for skin lesions
Polyomavirus
JC Virus –> progressive multifocal leukoencephalopathy (PML) in HIV pts
