Micro Viruses Flashcards
Reassortment What is it? What does it lead to? Danger? Example
Viruses with segmented genomes exchange segments
High frequency re-combination
Worldwide pandemics
Influenza virus
Complementation
1 of 2 viruses that infects a cell has a mutation that results in a nonfunctional protein. The non-mutated virus complements the mutated one by making a functional protein that serves both viruses
Phenotypic mixing
Simultaneous infection –> Genome of virus A partially or completely coated in surface protein from virus B
Live attenuated vaccines
What does it induce?
Risk
Names
Humoral and cell-mediated immunty
Reversion to virulence (rare)
“Live! one night only! see Small Yellow Chickens get vaccinated with Sabin’s and MMR! It’s INcredible”
Smallpox, Yellow fever, Chickenpox (VZV), Sabin’s Polio, MMR, Influenza (intranasal)
Can MMR be given to HIV pts?
Even though its a live attenuated vaccine, it can be given to HIV pts if they don’t show signs of immunodeficiency
Killed Vaccines
What does it induce?
Names
Only humoral response
“SalK = Killed. RIP Always”
Rabies, Influenza (injected), Salk Polio, HAV
Recombinant vaccines
HBV (Ag = recombinant HBsAg)
HPV (6, 11, 16, 18)
dsDNA viruses
All DNA viruses except Parvoviridae
ssDNA viruses
Parvoviridae (Parvovirus)
“Part-of-a-virus” has less DNA”
Circular DNA viruses
Papilloma and Polyoma (circular supercoiled), and Hepadnaviruses (circular, incomplete)
Linear DNA viruses
All DNA viruses except for Papilloma, Polyoma, and Hepadnaviruses
ssRNA viruses
All RNA viruses except for Reoviridae
dsRNA viruses
Reoviridae
“REpeatO virus is redundant with 2 strands”
+ssRNA viruses
“I went to a Retro Toga party where i drank Flavored Coronas and ate Hippy California Pickles”
Retrovirus, Togavirus, Flavivirus Corona virus, Hepevirus, Calicivirus, Picornavirus
Naked viral genome infectivity
Infectious: dsDNA viruses (except Poxvirus and HBV), and +ssRNA (like mRNA) viruses
Non-infectious: -ssRNA and dsRNA. Require polymerase contained in complete virion
Virus ploidy
All viruses are haploid except retrovirus which has 2 identical ssRNA molecules
Where do viruses replicate?
All DNA viruses replicate in the nucleus except poxvirus
All RNA viruses replicate in the cytoplasm except influenza and retroviruses
Non-enveloped viruses
Names
Where is envelope from?
“give PAP smears and CPR to Naked HEPpy”
DNA = PAPP, RNA = CRP and HEP
Papillomavirus, Adenovirus, Parvovirus, Polyomavirus, Calcivirus, Picornavirus, Reovirus, Hepevirus
Usually from cell membrane except for Herpes, which gets it from nuclear membrane
DNA viruses names
“HHAPPPPy”
Hepadna, Herpes, Adeno, Pox, Parvo, Papilloma, Polyoma
Icosahedral DNA viruses?
All except Pox (complex)
DNA viruses that replicate in the nucleus?
All except Pox (carries its own DNA dependent RNA pol)
Herpesviruses
Nucleic acid? Envelope?
Names
dsDNA, Linear. Enveloped
HSV1, HSV2, VZV (HHV3), EBV (4), CMV (5), HHV6, HHV7, HHV8
Hepadnavirus Nucleic acid? Envelope? Names w/ disease Vaccine Transcription
dsDNA, partially circular. Enveloped
HBV: acute or chronic hepatitis
Vaccine available. Contains HBV surface Ag
Not a retrovirus but has a reverse transcriptase
Adenovirus
Nucleic acid? Envelope?
Diseases
dsDNA, Linear. Not enveloped Febrile pharyngitis (sore throat, acute hemorrhagic cystitis), Pneumonia, Conjunctivitis (pink eye)
Parvovirus
Nucleic acid? Envelope?
Names with diseases
-ssDNA, Linear. Not enveloped
B19: aplastic crisis in sickle cell disease, Erythema infectionsum (5th disease, slapped cheek), RBC destruction in fetus –> hydrops fetalis and death, Pure RBC aplasia and RA-like symptoms in adults
Papillomavirus
Nucleic acid? Envelope?
