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Y4: Infectious Disease > Herpes virus infections > Flashcards

Herpes virus infections Flashcards

1
Q

Describe herpez simplex virus 1 and 2 (HSV1 and HSV2)?

A
  • Viruse multiplies in epithelial cells of mucosal surfaces
    • Producing vesicles or ulcers
  • Lifelong latent infection when virus enters sensory neurones at infection site
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2
Q

A 20 year old woman who is 16 weeks pregnant presents with pain passing urine and an irritating rash. On exmination she has a tender, red, vesicular rash on her vulva. A urine dipstick shows both blood and white cells. What is the best treatment?

A

Oral aciclovir

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3
Q

Describe the presentation of HSV1 and 2?

A
  • Sensory tingling prodrome -> vesicles -> ulcers
  • Systemic symptoms are possible
  • Reactivation is usually less severe unless immunocompromise
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4
Q

Describe Herpes labialis?

A
  • Cold sore lesion at lip border
  • Predominantly HSV-1
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5
Q

Describe Genital herpes?

A

Usually HSV2

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6
Q

Describe Gingivostomatitis?

A
  • Fever, sore throat -> tender oropharyngeal vesicles
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7
Q

Describe Herpetic whitlow?

A
  • Painful vesicles on distal phalynx
  • Innoculation through break in the skin
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8
Q

Derscribe Herpex encephalitis?

A
  • HSV1 in immunocompromised
  • Transfer of virus from peripheral site to brain via neuronal transmission
  • Prodrome: fever, headache, malaise
  • Then: encephalopathy
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9
Q

Describe the diagnosis of a herpes simplex virus?

A
  • Clinical diagnosis
  • Viral PCR of CSF, swab or vesicle scraping
  • Also culture, immunofluorescence, serology
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10
Q

Treatment for herpez simplex viruses?

A
  • Aciclovir
    • Reduces symptoms and viral shedding
    • Does no prevent latent infection
  • IV aciclovir for HSV encepphalitis
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11
Q

Management of a woman with primary genital herpes in her third trimester of pregnancy?

A
  • Oral aciclovir until delivery
  • Delivery by caesarean section
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12
Q

Describe varicella zoster virus (human herpes virus 3)?

A
  • Primary infection transmitted via respiratory droplets
  • Invades respiratory mucosa, replicates in lymph nodes
  • Virus containing vesicles = chicken pox
  • Dermatomal reactivation of dormant virus = shingles
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13
Q

Describe Chicken pox?

A
  • 2 day prodrom: fever, malaise, headache
  • Then rash: pruritic, erythematous macules
  • Complications in immunosuppressed:
    • Encephalitis, VZV pneumonia, transverse myelitis
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14
Q

Describe shingles?

A
  • Painful, hyperaesthetic area
  • Macular, vesicular rash in dermatomal distributiion
  • Infectious until scabs appear
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15
Q

Complications of shingles?

A
  • Post-herpetic neuralgia
  • Ramsey hunt syndrome
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16
Q

Describe the diagnosis of Varicella zoster virues?

A
  • Clinical unless immunocompromised
  • Viral PCR, culture, immunofluorescence
17
Q

Treatment for VZV?

A
  • Oral aciclovir/valaciclovir for uncomplicated adults
  • IV aciclovir if pregnant, immunosuppressed, disseminated disease
18
Q

Describe the prevention of VZV?

A

Vaccination at age 70 to prevent shingles reactivation

19
Q

A 54-year-old woman who is currently receiving chemotherapy for breast cancer presents for advice. Her granddaughter has developed chickenpox, with the pox first appearing yesterday whilst she was looking after her. The patient has never had chickenpox herself and is concerned about developing it, although she is asymptomatic at the current time. What is the most appropriate management?

A

Arrange varicella zoster immunoglobulin

20
Q

Describe Epstein-Barr virus (human herpesvirus 4)?

A

Virus targets circulating B lymphocytes and squamous epithelium of oropharynx

21
Q

Describe the presentation of EBV?

A
  • Asymptomatic infection in childhood
  • Infectious mononucleosis in primary infection of adults
    • Sore throat, fever, anorexia, lymphadenopathy, palatal petechiae
    • Hepatosplenomegaly, jaundice
  • Prominent malaise
22
Q

Describe the diagnosis of EBV?

A
  • Blood film
    • Lypmhocytosis
  • Heterophiles antibody tests
  • Serology
    • IgM to EBV viral capsid antigen in acute infection.
    • IgG if past indection
  • Reverse transcriptase viral PCR
23
Q

Treatment for EBV ?

A
  • Supportive
  • Seek expert help if immunosuppressed
24
Q

Presentation of CMV (human herpesvirus 5)?

A
  • Asymptomatic in most
  • Symptoms mimic infectious mononucleosis
  • Sever disease in immunsuppressed:
    • Oesophagitis, gastritis, colitis, pneumonitis, retinitis
  • Infection during pregnancy associated with congenital abnormality
25
Q

Describe the diagnosis of CMV?

A
  • Primary infection in immunocompetent
    • IgM
  • Immunosuppressed
    • Quantitative nucleic acid amplification testing (QNAT)
  • Invasive disease:
    • Tissue QNAT
    • Histopathology
26
Q

Describe the treatment for CMV?

A
  • Given in severe infection
  • Ganciclovir, valganciclovir
  • Foscarnet, cidofovir
27
Q

Describe human herpesvirus 6?

A
  • Roseola infantum
  • Febrile illness without rash
28
Q

Describe human herpesvirus 8?

A
  • Oncogenic
  • Castleman’s disease
29
Q
A

Y4: Infectious Disease (18 decks)

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