OD 39 - Oral mucosal viral infections Flashcards
What is the difference between HSV1 and 2?
1 = oropharyngeal 2 = genital/anal
How long does HSV1 and 2 incubate for?
4-7 days
Where does HSV1 remain latent?
Infects neurones on dorsal root and autonomic ganglia
Can be latent in trigeminal nerve
What are the features of primary herpetic gingivostomatitis?
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
What surfaces are affected by recurrent intra-oral herpetic infection?
Keratinised surfaces
What is HSV3?
Varicella zoster virus
Chickenpox and shingles
What are the clinical presentations of chickenpox?
Itchy erythematous papule –> pustules –> crusted lesions
Oral lesions
Fever/malaise..etc
What are the clinical presentations of shingles?
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)
What is HSV4? and how is it contracted?
Primary EBV
Contracted from infected saliva
What is the incubation period of HSV4?
20-40 days
What are the clinical presentations of HSV4?
Lymphadenopathy/ Sore throat
Fever/ Malaise
Rash
Soft palate petechiae
Who presents with hairy leukoplakia?
HIV infected male homosexuals (rarely seen due to HAART tx)
What are the clinical presentations of hairy leukoplakia?
Painless white patches on bilateral boarders of the tongue
Not premalignant
What is HSV5?
Cytomegalovirus (can get oral ulcers)
What cells does HSV8 infect predominantly?
B-lymphocytes
What are the oral lesions seen in kaposis sarcoma?
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
What are the 2 most cariogenic types of HPV?
HPV 16 and 18
What are papillomas?
Benign small lesions with spiky exophytic, rounded cauliflower like shapes
Clinically identical to warts (verruca vulgaris)
What HPV is prevalent in 1.warts and 2.papillomas?
- HPV 2 and 57
2. HPV 6 and 11
What is the treatment for papillomas?
Surgical excision
What is condyloma acuminatuma?
Genital/ anogenital warts
What are the oral manifestations focal epithelial hyperplasia?
Multiple flat, soft, elevated papules occurring extensively in oral mucosa
Spontaneously resolution after many years
What is the incubation period of hand, foot and mouth disease?
2-6 days
What are the oral manifestations of hand, foot and mouth disease?
Oral ulcers resembling herpetic stomatitis but without gingivitis
What is the incubation period of herpangia?
2-9 days
What are the oral manifestations of herpangia?
Pharyngeal ulcers
Moderate cervical lymphadenopathy
Name 2 coxsakie viruses.
Hand, foot and mouth disease
Herpangia
