Micro - opportunistic viral infections Flashcards
Egs of AIDs defining illnesses
CMV retiinitis HSV oesophagi's/bronchitis/pneumonitis Kaposi's Burkitt's lymphoma Progressive multifocal leukoencephalopathy
JC virus in an immunocompromised patient –>
Progressive multifocal leukoencephalopathy
In BMT patients, why are they so immunocompromised?
Continuous immunosuppression to prevent GvHD
Immunosuppressive treatments:
Depleting antibody treatment?
Non-depleting antibody treatment?
Depleting: Rituximab (antiCD20)
Non-depleting: Basiliximab (antiCD25)
In a patient who is post-BMT, which lab investigation result would make you suspicious of an opportunistic infection?
Raised transaminases (AST/ALT)
Which lab investigation is pointless in identifying presence of opportunistic infection in a post-BMT patient? therefore which investigation should you request?
Serology (pt can’t yet amount an immune response)
- viral PCR or rapid Ag test
3 routes of viral infection in transplant patients
1) From the GRAFT
2) immunosuppression –> REACTIVATION
3) immunosuppression –> INFECTION from outside
Name 2 herpes viruses which reside in WBCs?
EBV
CMV
When does HSV tend to affect transplant patients?
<1 month Post-transplant
How can HSV reactivation be prevented in transplant patients?
Acyclovir prophylaxis
What is PORN (lol) in the context of an immunocompromised patient?
Progressive Outer Retinal Necrosis
- VZV reactivation
In solid organ transplantation, what kinda serology is at highest risk of CMV infection
Donor +
Recipient -
In bone marrow transplantation, what kinda serology is at highest risk of CMV infection
Donor -
Recipient + (as chemo/radio wipes out the recipient’s antibodies)
CMV prophylaxis in solid organ transplant patients?
Valganciclovir for 10 days
How is potential CMV infection monitored in bone marrow transplantation patients?
CMV viral load monitoring and treated when it rises
