Mononucleosis Session 93 Flashcards
Hallmark of EBV infection
polyclonal B cell proliferation
Incidence of MONO is greatest…
2nd decade exposure to EBV
Process of IM
incubation 1-2 months lymporeticular dissemination Prodromal 2-5 days symmetrical lymphadenopathy Palatal exanthem
What immune cell increases and cause smptoms
B and T cells proliferate
T cells ar eatypical Downey bodies
T cell response causes disease
IM Agent Structure
Gamma Herpevirus
Envelope Ds Stranded DNA genome
Latenc in B cells
EBV 1 EBV 2
EBV Epidemiology
Person 2 Person Replicated in B cells, shed into SALIVA 1 month or life KISSING Disease Low contagious
Peak age of incidence HBV
17-25
EBV Latency
10 genes are expressed during latency ( differnt than HSV)
EBV Diagnosis
Presence atypical lymphocytes Heterophile antibodies present in IM IgM heterophile, paul-bunnell on rbc MONOSPOT serology tests useful for infants and small children IgG are permanent
IM Treatment
symptomatic relief
IM complications
rash w/ amox
Splenic rupture, NOT COMMON
Post transplatn Lymphoproliferative disease
immune suppressed,
virus exposure or latency reactivation
Burkitt Lymphoma
dysregulation of c-MYC, EBV is co-contributory
Non hogkins lymphoma
HIV and transplant receivein cyclosporin A
Hodgkins Disease
EBV role in pathogenesis
CMV affects what population the most
Infants,
Also transplant and HIV
Family of virus is CMV
betaherpes virus
CMV Epidemiology
Very young or elderly Endemic No seasonal Person to Person Adult contact with Children( DAYCARE )
CMV Clinical Manifestations
Disseminate via lymphocytes
Adult CMV Manifestions
Antibody heterophile NEGATIVE
Atypical Lymphocyte positive
Transplacental CMV Manifestations
Primary or reactivate of Mother
Transfusion/Transplant CMV manifestation
Reactivation of virus in host
HIV pateient CMV manifestation
Retinitis
GI
CNS diesease
Pneumonias
CMV Diagnosis
TORCH
Serology
Viral Culture
Viral Antigen
When do you suspect CMV?
Symptoms of IM, negative for heterophile, and EBV specific antigens
Signs of hepatitis but neg for A B C
CMV Treatment
Gancicyclovir
Foscarnet
Formivirisen
MUMPS
Paramyxovirus
Linear ssRNA - sense
Enveloped
Virus has spikes
Mumps Clinical Manifestations
Acute infection salivary glands w/ fever RAPID onset Can be asymptomatic Spread to other organs i.e. CNS Can develop Orchitis
MUMPS Diagnosis
febrile w/ bilateral parotitis
HA assay with infected tissue sample
MUMPS Epidemiology
Only natural host is HUMAN
HIGHLY COMMUNICABLE
use to be endemic
Mumps Complications
Deafness
Orchitis
oophoritus
mastitis
Mumps Treatment
Not antvirals
symptomatic relief
Mumps Prevention
MMR
Jeryl Lynn Attenuated virus
Not for egg or neomycin sensitive
