Orofacial viral infections Flashcards
What viruses can cause pharyngitis?
Adenovirus
Epstein Barr virus
Cytomegalovirus
What virus causes gingivostomatitis?
Herpes simplex 1
What virus causes parotitis?
Mumps virus
How is viral infections diagnosed?
Viral nuclei acid detection
Nucleic acid amplification
Serology
Interpreting significant viral antibodies
What are the 3 sub types of human herpes virus?
Alpha
- herpes simplex 1 and II
- varicella zoster
Beta
- cytomegalovirus
- HHV6 and HHV7
Gamma
- Epstein Barr virus
- HHV8 (Kaposi’s sarcoma associated virus)
What is the most common viral salivary gland infection?
Paramyxovirus (mumps)
- unilateral presentation with 2-3week incubation period
- 2nd attacks possible and common in childhood
Tx:
- vaccinations
- supportive fluids and pain relief
Wha viruses are associated with H&N malignancies?
HPV 16 and 18
EBV
HHV8 - kaposi’s sarcoma
Describe the aetiology, symptoms and treatment for measles?
Aetiology:
- RNA paramyxovirus
- highly contagious with droplet spread
- incubation 12day period
Symptoms:
- fever, malaise, conjunctivitis
- dry cough
- koplik spots found on buccal mucosa Before main rash develops
- red oropharynx
Treatment
- vaccination
- bed rest, fluids, analgesia
What are the orofacial manifestation associated with HIV and AIDS?
Hairy leukoplakia Kaposi’s sarcoma Non Hodgkin’s lymphoma HSV HPV VZV
Describe HHV8?
Virus causing Kaposi’s sarcoma - commonly in aids patients as well as primary effusion lymphoma.
Presentation
- purple or bluish macules or swellings affecting skin and oral mucosa mostly hard palate
Treatment
- ART drugs
What is the clinical presentation of PHG?
- pyrexia. Sore mouth and throat
- widespread vesicles which coalesce following painful ulcers
- self limiting
What is the management of PHG?
Supportive
- bed rest, fluids, anti-pyretics
- CHX MW/swab use
Severe/immunocompromised:
- Aciclovir 200mg 5x daily for 5 days
Wha virus causes PHG?
Herpes simplex virus 1
What causes herpes labialis?
Reactivation of Herpes simplex virus 1
- presents extra orally secondary to PHG as it lies latent in trigeminal ganglion
What antiviral therapy can be used for herpes labialis?
Aciclovir cream 5% 2g tube 5x daily for 5-10 days or once lesions have healed.
What can cause activation of herpes labialis?
Immunosuppression
UV light
Stress
Weather changed
What virus causes chicken pox and shingles?
Varicella zoster virus:
Varicella Chickenpox:
- primary infection affecting facial skin and oral mucosa vesicles
Zoster Shingles:
- remains latent in sensory ganglion and reactivates as shingles
What pattern of lesions occurs in shingles?
- distribution of lesions are strictly unilateral and doesn’t cross midline but can affect trunk coupled with face but follows dermatome.
What conditions can shingles cause?
Post herpetic neuralgia
Corneal scarring
Ramsay hunt syndrome - facial nerve affected causing facial paralysis and hearing loss
Peripheral motor neuropathy
What antiviral therapy is used for shingles?
Aciclovir 800mg 5x daily for 7 days within 72hrs of onset of rash
What is the aetiology, presentation. And treatment of herpangina?
Aetiology
- mouth infection caused by coxsackie virus A
- most common in young children
Presentation
- pinhead vesicles in tonsils, uvula, soft palate, tongue and oropharynx which rupture to form large ulcers with erythematous rim
- no cutaneous lesions or gingivitis
- lesions are all at the back of mouth
- healing within 5-7days
Treatment:
- leave to heal - self limiting
Pain relief
Increase fluid intake and bed rest
What is the aetiology, presentation and treatment for hand foot and mouth?
Aetiology
- caused by coxsackie virus A16
- 1 week incubation primarily in young children
Presentation
- maculopapular vesicular rash on soles of feet, oral mucosa and hands
- vesicles have erythematous halos where ulcers are shallow, painful and self limiting
Treatment:
- self limiting recover 5-7days
- increase fluid, rest and soft diet
- pain relief, anti inflammatory and anti-pyretics.
What condition is commonly caused by HPV16 and 11?
Oral mucosa squamous cell papilloma
It is exophytic cauliflower like appearance white or pink in colour
= most common on gingivae or palate
What conditions do Epstein Barr virus cause?
Mononucleosis/glandular fever Oral hairy leukoplakia Non Hodgkin’s Burkitt’s lymphoma Nasopharyngeal carcinomas
