EXAM #2: MAJOR VIRAL PATHOGENS Flashcards
Where do all Herpes viruses replicate?
Nucleus
Where do Herpes viruses remain latent?
Ganglion
How is Herpes transmitted?
- Direct contact with active lesions
- Asymptomatic shedding/secretion
*Can contract Herpes from asymptomatic partner
What is the tropism for HSV-1 and HSV-2?
HSV-1= oral mucosa HSV-2= genitals
In classic HSV-1 infection, which is usually more severe, primary infection or reactivation?
Primary infection
What are the complicated HSV-1 oral infections?
1) Gingivostomatitis
2) Eczema herpeticum
3) Erythema multiforme
What type of genital lesion is associated with HSV-2?
Painful vesicular lesions
What is HSV proctitis? What patient population is this most common in?
HSV leading to inflammation of the prostate; more common in HIV patients
What is wrestler’s herpes called?
Herpes Gladiatorum
What do you need to remember about HSV eye infections?
Can damage the retina i.e. it is an emergency
What radiologic sign is associated with HSV encephalitis?
Temporal lobe enhancement
What do you need to do if you have a patient with suspected HSV encephalitis b/c of temporal lobe enhancement?
Antvirals
What is Mollaret Syndrome?
Recurrent meningitis associated with HSV
How are HSV infections diagnosed?
1) Clinical
2) Tzanck smear (multi-nucleated giant cells)
3) Culture/PCR
What causes resistance to acyclovir?
Lack of thymidine kinase
What is the major adverse effect associated with acyclovir?
Crystal-induced renal failure
What does VZV cause in primary infection? What about reactivation?
Primary= chicken pox Reactivation= herpes zoster i.e. shingles
What is the characteristic rash seen with Chickenpox?
Different stages of vesicles
How is VZV transmitted?
1) Aerosolized droplets
2) Direct contact with vesicle fluid
How do you know when VZV is no longer contagious?
All vesicles are crusted
What is the most common visceral complication of VZV?
Varicella pneumonia
*Associated with smoking, pregnancy, and immunosupression
What antiviral is used for treatment of VZV?
Acyclovir
*Vaccine prior
What is treatment of Herpes Zoster aimed at treating/ preventing?
Acute neuritis and post-herpetic neuralgia
What is the treatment for Herpes Zoster? When should treatment be started?
- Ideally, start within 72 hours
- Acyclovir
How does EBV differ from the other Herpes viruses?
Does not have a cytopathic effect; rather, transforms in cells
Where is EBV latent in the body?
B and T-cells
How does EBV infection in kids and adolescents differ?
Adolescents= infectious mono Kids= typically subclinical
What can cause a rash in EBV infection?
Ampicillin
What is the normal treatment for EBV infection?
Supportive care/ no contact sports
What lymphporliferative disorder highly associated with EBV?
HLH
How is EBV diagnosed?
1) Heterophile antibody (monospot)
2) Antibodies VCA IgG/IgM
Where does CMV remain latency?
Multiple cell types/organ tissues
What is the histologic appearance of CMV?
Large cells with internucelar “owl eye” inculsions
What does CMV cause?
CMV mononucleosis (esp. in sexually active young adults)
How is CMV treated?
Ganciclovir
What are the consequences of congenital CMV?
1) Developmental delay
2) Hearing impairment
3) Ocular abnormalities
How is CMV diagnosed?
PCR
