Fever & Lymphadenopathy Flashcards
Mononucleosis syndrome
Herpesviruses,enveloped dsDNA
Children and young adults
Transmission by respiratory secretions
Usually due to EBV: >2/3 cases Clinical presentation
Fever,Malaise,Lymphadenopathy:Cervical,submandibular, axillary, inguinal, Painful exudative pharyngitis
Hepatosplenomegaly- Filtration and clearance of pathogens; Enlarged with some infection
Mononucleosis syndrome
Labs
Downey cells
Heterophile-positive (Monospot) - EBV
Latex agglutination assay using ‘other’ species RBCs as the substrate
IgM cross-reaction
Mononucleosis syndrome complications
Splenic rupture- Rare, Limit contact sports
ACUTE RETROVIRAL SYNDROME sx
Symptoms occur 2-4 weeks following infection
Fever
Fatigue
Myalgia
Rash
Headache
Pharyngitis
Also mucocutaneous ulcers
Usually painful, mimics HSV
May represent co-infection (syphilis)
ACUTE RETROVIRAL SYNDROME lab testing
HIV RNA viral load
>1 million copies/mL
Positive 5-15 days after
infection
Sensitive 4th generation combination antigen/antibody test
+ p24 antigen
Becomes positive ~1 week after viremia is detected (15-20 days after infection)
HIV IgM
Becomes positive 45-60 days
following infection
Followed by WB
Western blot usually negative or indeterminate (35-50 days) early on
TOXOPLASMA GONDII cd
HIV,CD4<100
Encephalitis
Chorioretinitis
Pneumonitis
FRANCISELLA TULARENSIS
“rabbit fever,” “ulceroglandular disease,” “Perinaud’s disease”
Small gram negative coccobacillus
Risks
Exposure to infected animal tissue
Skinning rabbits
Lawn-mower
LYMPHOGRANULOMA VENEREUM (LGV)
Chlamydiatrachomatis (SerogroupsL1,L2,L3)
Rare, associated with outbreaks, mainly among MSM, HIV+
Primary infection
Genital ulcer or a mucosal inflammatory reaction at the site of inoculation
The incubation period is 3 to 12 days
These lesions spontaneously heal within a few days.
Secondary infection
2-6 weeks later and is related to local direct extension of the infection to regional lymph nodes (ie, inguinal and/or femoral nodes)
Extensive painful lymphadenitis
HISTOPLASMA CAPSULATUM
Mold form in the environment
Inhaled
Engulfed by macrophages
Disseminate
Yeast form in host tissue
Soil
Bat/bird droppings
Lymphadenopathy related to Histoplasma
Mediastinal & hilar lymphadenopathy
COCCIDIOIDES IMMITIS
Characteristics/ where found
Mold in nature
Yeast in tissue
Spherule with endospores
Deserts of southwestern US
Arizona, New Mexico,Texas
Central & South America
Mexico
COCCIDIOIDES IMMITIS
Clinical disease
Pneumonia
Valley fever
Desert rheumatism
Fatigue
Arthralgia
Skin: E. nodosum
PARACOCCIDIOIDES Microscopy
“mariner’s wheel”,“pilot’s wheel”
PARACOCCIDIOIDES characteristics
Central & South America
Mold in nature
Inhalation
Dissemination Granulomas
Yeast in tissue
Clinical manifestation
Pneumonia
Lymphadenopathy
Draining fistulas
