HSV Flashcards
Almost everyone has been infected with at least one herpesvirus
yep, extremely ubiquitous
HSV are like diamonds
yep, they last forever
9 human herpesviruses are highly prevalent and there are 3 types
- alpha
- beta
- gamma
HSV transmission
requires close contact- oral route and urogenital route
____ is typically spread by oral route, in saliva, and is typically acquired at a very young age. It can also, but less frequently, be spread through sexual contact and is then acquired in early adulthood. ____ is found in 95% of oral sores and 40% of genital sores
HSV-1
___ is typically spread through sexual contact. It can also be spread by oral route, in saliva. ____ is acquired in early adulthood. ____ is found in 5% of oral sores and 60% of genital sores
HSV-2
HSV replicates in ____ cells
epithelial
After primary mucosal infection, HSV spreads to local ____ neuron endings
PNS
HSV travels to the craniospinal ganglia
Trigeminal nerve ganglion
Sacral ganglion
HSV latent infection hiding place
trigeminal nerve ganglion
Most transmission occurs while source contact is asymptomatic
yikes yep
recurrent oral herpes prodrome
tingling, warmth or itching at site which precedes rash about 12 hours
genital herpes
lesions may be primary or recurrent and they are very painful
what is the catch with HSV antiviral therapy
Antiviral therapy can reduce the severity and the frequency of outbreaks, but it will not eliminate the virus completely.
They target replicating virus in the mucocutaneous areas. Latent virus does not replicate and so cannot be targeted by current antivirals.
Herpetic Whitlow –
acute infection that affects the fingers; doctors, nurses (HSV-1 and HSV-2)
Ocular herpes –
a broad spectrum of ocular disease. HSV keratitis can cause blindness
severe SE of HSV infections (3)
- Herpes encephalitis
- neonatal herpes
- disseminated disease in the immuno-compromised
it is the most common viral encephalitis and the only treatable one
Herpes Simplex encephalitis
Herpes Simplex encephalitis is characterized by
hemorrhagic necrosis of temporal lobes
neonatal herpes is acquired when?
at delivery
**Prevention: offer caesarean section to mothers with genital HSV lesions or history of genital herpes
Primary infection with VZV causes the disease ______
chickenpox or Varicella.
severe varicella (2)
- in immunocompromised
2. congenital
VZV is the only herpesvirus that can spread by respiratory route
yep
latency of VZV in the
dorsal root ganglia
varicella vaccine is what type of vaccine?
live attenuated
A vaccine against chickenpox has been available since 1995. In the US, it is a part of routine vaccinations in children. Two vaccinations are typically given. Vaccinations have led to a drastic decrease of chickenpox. But: Varivax is a live vaccine, so the VZV in the vaccine is infectious and becomes latent in the body. This latent virus can reactivate and cause shingles.
VariZIG
passive immunization–> zooster immunoglobulin
people at risk such as early pregnancy or immunocompromised
first vaccine ever was for
smallpox
single crop of bumps filled with a thick, opaque fluid
often, depression or dimple in the center
severe pathology involving any organ
smallpox
smallpox vs chickenpox
- stage lesions
- distribution
- evolution of rash
- stage lesions: same vs different
- distribution: centrifugal vs centripetal
- evolution of rash: slow vs rapid
Transmitted by direct contact Symptoms: raised bumps on skin Torso, face Common in children 1-12 yo Resolve in 6-12 months
molluscum contagiosum virus
Shingles are very painful vesicular blisters, usually, on the face or the upper trunk. Symptoms are ______, painful vesicular blisters, usually in the head or upper trunk. what are the blisters filled?
unilateral
Blisters are filled with fluid containing high viral titers.
Patients with zoster are infectious until blisters scab
yep
________ is the most common complication of shingles, with pain lasting up to several months but
Allodynia – hypersensitivity to touch – is also common
Postherpetic neuralgia
____ is very common; by adulthood, most people are infected. The virus is encountered in saliva and typically transmitted through kissing. _____ reinfections are possible as multiple strains have been isolated from the same patient.
EBV known as the kissing disease “infectious mononucleosis” in adolescents
***** in children it is asymptomatic
EBV infection begins in ___________ cells of the mouth and the pharynx it then spreads to ______and latency is at _____________
EBV infection begins in epithelial cells of the mouth and the pharynx it then spreads to B lymphocytes and latency is at B lymphocytes
there is Low-grade virus replication of EBV and shedding in the epithelial cells of the pharynx of all seropositive individuals
yep
in the diagnosis of EBV we the what type of lymphocytes? what is the serologic test?
we see >10% atypical lymphocytes and we use the monospot test (transient appearance of heterophile ab)
Typically, EBV mononucleosis occurs only once
yep
are antiviral therapy effective in EBV?
nope
EBV causes tumors… what types?
**Caused by EBV latent infection in some cases with involvement of reactivation,
not new infections
1, lymphoid such as non-hodgkin’s (think of burkitts)
2. epithelial such as nasopharyngeal carcinoma
CMV is one of the most successful human pathogens
ok sure if you say so
latency of cytomegalovirus
hematopoietic stem cells (bone marrow)
cytomegalovirus
- vertical transmission
- horizontal transmission
- infects
- vertical transmission- congenital CMV
- horizontal transmission- through saliva
- infects multiple organs
CMV is different to EBV in two important points
- CMV is monospot negative
2. CMV can recur
Leading cause of hearing loss and brain disease in children as it is the most common congenital viral infection, 0.3-1%
CMV
**CMV»_space; Down syndrome > spina bifida > CF > toxoplasma
pizza pie retina
CMV retinitis
CMV in the immunocompromised can lead to issues in the (3)
- lungs
- retina
- GI
there is a live vaccine for CMV
nope
Prevention of CMV disease in transplant recipients
antiviral prophylaxis
Prophylaxis with ganciclovir: seronegative recipient gets ganciclovir if the donor is seropositive. Seropositive recipients also get gancyclovir
ganciclovir is approved for use in pregnant women
ganciclovir is NOT approved for use in pregnant women (highly toxic)
