Herpes Flashcards
all herpes are what kind of virus
DNA
herpes simplex virus is composed of
herpes 1 and herpes 2
herpes 1 takes place
over the waist
seen in 80% of the population
herpes 2 takes place
below the waist
20% infected with this
common genital STD
how is herpes spread
contaminated secretions
liquid in lesions contain live virus
herpes 1 is also called
herpes labialis
-oral herpes (cold sores, fever blisters)
in children herpes 1 can cause
pharnygitis
where can oral lesions be seen
inside the mouth, on lips
associated with stress, fever
sunlight can cause fever blisters
-can be found in genital area but not STD
herpes 2 is found where on men and females
female- anywhere genital
male- around the penis
-may be asymptomatic for years
last 10-14 days and can be painful
possibly in the urethra
can herpes 2 be transmitted when asymptomatic
yes
not curable, treat the symptoms
neonatal herpes
pass from mother to baby and be infectious/deadly
during birth 60% mortality rate if baby not treated within first 12 hours
C section suggested
herpes encephalitis
follows herpe 1 infection
takes place in the brain
-leaves people disabled
normal glucose levels
protein normal to slightly increased
-lymphs increased
to diagnose need brain tissue
ocular herpes
latent
may infect cornea and cause destruction of it
lead to partial or complete blindness
herpes 1
gold standard for diagnosis of herpes
looking for CPE on viral cultures
-no calcium alginate swabs will kill virus
can you look for antibody for herpes
not that useful because so many people have herpes 1
-IgM is better
antibodies for herpes 1 and 2 will
cross react= give positive
diagnosis via lesions and symptoms
varicella zoster
chickenpox – kids
infections are worse the older you get and can lead to complications
infectious until all lesions are healed
chicken pox transmission
highly contagious
direct contact with person
respiratory droplets
open lesions
not associated with congenital infections
to see if someone had chicken pox vaccine
antibody titers
IgG are good
latent chickenpox can turn into
shingles
shingles can be activated by
stress
immunocompromising disease
shingles affects
nerve ganglia and outbreak be anywhere
follows a nerve -can lose feeling
starts as hives, lesions with fluid and become black
(infectious until all gone)
shingles on the face called
Bell’s palsy
prevention of shingles
vaccine for shingles recommended for people over 50
-once you have had shingles you should not get the vaccine for 3-6 months once gone
if you are near someone who has not have chickenpox or shingles you can transmit to them and give them
chicken pox
herpes 8
more seen in AIDs patients
blister red outbreak in HIV + people
turn into black and blue
kaposi sarcoma
tumor of the blood
-viral
rarely seen in healthy people
1 route of transmission for kaposi sarcoma
sexual contact
how is kaposi sarcoma detected
PCR
no treatment
by the time you are a teenager you have antibodies to
EBV
EBV is called mono because
atypical lymphs used to be called monocytes
how is EBV transmitted
-oral secretions
-blood transfusions
-mother to baby
what cancers EBV associated
-Burkitt’s Lymphoma
-Hodgkin’s Lymphoma
-Nasopharyngeal cancer
-gastric cancer
EBV does not cause
hepatitis
-but associated with inflammation of the liver
Reye’s syndrome
inflammation of liver (children taking aspirin during a viral infection)
what is increased with liver involvement (analyte)
ammonia
liver involvement= also spleen involvement (enlarged)
treatment for mono
supportive treatment
-most prominent population is young adults
B cells are infected through what marker
CD21
how long are people infectious with mono
6 weeks
testing for EBV- screen
heterophile antibodies
what is heterophile antibodies
antibody like substance that is known to cross react with antigens that were not part of inducement
-different species
-agglutinates cow RBC
-mono not the only one like this (also lupus)
infectious mono antibodies are
NOT absorbed out/ neutralized by guinea pig antigen
-other heterophile antibodies are
screen procedure for mono
1) mix serum with guinea pig antigen
-will neutralize out other heterophile antibodies leaving infectious mono
2)infectious mono antibodies can agglutinate sheep RBCs
now mix with sheep RBC and if agglutinates= mono
now if mix patient serum with bovine RBC membrane antigen will only react with infectious mono antibodies
does negative screen rule out mono
no
-children under 3 rarely produce heterophile antibodies
-70% of adult population will produce them
-now test for antibodies specific for mono
antibodies we can also test for EBV
viral capsid antigen
early antigen
EBV nuclear antigen
viral capsid antigen
most common of antigens that we test for antibody production
-best to test for IgM
-IgG rises slightly after
if only doing IgG have to look for
4 fold rise in titer between acute and convalescent
early antigen
rises a little after viral capsid and wan 4-5 months
-Appears during late acute or early convalescence stage
EBV nuclear antigen
heighten 5-6 months after primary infection and only last 2-3 months
-indicates recent past infection
know mono chart
notes
EBV and transplants
causes illness in transplants
-if put on immunosuppresents and EBV can be a risk factor for these cancers
CMV
cytomegalovirus
-causes illness like mono
-can be misdiagnosed as EBV
why CMV called that
causes enlargement of cells it infects
organs CMV involves
involves the spleen more than EBV
-some liver involvement
-high rate through transplanted organs
how is CMV transmitted
same as mono
can in body fluids
-semen, breast milk
does CMV produce heterophile antibodies
NO
CMV one of the most common
congenital infections
-if you are born with CMV
-leading cause of children are born deaf
-associated with heart and liver anomalies
when doctors suspect CMV what profile is done
torch
TORCH stands for
toxoplasmosis, other (IgM titers), rubella, CMV, herpes 2
when giving infant’s RBC’s need pedi pak to be
CMV - blood (iridate), Leuko reduced
do adults have antibody titers to CMV
yes
-CMV antibodies will cross react with EBV antibodies
-test IgM because doesn’t cross react as much as IgG
when testing infant for CMV
test the urine for presence of the antigen
CMV forms what when infects a cell
inclusion
-CPE
-formed in B cells (dumbbells)
-transplanted tissues also check for CMV
testing for CMV
DNA testing - PCR
