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Pediatrics Infectious Diseases > Herpes simplex infection, Varicella Zoster, Rubella, Parvovirus infection > Flashcards

Herpes simplex infection, Varicella Zoster, Rubella, Parvovirus infection Flashcards

1
Q

Herpes simplex infection

  1. source of infection
  2. route of infection
  3. incubation period
A
  • HSV 1 – skin and mucosal infection, HSV 2 – genital
    1. humans
    2. air-droplet, direct contact
    3. 3-7 days
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2
Q

Herpes simplex infection

-clinical manifestations (6)

A
  1. Herpes gingivostomatitis – HSV-1, 6 months – 3 y.o children, IP: 2-12 days, onset is acute – child becomes restless/irritable/complains of pain/ refuses to eat, disease progresses for 4-5 days
  2. Herpes zoster – on the area of the lips, blisters, rash hurts/ itching, lymph nodes may be enlarged, tends to recur
  3. Ocular herpes simplex – most common injury to one eye, sudden/sharp pain, photophobia, tearing, flushing and edema of the eyelids, ulcers appear on the cornea, visual impairment
  4. Whitlow finger – vulnerable distal phalanges – redness, swelling, pain, herpes rash (caused by child sucking thumb)
  5. Herpes encephalitis – lesions in the temporal lobes of the brain, sudden fever, malaise, headache, behavioral changes, mental, orientation, memory disorders, hallucinations
  6. Herpes eczema – elevated IgE, eosinophilia, allergic background of the patient – caused by impaired cellular immunity of atopic skin and impaired cytokine production.
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3
Q

Herpes simplex infection

  1. diagnosis
  2. treatment
A
  1. PCR, detection in CSF

2. treatment of primary diseases should be continued, Acyclovir, treatment of secondary bacterial infections

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4
Q

Varicella Zoster

  1. source of infection
  2. route of infection
A
  • Primary manifestations: chicken pox
  • VZV persists lifelong in the ganglia of sensory neurons in the spinal cord –> reactivation of latent VZV manifest as shingles
  1. sick person
  2. direct contact with the rash, aerosol, vertical transmission
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5
Q

Varicella Zoster

-when does the patient spreads the infection?

A

The patient spreads the infection for the last 2 days of the incubation period and 5 days after the appearance of the last rash element

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6
Q

Varicella Zoster - Congenital chickenpox syndrome

A
  • when a pregnant woman develops chickenpox in the first 5 months of pregnancy, the newborn will have it
  • Characterized by: intrauterine growth retardation, microcephaly, hydrocephalus, cortical atrophy and mental retardation, limb hypoplasia, eye disorders, skin scars
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7
Q

Varicella Zoster - Congenital chicken pox

A

if a pregnant woman is exposed to VZV or develops chickenpox 2 weeks or less before delivery, the baby is born with chickenpox symptoms or develops them 5-10 days of life

  • Vesicular rash, fever
  • Possible hemorrhagic syndrome
  • Impaired consciousness, convulsions
  • The disease may manifest as viral pneumonia, hepatitis, meningoencephalitis
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8
Q

Varicella Zoster - Neonatal chickenpox

A

when a newborn is exposed to VZV infection and becomes ill after birth

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9
Q

Varicella Zoster

  1. pathogenesis
  2. diagnosis
  3. treatment
  4. prevention
A
  1. Ocular compound, upper respiratory mucosa infection –> replication in regional lymph nodes –> primary viremia –> replication in liver, spleen, parenchyma organs –> secondary viremia –> skin infection, vesicular rash
  2. epidemiological history, serology, PCR, blood tests (blood count, CRP), chest radiography, lumbar puncture – if neurological symptoms are present, skin bacteriology
  3. acyclovir
    - Symptomatic treatment: anti pyrectics, anti-histamines, fluids, skin hygiene
  4. vaccination
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10
Q

Shingles

  1. prodrome
  2. after 1-14 days
  3. treatment
A
  1. headache, weakness, fever
  2. rash of clustered papules, blisters, full of clear liquid. Spilled areas hurt, burn, sting.
  3. antiviral drugs, acetaminophen to reduce pain
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11
Q