Names with diseases
Vaccine
dsDNA, Circular. Not enveloped HPV 1,2,6,11: warts Cervical intraepithelial neoplasia (CIN) Cervical cancer (16, 18) Vaccine for 16 and 18
Polyomavirus
Nucleic acid? Envelope?
Names with diseases and Findings
dsDNA, Circular. Not enveloped
JC: progressive multifocal leukoencephalopathy (PML) in HIV pt
MBP present in CSF
BK: Transplant pt, commonly targets kidneys
“JC = Junky Cerebrum. BK = Bad Kidney”
Poxvirus
Nucleic acid? Envelope?
Diseases
dsDNA, Linear. Enveloped
Smallpox, Vaccina (cowpox - milkmaid’s blisters)
Molluscum contagiosum: flesh colored dome lesions with central dimple
HSV1 Nucleic acid? Envelope? Diseases caused by it? Latency? Transmission?
dsDNA, Linear. Enveloped
Oral (and some genital lesions), Gingivostomatitis, Keratoconjunctivitis, Temporal lobe encephalitis (most common cause of sporadic encephalitis in the US), Herpes Labialis
Latent in V ganglia
Respiratory secretions, Saliva
HSV2 Nucleic acid? Envelope? Diseases caused by it? Latency? Transmission?
dsDNA, Linear. Enveloped
Genital (and some oral lesions), Herpes genitalis, Neonatal herpes
Latent in Sacral ganglia
Sexual contact, Perinatal
VZV Name Nucleic acid? Envelope? Diseases caused by it? Latency? Vaccine? Transmission?
HHV3 dsDNA, Linear. Enveloped Varicella-Zoster (chickenpox and shingles), Encephalitis, Pneumonia Latent in DRG or Trigeminal Ganglia Vaccine available Respiratory secretions
EBV Name Nucleic acid? Envelope? What does it infect? Diseases caused by it? Latency? Transmission?
HHV4 dsDNA, Linear. Enveloped Infectious mononucleosis, Burkitt's Lymphoma, Hodgkin's Lymphoma, Nasopharyngeal carcinoma Infects B cells Latent in B cells Respiratory secretions, Saliva
CMV Name Nucleic acid? Envelope? Diseases caused by it? Who gets infected? Histo Latency? Transmission?
HHV5
dsDNA, Linear. Enveloped
Congenital infection, Mononucleosis (negative Monospot), Pneumonia, Retinitis
Immunosuppressed and Transplant pts
Owl’s eye inclusions
Latent in mononuclear cells
Congenital, Transfusion, Sexual contact, Saliva, Urine, Transplant
HHV6 Nucleic acid? Envelope? Diseases caused by it with presentation? Transmission Related virus?
dsDNA, Linear. Enveloped
Roseola (exanthem subitum): high fevers for several days that can cause seizures, followed by diffuse macular rash
Undetermined transmission
HHV7 a less common cause of Roseola
HHV8 Nucleic acid? Envelope? Diseases caused by it? Who gets it? Transmission
dsDNA, Linear. Enveloped
Kaposi sarcoma in HIV pt
Sexual contact
HSV identification
PCR is test of choice
Tzaneck test: smear of an open skin vesicle to detect multinucleated giant cells commonly seen in HSV1, HSV2, VZV
Infected cells also have intra-nuclear Cowdry A inclusions
Mononucleosis Caused by... Presentation Peak incidence? Histo Diagnosis
EBV infecting B cells
Fever, HSM, Pharyngitis, and Lymphadenopathy (esp posterior cervical nodes)
15-20 years of age
Atypical lymphocytes seen on peripheral blood smear are not infected B cells, they are reactive Tc cells
+Monospot test
Monospot Test
What is it?
