Dr. Trump Virus lecture Flashcards
Herpes simplex virus type 1
spread primarily through saliva or active perioral lesion
Herpes simplex virus type 2
spread primarily through sexual contact
if you are younger than 18 and you get HSV-1 what is the clincial presentation going to be called?
gingivostomatitis
if you are older than 18 and you get HSV-2 what is the clinical presentation going to be called?
pharyngotonsillitis
Primary herpes-acute herpetic gingivostomatitis
- most common pattern of primary HSV-1 infection
- most cases are before age 5
- affected mucosa develops pinhead vesicles that rapidly collapse and form small red lesions
- initial lesions enlarge and develop central areas of ulceration covered by yellow fibrin
- adjacent ulcerations coalesce
primary herpes-acute herpetic gingivostomatitis presentation in oral cavity
- on both movable and attached oral mucosa
- gingiva looks enlarged, painful, and extremely erythematous
- can spread onto vermillion
- self inoculation of fingers, eyes can occur
primary herpes-pharyngotonsillitis symptoms
sore throat
fever
headache
primary herpes-pharyngotonsillitis presentation
numerous small vesicles develop on tonsils and posterior pharynx
- rapidly rupture to form shallow ulcerations which coalesce
- diffuse, gray-yellow exudate forms
- can be due to HSV-1 and HSV-2
recurrent Herpes simplex aka secondary herpes
can occur anywhere along the surface epithelium supplied by the involved ganglion(trigeminal)
most common site of recurrence for HSV-1 is where?
vermilion border and adjacent skin of the lips
- herpes labialis
- cold sore
- fever blister
- usually will have prodrome 24 hr b4 lesion
what can cause a recurrence
age stress pregnancy allergies trauma illness UV-only condition to induce lesion experimentally -immunosuppression
recurrent herpes simplex- intra oral lesions
almost ALWAYS on keratinized, bound mucosa
-palate, and attached gingiva
are symptoms less or more intense than primary infection?
less
presentation of secondary intra oral herpes lesions
begin as 1-3 mm vesicles
- rapidly collapse to form a cluster of erythematous macules that coalesce and slightly enlarge
- damaged epithelium is lost
- central, yellowish area of ulceration
- heals in 7-10 days
HSV-1 less common presentation
-herpetic whitlow(herpetica paronychia)
infection of the thumb or fingers
HSV-1 less common presentation
-herpes gladiatorum or scrumpox
herpetic infection found in wrestlers or rugby players with contaminated abrasions
HSV-1 less common presentation
-herpes barbae
herpes over the bearded region of the face into minor injuries created by daily shaving
histopathologic features of HSV
ballooning degeneration
multinucleation
Tzanck cells
Varicella-zosters virus
chickenpox is primary infection
herpes zosters (shingles) is recurrence
-spreads through air droplets or direct contact w/acitve lesions
-most cases of primary between ages of 5-10
-90% infected by age 15
Shingles
occurs in 20% of those who had chicken pox
prevalence increases with age
-single recurrence
shingles oral lesions
occur with trigeminal nerve involvement
present on movable or bound tissue (diff than HSV)
lesions extend to midline and stop
important things to look for in shingles
if the tip of the nose is involved, it is a sign ocular infection may occur
*referral to ophthalmologist is mandatory if pt experiences these lesions
what is Ramsay Hunt Syndrome
cutaneous lesions of the external auditory canal with shingles
- involvement of ipsilateral face and auditory nerves
- facial paralysis
- hearing deficits
- vertigo
HHV-8
Kaposi’s sarcoma herpesvirus (causes cancer)
primary infection via sexual contact
-asymptomatic primary infection
-associated with a variety of lymphomas and Castleman’s disease
HHV-6
creates specific pattern called roseola
HHV-7
similar to HHV6
In HHV-6 and HHV-7 where does primary latency reside?
in CD4 lymphocytes
-recurrences can result in widespread multiorgan infection
HHV-4
epstein barr
HHV-5
cytomegalow virus
facts about the herpes virus
- humans are only natural reservoir
- all types cause primary infection and remain latent within specific cell types for life
- virus is shed in saliva or genital secretions
