Exam 4 skin viral infections 2 Flashcards
What are the clinical presentations of HPV?
Acute: warts (penis, vulva, cervix, fingers, hands), Chronic: asymptomatic or carcinomas
What is the pathology of HPV?
transmitted by close contact, virus infections squamous basal cells, transforming to block p53 with viral protein E6, leading to benign growth
What is the diagnosis tool of HPV?
1% acetic acid turns lesions white, colposcopy + biopsy of white lesions, PCR using viral-specific primers
What is the treatment of HPV?
50% of warms regress within 2 years, Ablation, HPV vaccine
What is the clinical presentation of MCV?
pearly skin papules and nodules
What is the pathology of MCV?
Virus transmitted by casual contact and infects epidermal cells creating large eosinophilic inclusion bodies, these enlarge, rupture, become a crater
What is the diagnosis of MCV?
clinical presentation, skin biopsy (molluscum bodies)
Treatment of MCV?
Self resolves in 6-12 moths or surgically remove lesions
What is the clinical presentation of Smallpox?
rash (begins as macules, evolves to vesicles)
What is the pathology of smallpox?
2 routes of infection: 1: inhaled, virus infects respiratory mucosa, penetrates and enters blood stream, infection internal organs, release visions to infect skin (leading to focal lesions). 2: skin infected, particles collect and replicate in the epidermis forming merciless first in head then extremities, host immune response makes vesicles, crust forms and releases infectious particles
Diagnosis of smallpox
detection of vesicular fluid, serology
Treatment of smallpox
Vaccination
Clinical presentation of Orf virus?
Exanthemous disease causing denuded lesions
Pathology of Orf virus
Zoonotic disease, humans come into contact with infected sheep, virus causes local purulent-appearing papule with usually no systemic infections.
Diagnosis of Orf virus
Case history and clinical presentation
Treatment of Orf virus
1% topical cidofovir
Clinical presentation of Varicella zoster virus
Chicken pox or shingles
pathology of varicella/zoster virus
Contracted through respiratory secretions or contact with ruptured vesicles, infects respiratory tract, after 2 weeks it establishes viremia, flu like systems, dow on a rose petal, spreads centrifugally. Stops systemic, enters nerve roots
Diagnosis of varicella/zoster virus
Clinical aspect of the rash, multinucleate giants cells on Tzanck smear of skin lesions
Treatment of varicells/zoster
supportive, acyclovir or famciclovir for sever infections, Anti-VZV immunoglobulin, vaccines (live attenuated VZV)
What can be associated with aspirin treatment during chickenpox infection?
Reye’s sydrome, liver damage and encephelomyelitis
What is the clinical presentation of HSV 1
gingivostomatitis, keratoconjuctivis, herpes labialis, temporal lobe encephalitis
What is the pathology of HSV-1?
Virus is transmitted via saliva, invades mucous membranes leading to primary local infection, becoming latent in sensory ganglia
What is the diagnosis of HSV-1?
detection of virus, multinucleate giant cells on Tzanck smear, eosinophilic cowry intranuclear inclusion bodies on skin biopsy
Treatment of HSV-1?
acyclovir, trifluridine
Clinical presentation fo HSV-2?
genital herpes or neonatal herpes
Pathology of HSV-2?
Virus invades mucous membranes leading to primary local infection, becoming latent in sensory ganglia
What is another complication of HSV-2?
Pregnant mother can transfer the virus to fetus through placenta or during delivery, leading to congenital defects, abortion, or neonatal encephalitis
Diagnosis of HSV-2?
detection of virus, multinucleate giant cells on Tzanck smear, eosinophilic cowry intranuclear inclusion bodies on skin biopsy
Treatment of HSV-2?
acyclovir, prevention (C section in infected mothers)
Clinical presentation of Roseolovirus (HHV6 and 7)
Exanthem subitum (sixth disease), reaction can occur in organ transplant pts leading to encephalitis, bone marrow suppression, pneumonitis
Pathology of Roseolovirus?
Usually in children 3 mos-3 yrs, transmitted through aerosols leading to an acute febrile illness, fine maculopapular rash on neck and trunk after fever.
When does roseolovirus peak?
Usually in the spring
How do you diagnose roseolovirus?
Clinical presentation, ELISA or indirect immunoflourescence
Treatment of roseolovirus?
ganciclovir
What are patients with Epstein-barr virus at risk for?