Positive test equals…
Heterophile Abs detected by agglutination of sheep or horse RBCs
Mononucleosis, Hodgkin’s lymphoma, Endemic Burkitt’s lymphoma, Nasopharyngeal carcinoma
Reovirus
Nucleic acid? Envelope? Segments
Caspid
Diseases
dsRNA, Linear, Not enveloped, 10-12 segments
Icosahedral (double)
Coltivirus: Colorado tick fever. Arbovirus transmitted by arthropods (mosquitoes and ticks)
Rotavirus: #1 cause of fatal diarrhea in children
Picornaviruses Nucleic acid? Envelope? Segments Caspid Diseases Replication process Transmission
+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
“PERCH”
Polio, Echovirus (aseptic meningitis), Rhinovirus (common cold), Coxsackievirus [aseptic meningitis, herpangina (mouth blisters, fever), hand-foot-and-mouth disease, myocarditis], HAV
All cause aseptic (viral) meningitis except rhinovirus and HAV
RNA is translated into 1 large polypeptide that is cleaved by proteases into functional viral proteins
All are enteroviruses (fecal-oral spread) except Rhinoviruses
Hepevirus
Nucleic acid? Envelope? Segments
Caspid
Diseases
+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
HEV
Caliciviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
Norovirus: viral gastroenteritis
Flaviviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
+ssRNA, Linear, Enveloped, Non-segmented
Icosahedral
“CYD went from STL to the Nile”
HCV, Yellow fever, Dengue, St Louis encephalitis, West Nile Virus.
All except HCV are Arbovirus: transmitted by arthropods (mosquitoes and ticks)
Togaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
+ssRNA, Linear, Enveloped, Non-segmented
Icosahedral
Rubella
Eastern/Western Equine Encephalitis (Arbovirus: transmitted by arthropods (mosquitoes and ticks))
Retrovirus Nucleic acid? Envelope? Caspid Special capability Diseases
+ssRNA, Linear, Enveloped
Icosahedral (HTLV), Complex and Conical (HIV)
Reverse transcriptase
HTLV: T cell leukemia, HIV: AIDS
Coronaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
+ssRNA, Linear, Enveloped, Non-segmented
Helical
Common cold and SARS
Orthomyxoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
-ssRNA, Linear, Enveloped, 8 segments
Helical
Influenza virus
Paramyxoviruses Nucleic acid? Envelope? Segments Caspid Diseases Markers Treatment
-ssRNA, Linear, Enveloped, Non-segments
Helical
Causes disease in children “PaRaMysovirus”
Parainfluenza (croup: seal-like barking cough), RSV (bronchiolitis in babies, treat with Ribavirin), Measles, Mumps
Surface F (fusion) protein causes respiratory epithelial cells to fuse and form multi-nucleated cells
Palivizumab (monoclonal Ab against F protein) prevents pneumonia caused by RSV infection in premature infants
Rhabdoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
-ssRNA, Linear, Enveloped, Non-segments
Helical
Rabies
Filoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
-ssRNA, Linear, Enveloped, Non-segments
Helical
Ebola/Marburg hemorrhagic fever
Often fatal
Arenaviruses Nucleic acid? Envelope? Segments Caspid Diseases Transmission
-ssRNA, Circular, Enveloped, 2 segments Helical LCMV: Lymphocytic Choriomeningitis Virus Lassa fever encephalitis Spread by mice
Bunyaviruses Nucleic acid? Envelope? Segments Caspid Diseases Transmission
-ssRNA, Circular, Enveloped, 3 segments
Helical
California encephalitis, Sandfly/Rift Valley fevers, Crimean-Congo hemorrhagic fever
Hantavirus (hemorrhagic fever, pneumonia)
All but Hantavirus are Arbovirus: transmitted by arthropods (mosquitoes and ticks)
Delta Virus
Nucleic acid? Envelope? Segments
Caspid
Diseases
-ssRNA, Circular, Enveloped, Non-segmented
Uncertain symmetry
HDV is a defective virus that requires HBV co-infection
Negative-Stranded Viruses
Replication process
What special proteins does it have?
