human herpes virus part 2

Question 1

which virus is HHV 3?

Answer 1

varicella zoster virus

Question 2

what are the types of infection with varicella zoster virus?

Answer 2

primary infection (chickenpox)
latency in the dorsal root ganglia ( zoster/ shingles)

Question 3

what is the mode of transmission with varicella zoster virus ?

Answer 3

airborne/droplet ( more common)
direct contact ( less common)

Question 4

what is the prognosis of chicken pox in children?

Answer 4

v good prognosis and is self limited

Question 5

what is the clinical presentation of varicella ?

Answer 5

usually in young children
fever
distribution of a rash mainly along the trunk and head rather than extremities

Question 6

which population is at risk when it comes to varicella ?

Answer 6

adults (especially pregnant women) and the immunocompromised

Question 7

what are the complications of varicella ?

Answer 7

secondary bacterial infection 
pneumonitis 
haemorrhagic chickenpox 
encephalitis 
congenital varicella syndrome

Question 8

how is a diagnosis of varicella made ?

Answer 8

• mainly a clinical diagnosis
• characteristic of a rash
• different stages of the lesion will be present simultaneously
• history of exposure to an infected person

Question 9

what investigations would you carry out to confirm a diagnosis ?

Answer 9

PCR

serology

Question 10

what is the differential diagnosis in varicella ?

Answer 10

disseminated HSV

viral exanthems

Question 11

what are the preventative measures of varicella ?

Answer 11

immunization (live attenuated vaccine)

VZIG ( varicella zoster Immunoglobulin) in high risk contact such as neonates , pregnant women and the immunocompromised

Question 12

what is the treatment for varicella and what are the indications for therapy?

Answer 12

Antiviral therapy (acyclovir)
to the immunocompromised whenever the vesicles start to appear
to pregnant women within 3 days of a rash, pneumonitis
to adults within 3 days of a rash, pneumonitis

Question 13

what is the clinical presentation of herpes zoster ?

Answer 13

usually affecting the elderly and immunocompromised
pain followed by appearance of lesions
primary lesions are painful grouped vesicles on an erythmatous base
the distribution is unilateral dermatomal commonly in the head and trunk

Question 14

what is the fate of herpes zoster lesions ?

Answer 14

resolves n 2 weeks

Question 15

what are the predisposing factors of herpes zoster ?

Answer 15

old age, immunosuppressive therapy and systemic steroids

Question 16

what are the complications of herpes zoster?

Answer 16

bacterial skin infections
post-herpetic neuralgia 
ophthalmic zoster 
encephalitis 
ramsay-hunt syndrome

Question 17

how is a zoster diagnosis made ?

Answer 17

mainly a clinical diagnosis

Question 18

what is the treatment of herpes zoster ?

Answer 18

• rest and analgesics
• topical and systemic antibiotics
• oral acyclovir
• anticonvulsants
• calamine