Microbiology 22: Opportunistic Viral Infections Flashcards
Which 2 organisms can cause Infective mononucleosis ?
CMV
EBV
Which Virus causes Kaposi Sarcoma ?
HHV8
Which virus causes Burkitss lymphoma in HIV patients ?
EBV
Which infections are people receiving anti -TNF therapy particularly predisposed to ?
Intracellular infections- TB
Can BMT patients receive VZV vaccination ?
No because it is a live virus and they are immunocompromised.
What is the difference in Immunocompromise of solid organ and bone marrow transplant patients ?
BMT patients are the most immunocompromised just before receiving the transplant because their own bone marrow is wiped out. After receiving the transplant a new immune system has to be established from the donors bone marrow.
Solid organ patients are less immunocompromised but then have to suppress their immune system for the rest of their lives.
List different herpes viruses ?
HSV 1 and 2
VZV
CMV
EBV
HHV8
HHV6
Where does VZV lay dormant ?
Dorsal root ganglia
In which cells does CMV lay dormant ?
Monocytes
In which cells does EBV lay dormant ?
B lymphocytes
What is the main treatment for HSV infection ?
Acyclovir
What are 2 treatment/prophylaxis of VZV options for immunocompromised or pregnant women ?
- Prophylactic aciclovir
- Post-exposure prophylaxis with VZig (more commonly used)
Which virus is associated with Progressive Multifocal leukoencephalopathy ?
JC virus
Which virus causes mouth ulcers in post transplant patients ?
HSV
Which viruses causes a patient to be very unwell and appear septic with high fevers post bone marrow transplant (think about this virus after bone marrow transplant in kids)?
Adenovirus
What is the typical serology of a patient with chronic hepatitis B infection ?
HBs Ag +ve
IgG HBc antibodies +ve
IgM HBc antibodies -ve
HBs antibodies -ve
List 2 things that are caused by EBV in HIV patients ?
oral hairy leukoplakia
lymphomas: Burkitt’s lymphoma, Hodgkin’s
Which disease is caused by EBV in patients post transplant ?
post-transplant lymphoproliferative disorder (PTLD)
Which virus causes graft rejection ?
HHV6
list some primary causes of immunocompromise (5)
- UNC93B deficiency and TLR3 deficiency
- SCID
- epidermodysplasia verruciformis
- STIM1
- haemophagocytic lymphohistiocytosis in perforin deficiency
when do infections commonly occur after BM transplants
- early (within 1 month)
- from graft - HBV
- reactivation from host - HSV
- new infection - VZV
VZV manifestations
- skin lesions
- pneumonitis
- encephalitis
- hepatitis
- purpura fulminans in neonates
- acute retinal necrosis
- VZV-assciated vasculopathy
- shingles = late manifestation
CMV manifestations
retinitis
encephalitis
pneumonia
gasteoenteritis
histology - owls eye
EBV treatment in immunosuppression
- reduce immunosuppression
- anti-CD20 monoclonal antibodies (rituximab)