Names
Transcribe neg strand to +
Brings its own RNA-dependent RNApol
“Always Bring Polymerase Or Die Failing Replication”
Arenavirus, Bunyavirus, Paramyxovirus, Orthomyxovirus, Delta virus, Filoviruses, Rhabdoviruses
Segmented Viruses
All are RNA viruses
“BOAR”
Bunyaviruses, Orthomyxoviruses (influenza), Arenaviruses, Reoviruses
Rhinovirus Kind of virus Diseases it causes? Types Route of infection
Picornavirus
Causes common cold
Over 100 serologic types
Acid labile - destroyed by stomach acid
Yellow Fever Virus Kind of Virus Transmission Reservoir Presentation
Flavivirus (also an arbovirus)
Aedes Mosquitoes
Monkey and human reservoir
High fever, black vomit, jaundice
Rotavirus Kind of virus? Diseases it causes Context PathoPhys Prophylaxis
Reovirus
“ROTAvirus = Right Out The Anus”
Infantile gastroenteritis: acute diarrhea
Winter, day-care centers, kindergartens
Villous destruction with atrophy leads to ↓ absorption of Na and loss of K
CDC recommends vaccination of all infants
Influenza Viruses Kind of virus Ags What are pts at risk for? Evolves? Vaccines
Orthomyxoviruses
Hemagglutinin (promotes viral entry) and Neuraminidase (promotes progeny virion release)
Pts at risk for fatal bacterial superinfection
Rapid genetic changes
Killed vaccine is a major mode of protection. Vaccine containing live, temp sensitive mutant that replicates in the nose but not in lung also available for children
Influenza virus
Genetic Shifts/Antigenic Shifts
Genetic Drifts
“Sudden Shifts more deadly than graDual Drift”
Shifts cause pandemics. Reassortment of viral genome; segments undergo high frequency recombination such as when human flu A virus recombines with swine flue A virus
Drift causes epidemics. Minor (antigenic drift) changes based on random mutation
Rubella Virus
What kind of virus
Presentation
Children vs Congenital disease?
Togovirus
Rubella (German 3 day measles): Fever, Postauricular adenopathy, Lymphadenopathy, Arthralgias, Fine Truncal rash that starts at head and moves down
Mild disease in children, Serious congenital disease (ToRCHS infection)
Measles What causes it? Presentation Possible sequelae Do not confuse with?
Paramyxovirus
“3Cs: Cough, Coryza, Conjunctivitis”
Koplik spots (red spots with blue-white center on buccal mucosa) and descending maculopapular rash. Presents last and spreads from head to toe including hands and feet (vs truncal rash in rubella)
SSPE (Subacute Sclerosing Panencephalitis) occuring years later, Encephalitis, Giant cell pneumonia (rarely in immunosuppressed)
Do not confuse with Roseola (HHV6)
Mumps
What causes it?
Presentation
Danger
Paramyxovirus
“Mumps makes your parotid glands and testes as big as POM-poms”
Parotitis, Orchitis (inflammation of testes), and aseptic Meningitis
Sterility (esp after puberty)
Rabies Virus What kind of virus? Shape? Histo? What does it infect? Incubation Post-exposure treatment How does it travel? Presentation Transmission
Rhabdoviruses. Bullet-shaped virus
Negri bodies in cytoplasm of neurons
Purkinje cells of cerebellum
Weeks to months incubation
Wound cleansing and vaccination +/- rabies immune globulin
Travels to CNS by migrating in a retrograde fashion up nerve axons
Fever, Malaise –> Agitation, Photophobia, Hydrophobia –> Paralysis, Coma –> Death
Bat, Raccoon, Skunk, Dog bites
HAV Kind of virus? Mode of transmission? Carrier Incubation time HCC risk Symptoms Time course of infection
Picornavirus (Non-enveloped +strand RNA) Fecal-Oral No carrier Short incubation (weeks) No risk of HCC Asymptomatic Acute
HBV Kind of virus? Mode of transmission? Carrier Incubation time HCC risk
Hepadnavirus (Enveloped dsDNA) Parenteral, Sexual, Vertical Has Carriers Long incubation (months) Integrates into host genome and acts as oncogene
HCV Kind of virus? Mode of transmission? Carrier Incubation time HCC risk Course of infection What can it cause?
Flavivirus (Enveloped +sRNA) Primarily blood, IVDU, Post-transfusion Has Carriers Long incubation HCC risk from chronic inflammation Chronic course Cirrhosis, Carcinoma
HDV Kind of virus? Mode of transmission? Carrier Incubation time HCC risk Can it infect alone? Prognosis
RNA delta virus (enveloped, -ssRNA) Parenteral, Sexual, Vertical Has carriers Superinfection - short. D infects after B Co-infection - long. B and D infect together HCC risk Defective virus and dependent on HBV Superinfection has worsened prognosis
HEV Kind of virus? Mode of transmission? Carrier Incubation time HCC risk High mortality rate in Mnemonic
Hepevirus (Non-enveloped +ssRNA) Fecal-Oral especially with water-born epidemics No carriers Short intubation No risk for HCC High mortality rates in pregnant women Enteric, Expectant, Epidemics
Signs and Symptoms of all Hepatitis viruses
Fever, jaundice, elevated ALT/AST
Viral reproduction of HBV
B uses its own DNA dependent DNA pol to make full dsDNA
Uses host RNA pol to make mRNA
Anti HAV (IgM) Best to detect?
