Peds Virus Jones Flashcards
CMV symptoms
1% have congenital CMV
90% of infected infants are asymptomatic
MC - Microcephaly Periventricular calcifications Chorioretinitis HSM Purpuric rash - Blue berry rash Anemia Thrombocytopenia
CMV Diagnosis
Urine can establish dx
CSF, Stool, or respiratory secretions possible
Classic EBV
Fever Exudative Adenopathy HSM Fatigue for several weeks Many asymptomatic
Monospot test
Rash w/ amoxicillin/PCN
EBV and Neurologic syndromes
Guillain-Barre syndrome Aseptic meningitis Meningoencephalitis Transverse myelitis Peripheral neuritis Facial nerve palsy Optic neuritis
EBV and hematologic complications
Splenic rupture Agranulocytosis Thrombocytopenia Hemolytic anemia TTP DIC Hemophagocytic lymphohistiocytosis
HSV Transmission, Types, Tx
Focus on perinatal infections
SEM
Encephalitis
Disseminated HSV Infections
Tx: IV acyclovir in neonatal period
HSV testing
Perform surface viral cultures in newborn 24-36 hrs after delivery
Swab mouth, nasopharynx, conjunctivae, rectum
Varicella-zoster virus
Sx: Fever, Malaise, NOT lethargy, anorexia, HA, mild abdominal pain 24-48 hrs prior to rash
Pruritic erythematous macules -> Papules -> fluid filled vesicles
Intermixed stages
Measles Clinical Manifestations
Rubeola
High fever
Enanthem (Koplik spots)
Cough, Coryza, Conjunctivitis
Prominent exanthem startingn at head and spreading down the body
Measles Diagnosis
Rubeola
Clinical appearance
serology (IgM ab)
Measles Complications
Pneumonia
febrile seizures
Encephalitis
Subacute sclerosing panencephalitis (SSPE)
Rubella Congenital syndrome sx
Cataracts, Congenital glaucoma, Microphthalmos
Congenital heart disease: PDA or peripheral pulmonary artery stenosis
Hearing Impairment
Neurologic abnormalities: developmental delay, microcephaly
Other: IUGR, interstitial pneumonitis, HSM
“Blueberry muffin” rash, jaundice, thrombocytopenia
Rubella diagnosis
IgM antibody
Parvovirus B19 Pathogenesis
Viral infections -> possibly postinfectious phenomena (exanthem, arthritis)
Babies in womb and fetal hydrops (2nd trimester)
Parvovirus B19 Clinical manifestations
Erythema infectiosum - Slapped cheek rash
Lacy, reticulated rash entire body
transient aplastic crisis rare
Roseola
Human Herpesvirus type 6
Hx: Fever for 3 days -> No fever -> christmas tree rash
erythematous maculopapular rash on trunk and extremities
No rash on palms or soles of feet
Other findings: LAD, N/V/D, febrile seizure, respiratory sx
No GI/ sinuses
Tx: Hydration
Adenovirus
can cause maculopapular rash, will have D, conjunctivitis, or wheezing, constitutional sx
Nasal test
HIV
Screening tests
younger than 18 months - DNA PCR
If suspected - Nursery -> 14-21 days -> 1-2 months -> 4-6 months
Older than 18 months - Ab test
Enteroviruses (echo, coxsackie, entero)
Hand-foot-and-mouth disease: Fever, rash from coxsackie
Anterior Oral ulcer, Elliptical vesicles on hands and feet
Herpangina: Fever, sore throat, dysphagia, lesions in Posterior pharynfrom entero
Encephalitis: Neonates - Adolescents
Sick, HA, MILD nuccal rigidity, N/V
Influenza Treatment
Neuraminidase Inhibitors: for A and B
Oseltamivir 6 months +, liquid
Zanamivir not for wheezers
Influenza A resistance to amantadine and rimantadine
RSV
MCC of Bronchiolitis
- MC occurs in children less than 2
- peak 2-6 mo.
Rapid viral ag test: nasopharyngeal secreations
Hep V virus
In utero exposure:
HBsAg dx acute HBV
Rabies
Bats, Raccoons, Skunks bites
Tx: Vacc + Ig 4-5 doses
0 - 1 - 7 - 14 - 28 days
Parainfluenza
“Croup” stridorous
Adenovirus
URI with conjunctivitis, D - multisystem
Rotavirus
Severe, Water Diarrhea
cruises
Rhinovirus
Common cold
MC in children
Arbovirus
WNV
Dengue fever
Hep A
Food handling
Dx: IgM Ab
Hep C
Check for transmission to baby at 18 months
