OD 39 - Oral mucosal viral infections

Question 1

What is the difference between HSV1 and 2?

Answer 1

1 = oropharyngeal 
2 = genital/anal

Question 2

How long does HSV1 and 2 incubate for?

Answer 2

4-7 days

Question 3

Where does HSV1 remain latent?

Answer 3

Infects neurones on dorsal root and autonomic ganglia

Can be latent in trigeminal nerve

Question 4

What are the features of primary herpetic gingivostomatitis?

Answer 4

Gingivitis
Diffuse purple boggy swelling of free and sometimes attached gingiva
Stomatitis = vesicles which rapidly breakdown and coalesce to form shallow painful ulcers
Mostly affect lips

Question 5

What surfaces are affected by recurrent intra-oral herpetic infection?

Answer 5

Keratinised surfaces

Question 6

What is HSV3?

Answer 6

Varicella zoster virus

Chickenpox and shingles

Question 7

What are the clinical presentations of chickenpox?

Answer 7

Itchy erythematous papule –> pustules –> crusted lesions
Oral lesions
Fever/malaise..etc

Question 8

What are the clinical presentations of shingles?

Answer 8

Pain/rash occurring in 1 dermatome 
Unilateral 
Vesiculating then scabbing 
Mouth ulcer
(pain 2-4days before/during/after rash)
(10% get post-herpetic neuralgia = persistent pain)

Question 9

What is HSV4? and how is it contracted?

Answer 9

Primary EBV

Contracted from infected saliva

Question 10

What is the incubation period of HSV4?

Answer 10

20-40 days

Question 11

What are the clinical presentations of HSV4?

Answer 11

Lymphadenopathy/ Sore throat
Fever/ Malaise
Rash
Soft palate petechiae

Question 12

Who presents with hairy leukoplakia?

Answer 12

HIV infected male homosexuals (rarely seen due to HAART tx)

Question 13

What are the clinical presentations of hairy leukoplakia?

Answer 13

Painless white patches on bilateral boarders of the tongue

Not premalignant

Question 14

What is HSV5?

Answer 14

Cytomegalovirus (can get oral ulcers)

Question 15

What cells does HSV8 infect predominantly?

Answer 15

B-lymphocytes

Question 16

What are the oral lesions seen in kaposis sarcoma?

Answer 16

Can be first sign of disease and lead to HIV diagnosis
Early oral lesion = red, purple, brown spots
Long standing lesions = become bluish, nodular and may ulcerate, extend/ disseminate

Question 17

What are the 2 most cariogenic types of HPV?

Answer 17

HPV 16 and 18

Question 18

What are papillomas?

Answer 18

Benign small lesions with spiky exophytic, rounded cauliflower like shapes
Clinically identical to warts (verruca vulgaris)

Question 19

What HPV is prevalent in 1.warts and 2.papillomas?

Answer 19

1. HPV 2 and 57

2. HPV 6 and 11

Question 20

What is the treatment for papillomas?

Answer 20

Surgical excision

Question 21

What is condyloma acuminatuma?

Answer 21

Genital/ anogenital warts

Question 22

What are the oral manifestations focal epithelial hyperplasia?

Answer 22

Multiple flat, soft, elevated papules occurring extensively in oral mucosa
Spontaneously resolution after many years

Question 23

What is the incubation period of hand, foot and mouth disease?

Answer 23

2-6 days

Question 24

What are the oral manifestations of hand, foot and mouth disease?

Answer 24

Oral ulcers resembling herpetic stomatitis but without gingivitis

Question 25

What is the incubation period of herpangia?

Answer 25

2-9 days

Question 26

What are the oral manifestations of herpangia?

Answer 26

Pharyngeal ulcers

Moderate cervical lymphadenopathy

Question 27

Name 2 coxsakie viruses.

Answer 27

Hand, foot and mouth disease

Herpangia