Picorna virus group

Question 1

priginally called

Answer 1

enteroviruses ( poliovirus, coxackievirus, echovirus)

small ssrna icosahedral viruses varying in size from 24-30nm.

only enterovirus types 70,71.
cox a16, and a6
echovirus and are significant causes of skin dx.

Question 2

Enterovirus infections

Answer 2

Person to person transmission occurs by intestinal oral route. oral to oral or respi. direct inocularion from active leaion or broken skin.

age 6mos- 6 years.

echovirus 9- most prevalent enterovirus causes morbilliform exanthem spec on face and neck.

Question 3

mosy common specific eruptions caused by enterovirus are

Answer 3

HFMD
herpangina
enterovirus superinfecting AD (eczema coxackium)
roseola like illness.

Question 4

infections with … xan be severe w dev of brainstem encephalitis; and fatal neurologic pulmo edema as well as ascending flaccid paralysis.

Answer 4

enterovirus 71

Question 5

Herpangina

caused by cox… number?

Answer 5

Coxackie A8,10,16

echovirus
enterovirus 71.

fever headhae soretheoat dusphagua anorexia and sometimes stiff neck.

Question 6

most significant finding for herpangina

Answer 6

One or more uellowish white lightly raised 2mm vesicles in the throat. usually surr by intense areola.

lesions found most freq: Anterior faucial pillars, tonsils uvula soft palate.

cluster rangijg from 1 to having visisble pharynx studded with them.
usually individual or coalescent vesicles ulcerate leaving shallow punched out grayish yellow crater 2-4mm in diameter. lesions disappear in 5-10 days.

cox10 causes acute lymphonodular pharyngitis.

Question 7

tx

Answer 7

Supportive.
topical anesthetics
maintain hydration.

Question 8

HFMD

Answer 8

CoxA16

6mos- 10 yrs. adults may also dev.
begins w fever and sore mouth.
in 90% of pxs- oral lesions develop. consist of small 4-8mm rapidly ulcerating vesicles rapidly ulcerating vesicles surr by a red areola on the buccal mucosa tongue soft palate and gingiva.

hands and feet- asymptomatic red papules that quickly become small gray 3-7mm vesicles surr by red halo.often oval linear or screscneting and run parallel to the skin lines on fingers and toes and more freq palms and soles.

Question 9

common cauae of atypical hfmd

Answer 9

CoxA6

Question 10

tx for hfmd

Answer 10

supportice
tx for ad ro prevent pruritus.
onychomadesis often follows hfmd about 1 month after the acute viral syndrome.

PCR.

H: intraepid blister formed by vacuolar and reticular degeneration of keratinocytes. inclusion bodies
multinucleated giant cells are absent.

HFMD is dist from herpangina by the distribution of oral lesions and presence of skin lesions.

HFMD usually req no tx.

Question 11

Eruptive pseudoangiomatosis

Answer 11

summer.

sudden appearance of 2-4mm blanchable red papules that resemble angiomas.
red ppules blanch on pressure often surr by 1-2mm pale halo. lesions often number about 10 but may be more numerous. exposed surgaces of face and extremities. trunk may also be affected.
children, lesions are short lived virtually always resolvinh within 10 days. lesions longer in adults.

H: Dilated upper dermal vessels. not increased numbers of blood vessels with prominent endothelial cells are seen.

No known tx.