Sketchymicro viral images/medical symptoms: DNA viruses

Question 1

Answer 1

erythema multiforme: HSV-1/2

Question 2

Answer 2

herpetic witlow HSV1/2

Question 3

Answer 3

Gingivastomatitis, hsv 1/2

Question 4

Answer 4

keratoconjunctivitis, hsv 1/2

Question 5

Answer 5

keratoconjunctivitis, hsv 1/2

Question 6

Answer 6

gingivastomatitis, hsv 1,2

Question 7

Answer 7

herpes labialis, hsv 1/2

Question 8

which hsv causes genital herpes?

Answer 8

hsv 2

Question 9

Answer 9

African Burkitt Lymphoma: large jaw swelling/lymphadenopathy

Question 10

Answer 10

Burkitt lymphoma, jaw swelling/lesion

Question 11

how would you distinguish this from candidiasis?

Answer 11

this will likely scape off if it is oral hairy leukoplakia seen in EBV infections;

Question 12

in whom is this lesion pattern most likely found?

Answer 12

hiv patients: oral hairy leukoplakia indicating EBV infection. benign lesion, not a cancerous precursor lesion.

Question 13

Answer 13

cervical lymphadenopathy seen with mononucleosis

Question 14

first thought

Answer 14

mononucleosis (EBV) caused submandibular lymphadenopathy

Question 15

Answer 15

non-specific, but can EBV-pharyngitis

Question 16

Child was diagnosed with strep pharyngitis and given a medication. The image was taken several hours later. What was the medication and what is a possible diagnosis?

Answer 16

maculopapulary rash: Nonspecific allergic rxn but according to sketchy micro this is a typical presentation when EBV is misdiagnosed

Question 17

nasopharyngeal carcinoma

Answer 17

EBV is the most common cause; asian men have the highest incidence rate

Question 18

Answer 18

CMV esophagitis

Question 19

Answer 19

HSV 1 esophagitis

Question 20

Answer 20

“blue berry muffin rash” can seen with cytomegalovirus (CMV), rubella, and parvovirus B19

Question 21

Answer 21

“pizza pie retinitis” or CMV retinitis

Question 22

How would you single out the identity of the virus associated with this MRI

Answer 22

paraventricular calcifications: CMV

Calcifications may occur in the following conditions:

1. Viral infections such as:
   
   • Rubella: in the USA, only 10% of females are susceptible
   • Varicella-zoster: only 15% of females are susceptible
   • Herpes Simplex infection
   • Venezuelan Equine Encephalitis
   • Toxoplasmosis
   • Congenital Cytomegalovirus infection: most common congenitally acquired infection
2. Infarctions
3. Teratoma
4. Familial mitochondrial encephalopathy
5. 3-hydroxyisobutyric aciduria
6. Moebius syndrome
7. Fahr”s syndrome

Most of these diagnoses can readily be eliminated since they do not present with periventricular calcifications but instead basal ganglia or parenchymal calcifications. The only serious differential diagnosis is the Familial mitochondrial encephalopathy. The ultrasound findings of intracranial calcifications are mostly important to distinguish between CMV and Toxoplasmosis. CMV most commonly is represented in the periventricular area as compared to Toxoplasmosis where the lesions are seen more commonly in the brain parenchyma.

<big>Diagnosis: Congenital CMV</big>

Question 23

Temporal lobe distinguished in this image, what virus most likely localizes to the temporal lobe in order to cause an encephalitis?

Answer 23

herpetic temporal lobe encephalitis

Question 24

EBV vs CMV: Hepatosplenomegaly or Splenomegaly

Answer 24

EBV most likely splenomegaly; CMV more likely hepatosplenomegaly

Question 25

symptoms of congenital CMV

Answer 25

blue berry muffin rash, jaundice, hepatosplenomegaly, sensorineural hearing loss, ventriculomegaly, periventricular calcifications, seizures

Question 26

Congenital Varicella Zoster syndrome

Answer 26

1. Limb hypoplasia
2. scarring in a dermatomal pattern
3. microcephaly
4. optic atrophy
5. choriorentisis
6. coritcal atrophy
7. seizures
8. cataracts
9. renal hydrodysgenesis

Question 27

Answer 27

herpes zoster opthalmicus: V1 is infected

Question 28

Likely diagnosis and what makes its distinct

Answer 28

rash in a dermatomal pattern, but it crosses the midline: indicating this is likely herpes zoster in an immunocompromised patient

Question 29

Answer 29

Varicella Zoster: chicken pox. Generalized exanthema.

Question 30

Answer 30

varicella zoster, generalized exanthemas (chicken pox)

Question 31

Answer 31

herpes zoster (shingles). varicella zoster is called herpes zoster once it is reactivated.

Question 32

child has a fever lasting 3-4 days and develops a rash on the 4th day. shown in the image is the rash (rash is sparing the face). what was one of the doctor’s fears during the febrile period?

Answer 32

seizures.

this is HHV-6: roseola, rose-6-eola