A rupture of their spleen due to splenomegaly
clinical presentation of epstein-barr virus
infectious mononucleosis, limpoid organ-related cancers: Burkitt’s lymphoma, nasopharyngeal cancer
What is the pathology of Epstein-barr virus?
transmitted via saliva/respiratory, infects oropharynx epithelium, infects B cells where it remains latent as episomal DNA, they then transform and multiply, creating an immune response to B cells that leads to enlarged lymph nodes and spleen
What is the diagnosis of Epstein-barr infection?
monospot test (detects heterophil antibody), blood smear, detection of certain antibodies (Anti-EBV IgM and IgG)
Treatment of epstein-barr virus
acyclovir in severe cases
what is a complication of Parvovirus B19?
chronic severe enemia
What is the clinical presentation of Parvovirus B19
erythema infectiosum, transit aplastic anemia crisis
Pathology of Parvovirus B19?
Infects nasal cavity, 6 days incubation, lysis erythroid precursor cells in bone marrow, immune complexes form leading to slapped cheeks
Diagnosis of parvovirus B19?
detect viral DNA, serology
Treatment of parvovirus B19
supportive, RBC transplant, in immunocompromised individuals: Ig transfer
What is coxsackievirus A and B also known as?
hand-foot-and-mouth disease
Clinical presentation of coxsackie A?
Herpangia, hand-foot-and-mouth disease, aseptic meningitis, paralysis, upper respiratory tract infection
clinical presentation of coxsackie B
pleurodynia myocarditis, pericarditis, aseptic meningitis, paralysis, upper respiratory tract infection
Pathology of coxsackie A and B?
Infected via aerosols or fecal oral route, virus travels to GI, virus spreads through blood stream, infecting and lysing skin and mucosal epithelium (group A), Group B travels to heart and pleural surfaces, both can travel to meninges and anterior motor neurons to cause meningitis and paralysis
Diagnosis of coxsackie
Isolate virus, serology
Treatment of coxsackie
symptomatic infections, anti-inflammatory agents, 0 antiviral or vaccines
Clinical presentation of ECHO virus
Acute febrile illness often in male children, non-specific exanthem
Pathology of ECHO virus
Fecal-oral route, salivary aerosols, can be fatal to neonates, myocarditis in adults, sometimes just non-specific illness with fever, possibly rash that spreads from face down neck and upper extremities
Treatment of ECHO virus
supportive, pleconaril
What are the two most common reasons for measles hospitalizations?
respiratory tract infections, pneumonia
What is the clinical presentation of measles virus?
Rubeola, flue-like symptoms, Koplik’s spots followed by a rash, encephalitis, subacute sclerosing panaencephalitis
Pathology of measles virus
Spread via aerosol droplets, infects and destroys epithelial cells, first and secondary viremia infecting other areas of body. infection promotes inflammation of capillaries leading to Koplik’s spots and rash
Diagnosis of the measles virus
Isolate virus from nasopharyngeal secretions, blood, urine. Warthin-Finkeldey cells in respiratory secretions, Serology.
Treatment of measles
Vaccine of a live-attenuated virus in the MMR vaccine, sever cases in infants treated w/ high doses of vitamin A
Clinical presentation of Rubella Virus
Fever followed by descending rash, congenital rubella: congenital malformations (deafness, patent ductus arteriosus, pulmonary artery stenosis, cataracts, microencephaly)
Pathology of rubella virus
Transmitted through aerosols, infects nasopharynx, replicates in local lymph node. Spreads via bloodstream, Ab reaction leads to maculopapular rash starting in face and going to extremities. Can cross placenta during first trimester and infect fetus
Diagnosis of rubella virus
detection of anti-rubella Abs, IgM if recent infection, IgG if immune. Virus in amniocentesis indicates congenital rubella.
Treatment of rubella virus
self-limiting (no anti-viral), Vaccine (MMR)
Clinical presentation of west nile virus
Fever, fatigue, headache, myalgia, anorexia, eye pain, nausea, vomiting, diarrhea, rash. Neuroinvasive disease that can cause encephalitis or meningitis
Pathology of west nile virus
Spread via mosquitos, birds, humans, Replicates in langerhans cells which go to lymph nodes and subsequent infection of multiple organs including CNS
Diagnosis of west nile virus
IgM Ab in serum or CSF, PCR of the CSF
Treatment of west nile virus
None: supportive, prevent mosquito bites
