Microbiology 2 Flashcards
what causes chickenpox and shingles?
varicella zoster virus
chickenpox = varicella
shingles = zoster or herpes zoster
how does chickenpox present?
macules which then become papules which then become vesicles
vesicles then scab over and begin to recover
lesions can vary in density - either in clusters or spread out
Occurs on first exposure
what complications can arise from chickenpox and who are these common in?
secondary bacterial infection varicella pneumonia haemorrhagic rash (darker) encephalitis scarring more common in adults/very young or immunocompromised
what is neonatal varicella zoster virus?
secondary infection in newborn due to chickenpox in mother during late pregnancy (within 5 days of birth)
high mortality
can neonatal VZV be prevented?
yes
varicella zoster immune globulin given to susceptible women
what is shingles?
reactivation of varicella zoster virus later in life
usually in elderly or immunocompromised
how does shingles present?
same as chickenpox - macules > papules > vesicles > scabs
limited to a single dermatome
associated neuralgic pain
what is post hepatic neuralgia and when is it more likely?
when the neuralgic pain associated with shingles lasts for more than 4 weeks
more common in elderly and if the shingles is on the face (trigeminal)
does scarring occur in shingles?
usually not
what is ophthalmic zoster?
when shingles occupies the ophthalmic division of the trigeminal nerve (upper corner of face)
urgent ophthalmic referral indicated
when is ophthalmic zoster common?
can happen in children if they contract the virus in utero or if immunocompromised
what can it indicate if newborn/very young babies contract zoster virus?
in utero infection
what dermatomes are likely to be affected in adults and children by the herpes zoster virus?
adults - lower thoracic, upper lumbar, trigeminal
children - dermatomes supplied to cervical and sacral nerves (legs etc)
can the varicella zoster virus still occur if the patient has had the varicella vaccine?
yes
what is Ramsey-Hunt Syndrome?
vesicular rash in the auditory canal and throat
what are the symptoms of ramsey-hunt syndrome?
facial palsy (7th nerve palsy) irritation of 8th cranial nerve causing deafness, vertigo and tinnitus
what is ramsey hunt syndrome also known as?
geniculate or otic herpes zoster
what can ramsey hunt syndrome often be mistaken for and what is the difference?
Bells Palsy
both causes by same virus and facial paralysis but Bells doesn’t have the vestibulocochlear symptoms of ramsey-hunt
is there a vaccination for chickenpox?
yes
live attenuated vaccine is available but not really used in the UK, only for susceptible healthcare workers
is there a vaccination for shingles?
yes
same as chickenpox but in a much higher titre
used in elderly to reduce impact of shingles
what does the herpes simplex virus cause on first exposure?
primary gingivostomatitis causing extensive ulceration in and around mouth in pre-school children
lasts around a week