export_circulatory viruses ii and cmv Flashcards
CMV virus family and features
Herpesvirus
Enveloped, dsDNA
Latency occurs in monocytes
Diagnose CMV
Detection of viral DNA or virus culture from diseased tissue
Seroconversion
First line treatment of CMV
Gancyclovir
Valgancyclovir
Second line treatment of CMV
Cidofivir
Foscarnet
Gancyclovir
Converted to viral polymerase inhibitor by CMV enzymes
Valgancyclovir
Converted into gancyclovir within body, increases bioavailability
Cidofivir
Converted into viral polymerase inhibitor by cellular enzymes
More toxic than Gancyclovir
Foscarnet
Direct inhibitor of CMV polymerase
Mono-like illness
Caused by CMV
Fever, fatigue, abnormal T cells
Pharyngitis that is non-exudative (unlike in mono)
NO heterophile Ab production
Cytomegalic inclusion body disease
Congenital disease most often caused by mother contracting a primary infection during pregnancy
Symptoms of cytomegalic inclusion body disease
Hepatosplenomegaly
Jaundice
Petechiae/rash
Which viral pathogen is most common in complicating organ transplants
CMV
Prevention of CMV infection in immunocompromised patients
Donor matching
Prophylaxis or preemptive therapy with antivirals
CMV Ig
Myocarditis features
More common in adult men
May mimic MI
Most commonly associated with viral infection
Diagnose viral myocarditis
CHF with unknown origin
CXR, ECG
Biopsy - NAAT
Treatment for viral myocarditis
Manage symptoms of CHF and arrhythmias
Mumps symptoms
Swollen, tender parotid glands
Malaise/anorexia
Mumps virus family and features
Paramyxoviridae
-ssRNA
One serotype
Diagnose mumps
Parotid gland swelling for several days with no other apparent cause
Assays and serological tests are available
Treatment of mumps
Uncomplicated cases typically resolve within 10 days
Mumps prevention
Live attenuated vaccine
Part of the MMR and MMRV vaccine combinations
Kaposi’s sarcoma cutaneous lesions
Pink, purple, brown in color
Usually non-painful
Can become confluent
Increased proliferation of endothelial cells
Histological features of Kaposi’s sarcoma
Spindle morphology of cells
Four forms of Kaposi’s sarcoma
Classic
Endemic
Transplant-related
AIDS-related
Classic KS
Rare
Few lesions
Rarely life-threatening
Endemic KS
Can present like classic KS
Can be aggressive and is fatal within 3 years
Transplant-related KS
Occurs when individuals are experiencing immunosuppressive therapy for organ transplant
Lesions often resolve when immunosuppressive therapy is discontinued
AIDS-related KS
Often more widespread lesions than other KS forms
May include other symptoms (lymphadenopathy, fever, etc.)
Often fatal when lung involvement occurs
Human Herpes virus 8 (HHV-8)
Kaposi’s sarcoma-associated herpesvirus
Enveloped, dsDNA
Latent in KS lesions
HHV-8 transmission
Sexually contact
Needle sharing
Only small percentage of people will progress to KS
Treatment for HHV-8
Herpes antivirals are NOT effective because it’s in latent stage
Chemotherapy, radiation, and/or surgery
Adult T-cell lymphoma (ATL)
Lymphadenopathy
Hepatosplenomegaly
Hypercalcemia
Skin infiltration
ATL diagnostic feature
Flower cells
Diagnose ATL
Abs to Human T-cell leukemia virus 1 (HTLV-1)
HTLV-1 associated myelopathy (HAM)
Demyelination of neurons within the spinal cord
Likely autoimmune
HTLV-1 features
Infects CD4 and CD8 cells
Retrovirus
Enveloped, +ssRNA
HTLV-1 treatment
Combined chemotherapy, though it has limited effectiveness