Chicken pox

  1. incubation period
  2. stages of the disease
  3. complications
A
  1. 11-21 days
  3. Prodrome: fever, malaise and/or pharyngitis, decreased appetite
  4. Rash period: generalized herpes rash
  5. Reconvalescention
    - After recovery, hypo/hyperpigmentation areas may remain at the site of the former rash
    - Rash can be localized throughout the body
  6. secondary bacterial skin infections (most commonly S. aureus and group A Streptococci), thrombocytopenia (due to bone marrow suppression), other respiratory infections, neurological complications (cerebellum ataxia, encephalitis), viral pneumonia
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12
Q

Rubella

  1. source of infection
  2. route of infection
  3. the patient can infect others from…
  4. incubation period
A
  • Pathogenic only to humans
  • Poorly resistant to the environment
  1. sick humans
  2. air, transplacental
  3. The patient can infect other from 7 days before the onset of symptoms to 7 days after the onset of the rash
  4. 14-21 days
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13
Q

Rubella

-symptoms (3)

A
  • short term fever, enlarged lymph nodes, maculopapular skin rash
  • Prodromal period is short (1-2 days), general weakness, subfebrile
  • Rash begins in face and neck, small pink spots do not tend to merge –> rash spreads after 24h –> surface of limbs, joints, buttocks –> disappears after 1-5 days
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14
Q

Rubella

  1. complications
  2. diagnosis
  3. differential diagnosis
  4. treatment
A
  1. arthralgia/arthritis (more common in adults), post-infectious thrombocytopenia (more common in children), encephalitis, Guillain-Barre syndrome, Peripheral neuritis, myocarditis/ pericarditis
  2. serology (specific IgM antibodies or increase IgG antibodies super much), PCR
  3. allergic or drug induced rash, Kawasaki disease
  4. symptomatic
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15
Q

Congenital Rubella syndrome (CRS)

  1. symptoms
  2. most common symptom
  3. treatment
  4. prevention
A
  1. microcephaly, heart disease, petechiae and purpura, eye anomalies
  2. hearing and visual impairment
  3. long term treatment is necessary to prevent further complications, hearing tracking
    - Children are not allowed in group 7 days from the start of the rash
  4. vaccine
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16
Q

Parvovirus infection (3)

A
  • Infectious erythema, fifth disease
  • B19 parvoviruses
  • Parvoviruses pathogenic to humans are not pathogenic to animals and vice-versa
17
Q

Parvovirus infection

  1. seasonality
  2. age
  3. route of infection
  4. complications
A
  1. end of winter, spring
  2. 5-15 years
  3. air droplet
  4. rare
18
Q

Parvovirus infection

-clinical forms (4)

A
  1. infectious erythema
  2. arthritis and/or arthralgia
  3. aplastic crisis – due to hemoglobinopathy
  4. fetal parvovirus infection

***Papular purpuric glove and socks syndrome (PPGSS) – rare cases

19
Q

Parvovirus infection

-Infectious erythema

A

o most common clinical manifestation in children
o Incubation period: 4-14 days
o Prodrome period  one week before rash  subfebrile fever, headache, muscle aches, symptoms of upper respiratory tract infection
o Rash period  15-17 days – normal temperature
o “Slapping symptom” – erythema of the cheeks, pallor around mouth
o Rash on the torso, buttocks, limb extensor surfaces, may be itchy
o Join paint, swelling

20
Q

Parvovirus infection

-Arthritis and/or arthralgia

A

o Most common in adults

o Joints are symmetrically damaged

21
Q

Parvovirus infection

-Aplastic crisis – due to hemoglobinopathy

A

o Severe viremia, without rash, in 1-2 weeks goes away, requires EM transfusions, can infect others (isolation required)
- chronic B19 infection (chronic anemia) - for immunosuppressed patients

22
Q

Parvovirus infection

-Fetal parvovirus infection

A

o Severe anemia, amniotic fluid pathology, myocarditis, fetal heart failure
o Most dangerous up to 20 weeks –> fetal loss can occur at any moment

23
Q

Parvovirus infection

  1. diagnosis
  2. treatment
  3. prevention
A
  1. serology (specific antibodies – anti-B19 persists for 2-3 months, paired anti-B19 IgG tilters – after 4-6 weeks), PCR (rare), fetal ultrasound
  2. usually not needed, symptomatic
  3. no vaccine
24
Q

Parvovirus infection

-when are the patients infectious?

A

With the onset of parvovirus B19, patients no long infect others, no isolation required, with the exception of transient aplastic crisis and chronic B19 infection

Pediatrics Infectious Diseases (5 decks)

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