IgM Ab to HAV
Best test to detect HAV
Anti HAV (IgG) What does it indicate? What does it do?
IgG Ab indicates prior HAV infection and/or vaccination
Protects against re-infection
HBsAg
Surface antigen indicates Hep B infection
Anti HBs
What does it indicate
Ab to HBsAg
Indicates immunity to HepB
HBcAg
Antigen associated with core HBV
Anti HBc
IgM
IgG
Positive during…
Ab to ABcAg
IgM = acute or recent infection
IgG = prior exposure or chronic infection
Positive during window period
HBeAg
What is it?
What does it indicate?
A second, different antigenic determinant in the HBV core
Indicates viral replication and therefore high transmissibility
Anti HBe
What is it?
What does it indicate
Antibody to HBeAg
Indicates low transmissibility
Labs in Acute HBV HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg + Anti HBs - HBeAg + Anti HBe - Anti HBc IgM
Labs in Window HBV HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg - Anti HBs - HBeAg - Anti HBe + Anti HBc IgM
Labs in Chronic HBV (high infectivity) HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg + Anti HBs - HBeAg + Anti HBe - Anti HBc IgG
Labs in Chronic HBV (low infectivity) HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg + Anti HBs - HBeAg - Anti HBe + Anti HBc IgG
Labs in Recovery HBV HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg - Anti HBs + HBeAg - Anti HBe + Anti HBc IgG
Labs in Immunized HBV HBsAg Anti HBs HBeAg Anti HBe Anti HBc
HBsAg - Anti HBs + HBeAg - Anti HBe - Anti HBc -
Sequence of events in HBV infection
SECES
HBsAg, HBeAg, AntiHBc, AntiHBe, AntiHBs
Which Hepatitis viruses can cause acute infection?
A,B,C,D,E
Which hepatitis viruses can cause chronic infection?
B, C, D
HBV Treatment
Interferons (alpha and pagylated)
Lamivudine, Adefovir, Entecavir, telbivudine (Nucleoside Analogs –/ HBV DNApol)
HIV
Nucleic acid? Enveloped? Segments?
Structural genes
+ssRNA, Linear, Enveloped. Diploid (2 molecules of RNA)
env: gp120 and gp41 formed from cleavage of gp160 to form envelope proteins
gp120 stuck on top of gp41 and attaches to host CD4 T cell. gp41 is transmembrane and mediates fusion and entry
gag (p24): caspid protein
pol: Reverse transcriptase, aspartate protease, integrase
HIV Pathogenesis
Immunity
ssRNA –> dsDNA –> integrates into host genome
Virus binds CCR5 (early) or CXCR4 (late) co-receptor and CD4 on T cell
Binds CCR5 and CD4 on macrophages
CCR5 homozygous mutation = immunity
How are envelope proteins acquired by the HIV virus?
