skin 12: summary Flashcards
Need to know ALL names for agent/disease!
Variola virus – smallpox:
VZV - chickenpox and zoster
Human Parvovirus B19 (HPV B19) - Erythema infectiosum (aka Fifth disease)
(HHV-6) or (HHV-7) - Exanthem Subitum
(aka roseola infantum aka Sixth disease)
Measles virus – measles (aka rubeola, aka hard measles)
Rubella virus - rubella (aka soft measles, aka German measles)
Host and Reservoir: Humans are the source of infection:
Variola virus, Varicella-zoster,
HPV B19, HHV-6, HHV-7, measles virus, rubella virus
seasonality??
chickenpox, erythema infectiosum, measles, rubella
transmitted in respiratory secretions (primary mode):
variola, varicella-zoster, HPV B19, measles
and rubella virus
transmitted in lesions (secondary mode):
variola, varicella-zoster viruses
transmitted in saliva:
HHV-6, HHV-7
Primary POE is the URT inhalation of respiratory droplets:
variola, varicella-zoster, HPV B19, measles,
rubella viruses or direct inoculation of conjunctiva.
Primary POE is the oropharynx:
HHV-6, HHV-7.
Primary attack rate is high – thus asymptomatic infections are uncommon/rare:
varicella- zoster, measles virus; variola virus
Virus in lesion and lesions are infectious:
smallpox, chicken pox
Lesion is immune-mediated (virus not present):
erythema infectiosum, exanthem
subitum
Active, life-long infection:
HHV-6, HHV-7
Latent infections with recrudescence of virus infections:
varicella-zoster, HHV-6,
HHV-7
Persistent infections:
HHV-6, HHV-7, measles (SSPE), rubella (congenital infection)
Prodrome:
smallpox, chickenpox (primary infection in adolescents and adults), erythema infectiosum (mild), measles, rubella (mild or absent)
Acute Disease: Fever and a maculopapular rash:
variola virus, varicella-zoster, HPV B19, HHV-6, HHV-7, measles virus, rubella virus
Acute Disease: Rash appears 1st on face, hand and forearms spreads to trunk, legs:
smallpox; rash/lesions are present on the palms of hands and soles of feet
Acute Disease: Rash appears 1st on face spreads to trunk, limbs:
chicken pox, measles, rubella
Acute Disease: Rash appears 1st on face, spreads to limbs (palms and soles), sometimes torso or
trunk:
erythema infectiosum
Acute Disease: Rash appears 1st on face and trunk, spreads to limbs:
exanthem subitum
Acute Disease: Fever defervesces then rash appears:
HHV-6 and HHV-7 (sometimes), variola virus,
HPV B19
Acute Disease: Fever with rash:
chickenpox, measles, rubella
Acute Disease: Arthropathy, arthralgia with fever, in adults, (more common in women) + rash:
HPV B19, rubella virus
complications: of all?
Secondary bacterial infection and/or bacterial superinfection of skin or RT
complication: Viral pneumonia, viral encephalitis
smallpox, varicella-zoster, measles
complication: Aplastic crisis
Fifth disease
complication: In utero infection
varicella-zoster, Fifth disease, HHV-6 (likely), measles, rubella
complication: Congenital disease
varicella-zoster, HPV B19, measles, rubella
complication: Reye’s syndrome
varicella-zoster - aspirin contraindicated
complication: Diarrhea and pneumonia in malnourished populations
measles
complication: Otitis media in developed countries
measles
how to dx all viral exanthems
Clinical features, susceptibility, contact with infected person
how to dx congenital infections
TORCH/STORCH/TORCHS test
ddx: a person with a fever and maculopapular rash (excluding epidemiological factors such as age and seasonality):
all of above? + ECHOviruses, Coxsackie viruses enteroviruses 6871, arboviruses, Hepatitis B viruses, Dengue, Rocky Mountain Spotted Fever, Lyme Disease, Neisseria meningitidis, S. pneumoniae, scarlet fever, toxic shock syndrome
ddx: a person with arthropathy:
HPV B19, rubella virus, Lyme Disease, rheumatoid arthritis
Vaccine preventable -
smallpox, chickenpox, measles, rubella
Post-exposure prophylaxis with vaccine to prevent disease -
chickenpox vaccine.
Antiviral therapy -
chicken pox and zoster
Immune globulin -
chicken pox