Other Viral Flashcards by Al.Anoud Al.Adwan

Most common type of viral exanthem in children ????

Non specific (non poliovirus)

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Describe viral exanthem ?

Blanchable erythematous papules and macules on trunk and extremities
Self limited in 1w

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How long does viral exanthem last ?

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What are the enetrovirus and from which category is ?

From > picornavirus
They are ::
Echovirus
Coxsakie A and B

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Describe enterovirus ??

Ss RNA
Non enveloped capsid

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Mode of transmission of enterovirus ??

Feco oral
Respiratory droplets
Peripartum

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Incubation period of :
Enterovirus
Measles
Rubella
Erythema infectiousum
Roseola infantum
Poxvirus
Dengue fever

3-6
10-14
16-18
4-14
9-10
3-4
3-8

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Site of replication of enterovirus ??

Lymphoid tissues

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Mose common disease of enterovirus??

Hand foot mouth disease

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Describe clinically hand foot mouth disease??

Palmoplantar vesicular eruption + erosive stomatitis

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Variant of coxsakie causing hand foot mouth disease ?

A16

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Nail changes in hand foot mouth disease ??

Onychomadesis

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Name the term of coxsakie infection in atopic dermatitis?

Eczema coxsakium

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Vaccine against enterovirus ??

Inactivated vaccine against entero-71

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Diseases caused by enterovirus ??

1- hand foot mouth disease
2- herpangina
3- eruptive pseudoangiomatosis

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Describe herpangina ??

Painful vesicles and erosions of soft palate, uvula, and buccal mucosa

No skin exanthem

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Name viruses with cephalocaudal spread ??

Rubella
Rubeola
+- Roseola

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Triad of eruptive pseudoangiomatosis ??

Fever + vascular pustules + dilated blood vessels

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Viruses causing eruptive pseodoangiomatosis ??

Enterovirus
EBV
CMV

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Methods to diagnose enterovirus ??

Viral cx
RT-PCR
Bx is useless

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Treatment of enterovirus?

Supportive

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Treatment of enterovirus in immuno compromised patients??

Pleconaril

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Triad of measles ??

Cough and conjunctivitis + coryza + koplik spots

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Mode of transmission of measles ??

Respiratory droplets

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Under which category measles virus is ??

Paramyxovirus

What are koplik spots ?

Grey white papules on buccal mucosa

In each viral illness you have to describe ??

1- prodrome 2- exanthem 3- enanthem

What are prodromes of measles ??

Fever , cough , nasal congestion, conjunctivitis

What is exanthem of measles ??

Erythematous macules and papules over forehead, hairline and postauricular areas

What other viruses cause measles like morbiliform eruption?

Entero, EBV , parvo, HHV-6

What is atypical measles ??

Prodrome + pulmonary infiltrates + ABSENT coryza and conjunctivitis + non specific exanthem

Which vitamin that becomes deficient after measles ??

Vi A

Complications of measles ??

Otitis Pneumonia Encephalitis Myocarditis Subacute sclerosing panencephalitis (Seizures + personality disorder)

How to diagnose measles ??

RT-PCR from nasopharyngeal secretion or urine

Tt of measles ??

Supportive * ViA for all children

Dose of ViA in measles?

Once for 2 days >1y :: 200k IU 6m-1y :: 100k IU <6m :: 50k IU

Measles prophylaxis after exposure in non vaccinated individuals?

<3 days :: give vaccine 3-6 days :: IVIG

MMR vaccine ?

2 doses 1- 12-15m 2- 4-6 y

Rubella virus ??

Togavirus : SS RNA

Mode of transmission?

Respiratory droplets

Primary site of infection??

Nasopharynx

Prodrome of rubella ??

Headache , fever , URTI , or sub clinical

Exanthem of rubella ?

Eruption of erythematous rose macules and papules on face

Enanthem of rubella ??

Forch heimer spots (erythematous patechial macules on soft palate)

Site of lymphadenopathy in rubella ?

Postauricular Occipital Cervical

Complications of rubella ??

Arthritis / arthralgia (post pubertal girls) Hepatitis Hemolytic anemia Thrombocytopenia Peri/myocarditis

Dx of rubella ?

RT-PCR from nasal or throat swab Antirubella Igm or IgG are 4x

At what week does congenital rubella occur ??

First 16 weeks

Whats is congenital rubella ?

Cataract + deafness + heart defect (PDA, VSD) + microcephaly Blueberry muffin baby > dermal hematopoiesis

Other names of erythema infectiousum ??

Slapped cheeks Fifth disease

Cause of erythema infectiousum ?

Parvo virus B19 (ss DNA)

Mode of transmission of erythema infectiousum?

- respiratory droplets - perinatal - blood transmission

Whats tropism target for parvavirus ??

Erythroid proginator cells and RBC (P Ag)

When does reticulocytopenua occur after infection ??