Acquired through budding from host cell plasma membrane
HIV virus inside to outside
RNA + reverse transcriptase –> caspid protein p24 –> Matrix protein p17 –> Lipid membrane –> gp41 goes through membrane and gp120 on top of it
HIV diagnosis
When are they falsely negative
When are they falsely +
Presumptive Dx made with ELISA for antiHIV Abs (sensitive with high false positive rule out with low threshold)
+ results are confirmed with Western blot assay for AntiHIV Abs (specific, high false negative rate, rule in with high threshold)
Falsely negative in first 1-2 months after infection
Falsely + in babies born to infected mothers (anti gp120 crosses placenta)
HIV monitoring
PCR/viral load determines amount of viral RNA in the plasma
High viral load associated with poor prognosis
Used to monitor effects of drug therapy
AIDS Dx
CD4+ less than 200 (normally 500-1500)
HIV+ with AIDS-defining condition (PCP) or CD4/CD8 ratio less than 1.5
Couse of HIV infection
CD4 count drops then rebounds briefly (after HIV RNA copies peak) then steady decreases
HIV RNA copies peaks then drops (when CD4 count rebounds) then gradually rises
Stages of HIV infection
“4Fs”
- Flu-like acute
- Feeling fine (latent)
- Falling count
- Final crisis
What happens during latency
Virus replicates in lymph nodes
Common diseases of HIV+ adults
Reactivation of past infections (TB, HSV, Shingles)
Disseminated bacterial and fungal infections
Non-Hodgkin’s Lymphoma
HIV pt w/ low-grade fever, cough, HSM, Tongue ulcer
Pathogen
Findings
CD4
Histoplasma capsulatum (causes only pulmonary symptoms in immunocompetent hosts)
Oval yeast cells w/in Macrophages
CD4 less than 100
HIV pt w/ Fluffy white cottage-cheese lesions
Pathogen
Findings
CD4
C albicans (thrush) Pseudohyphae Oral if CD4 less than 400, Esophageal if CD4 less than 100
HIV pt w/ Superficial vascular proliferation
Pathogen
Findings
Bartonella henselae (bacillary angiomatosis Biopsy reveals neutrophilic inflammation
HIV pt w/ Chronic watery diarrhea
Pathogen
Findings
CD4
Cryptosporidium
Acid-fast cyst in stool when CD4 less than 200
HIV pt w/ Encephalopathy
Pathogen
Findings
CD4
JC virus reactivation (cause of PML)
Reactivation of latent virus
Results in demyelination
CD4 less than 200
HIV pt w/ Abscesses
Pathogen
Findings
CD4?
Toxoplasma gondii
Many ring-enhancing lesions on imaging
CD4 below 100
HIV pt w/ Meningitis
Pathogen
Findings
CD4?
Cryptococcus neoformans
India ink stain reveals yeast with narrow-based budding and large capsule
CD4 less than 50
HIV pt w/ Retinitis Pathogen Findings May also occur w/... CD4?
CMV
Cotton wool spots on funduscopic exam
May also occur with esophagitis
CD4 less than 50
HIV pt. w/ Dementia
Directly associated with HIV. Must differentiate from other causes
HIV pt w/ Superficial neoplastic proliferative vasculature
Pathogen
Do not confuse w/
Findings
HHV8 (causes Kaposi Sarcoma)
Do not confuse with bacillary angiomatosis caused by B henselae
Biopsy reveals lymphocytic inflammation
HIV pt w/ Hairy Leukoplakia
Pathogen
Location
EBV
Often found on lateral tongue
HIV pt w/ Non-Hodgkin’s Lymphoma
Pathogen
Location
EBV
Often on oropharynx (Waldeyer’s ring)
HIV pt w/ Squamous Cell Carcinoma
Pathogen
Location
HPV
Anus (men who have sex with men) or Cervix (women)
HIV pt w/ Primary CNS lymphoma
Pathogen
Distribution
Differentiate from
EBV
Focal or multiple
Differentiate from toxoplasmosis
HIV pt w/ Interstitial pneumonia
Pathogen
Findings
CMV
Biopsy reveals cells with intra-nuclear (Owl’s Eye) inclusion bodies
HIV pt w/ Invasive aspergillosis
Pathogen
Findings
Aspergillus fumigatus
Pleuritic chest pain, Hemoptysis, Infiltrates on imaging
HIV pt w/ Pneumonia
Pathogen
CD4
Pneumocystis jirovecii
CD4 less than 200
HIV pt w/ TB-like disease
Pathogen
CD
Mycobacterium avium-intracellulare
CD4 less than 50
Prions
Pathology
Qualities of the protein
Presentation
Conversion of a normal cellular protein (termed prion protein PrPc) to a β-pleated form (PrPsc) which is transmissible
PrPsc resists degradation and facilitates the conversion of still more PrPc to PrPsc
Spongiform encephalopathy and dementia, ataxia, and death
Forms of Prion disease
Sporadic: Creutzfeldt-Jakob disease –> rapidly progressive dementia
Inherited: Gerstmann-Straussler-Scheinker Syndrome
Acquired: Kuru
Icosahedral RNA viruses
Reovirus and All +ssRNA viruses except Coronavirus
Helical RNA viruses
All -ssRNA viruses + Coronavirus
RNA viruses with circular genomes
“BAD”
All are -ssRNA viruses
Arenavirus, Bunyavirus, Delta virus
