Oral Viral Infections Flashcards
what is a cellular feature of viruses making them different from bacteria and fungi
no intracellular organelles
discuss a viral swab
flocked swab unlike a bacterial or fungal swab
placed in molecular sample solution (MSS) which extracts viral DNA/ RNA
after immersion swab is removed from solution
what are viruses made up of
glycoproteins
proteins
phospholipids
nucleic acids
example of DNA and RNA virus
DNA - human herpes
RNA - hep C
what are the 8 stages of herpes simplex replication
- binding
- entry
- nuclear transport
- nuclear entry
- gene expression
- DNA replication
- packaging
- release
specimen for serology
EDTA blood
4 types of human herpes virus
HSV1
HSV2
varicella zoster
epstein barr
cytomegalovirus
primary herpetic gingivostomatitis
manifestation of HSV1 primary infection most commonly seen in children
hard palate and dorsum of tongue are most commonly affected
herpes labialis
cold sores
manifestation of reactivation of HSV1
herpetic whitlow
caused by herpes simplex viruses
painful infection of fingers caused by touching herpetic lesion of someone else - virus penetrates via break in skin near nail or other broken skin
Epstein Barr virus
Type of Human Herpes virus
spreads via saliva and other bodily fluids
causes glandular fever
post herpetic neuralgia
pain that continues after shingles rash has gone
(shingles = reactivation of varicella zoster)
what patient demographic is zoster (shingles) typically seen in
elderly or immunocompromised
chickenpox
primary infection of varicella zoster virus
discuss the pathogenesis of HSV
1 - primary infection - infects epithelial cells in mucosa or skin, replicates in epithelium then is taken up by sensory neurons and transported to sensory ganglia
2 - latency - latent infection established in ganglia
3 - reactivation - latent virus in ganglia reactivates and transported back to epithelium where lesions form
why may prodromal tingling/ pain be felt prior to recurrent HSV lesions occuring
due to virus reactivating in neuron first prior to being transported back to epithelium
clinical features of primary HSV infection
majority asymptomatic, if not - severe
in adults (less common) - pharyngitis
in children - gingivostomatitis
both often have systemic symptoms - fever, malaise, regional lymphadenopathy
appearance of gingivostomatitis
erythmatous and painful with multiple vesicles/ ulcerations
clinical features of recurrent HSV infection
cold sores. - usually on lips/ corners of mouth
can also develop sores on cornea (herpes keratitis)
what may act as a trigger for reactivation of HSV
sunlight
fever
stress
immunosuppression
lab diagnosis of HSV
rarely done
flocked swab, placed in molecular sample solution which extracts viral DNA/RNA - after immersion swab removed and sample sent to lab for PCR testing
treatment of primary herpetic gingivostomatitis
general adive and symptomatic relief
- nutritious diet, plenty fluids, bed rest
- analgesics
- antimicrobial MW
if immunocompromised or severe infection aciclovir
what antimicrobial MW could be prescribed for primary herpetic gingivostomatitis
CHX 0.2%, 1min, 10ml rinse 2 x daily
hydrogen peroxide 6%, 15ml diluted, 2 mins 3x daily
aciclovir regimen for immunocompromised patients or severe HSV infection
200mg, 5x daily, 5 days
treatment for herpes labialis
aciclovir cream 5%, apply to lesion every 4 hours for 5 days