7-10 days (when IgM starts appearing)

Whats prodrome of fifth disease??

Fever , myalgia , headache

Describe myalgia in fifth disease ?

Reversible 10% after 1w Affects small joints of the hands Female > males

Describe exanthem of fifth disease ?

1- initial stage ( bright eed macules of cheeks sparing nasal bridge) 2- second stage (Erythematous macules and papules on extrimities then form lacy reticulated pattern)

Main D Dx of fifth disease ??

Still disease (has higher fever, more chronic , +ive kobner)

Describe fifth disease in adults ??

Petechial rash on acral and periflexural areas

What causes papulo purpuric glove and socks syndrome??

Parvo virus B19

Describe papulo purpuric glove and socks syndrome ?

Edema and erythema of hands and feet * petechia and purpura Tt: supporive

Whats is the enanthem in fifth disease ?

Erosions and petechia on palate, pharynx and tongue

What fetal parvo transmission occurs ??

First and second trimester (mainly w20)

Fetal B19 parvo ??

1- abortion in second trimester 2- stillbirth 3- anemia Majority are asymptomatic Dx : PCR

Other name of roseola infantum ?

Sixth disease

What causes roseola infantum ?

HHV6,7

Avg age of roseola infantum?

6 months ( when maternal Ig drop)

Describe prodrome and exanthem of roseola infantum ??

High fever lasting 3-5 days then followed by rose macule or papule on neck, trunk or proximal extremities

Systemic findings in roseola infantum?

URTI Injection of tympanic membrane Cervical/occipital lymphadenopathy Edematous eyelids Bulged ant. Fontanelle

Whats is the enanthem of roseola infa ??

Nagayama spots :: Red papules on soft palate and uvula

What is the hallmark enanthem in roseola infantum ::

Palatoglossal junction ulceration

Reactivation of roseola infantum later can cause ??

DRESS

What are causes of unilateral laterothoracic exanthem ?

Spiroplasma Parvo B19 EBV

What is prodrome of unilateral laterothoracic exanthem ?

Fever + diarrhea + rhinitis

Main differential of unilateral laterothoracic exanthem ?

Gianotti crosti syndrome

What is other name of papular acrodermatitis of childhood ?

Gianotti crosti syndromes

What causes Gianotti crosti syndrome ?

EBV HBV

What is the prodrome of Gianotti crosti syndrome ?

URTI

What is the exanthem of Gianotti crosti syndrome ?

Monomorphic skin colored symmetric papules (face, buttock, and extensors)

Complications of Gianotti crosti syndrome ?

Hepatosplenomegaly

Treatment of Gianotti crosti syndrome ?

Supportive

Mode of transmission of poxvirus ?

Skin to skin contact

What causes molluscum contagiousum ?

Pox virus (Ds DNA with cytoplasmic replication)

Describe molluscum contagiousum ?

Firm umbilicated pearly papules with waxy sirfaces mainly on skin folds

Molluscum in Atopic dermatitis ?

Molluscum dermatitis

Histology of molluscum ?

Handerson patterson bodies (large intracytoplasmic inclusion bodies in epidermal keratinocytes)

Treatment of molluscum ?

Cryo Keratinolytics Topical codifovir

What causes viral hemorrhagic fever ?

Dengue virus- flavivirus

Dengue fever are transmitted by??

Mosquito or perinatal

Prodrome of dengue fever ?

Biphasic fever + retroorbital pain + nausea and vomiting

What is the exanthem of dengue fever ?

White islands in sea of red (morbilliform with spared areas)

Complications of dengue fever ?

Epistaxis Gingival bleeding RDS Thrombocytopenia (igG binds to Fc gamma R 3a)

What causes west nile virus ?

Flaviviridae (ss RNA)

west nile virus is transmitted by ??

Culex mosquito

Prodrome of west nile virus ?

Headache ، myalgia , encephalitis, fever , n&v 80% are asymptomatic

Exanthem of west nile virus ?

Polymorphic eruption on extrimities with small puncta

Dx of west nile virus ?

RT-PCR from CSF

What causes zika disease ?

Zika (flaviviridae)

Zika virus is transmitted by ?

Aedes

Main symptoms of perinatal zika ??

Microcephaly

What is the prodrome of zika ?

Fever , arthralgia , conjunctivitis

What is the exanthem of zika ??

Morbilliform scarlitiform eruption on face then trunk with FOLLICULAR ECCENTUATION and palmar involvement

Main complication of zika virus ?

Gullian barré syndrome

What causes chikungunya fever ?

Togavirus

chikungunya virus is transmitted by ??

Aedes

What is the prodrome of chikungunya virus ??

Fever Headache Nausea and vomiting

Hallmark symptom of chikungunya virus ??

Low back pain

What is the exanthem of chikungunya virus ??

Morbilliform eruption (acrofacial) With PIH FRECKLE LIKE MACULES flagellated streaks