Sydromes Flashcards
List viral infections causing retinitis
Rift Valley Fever
“usually bilateral, occurring 1–3 weeks after the primary febrile illness. Fifty per cent of cases suffer permanent loss of central vision; there may be permanent unilateral or bilateral blindness”
Herpes viruses (HSV, CMV)
VZV- PORN, ARN
Rubella- Congenital rubella causes pigmentary retintis, “salt and pepper” (also cataracts, micropthalmia)
Congenital
Viral infections causing conjunctivitis
acronym MEAANZ
Measles
EV- (specifically, EV-D70 or coxsackievirus A24), haemorrhagic conjunctivitis
Adenovirus
Avian influenza
Newcastles disease
Zikaand Dengue
(not inclusive,feel free to add more!)
MEAAN (this exam is so mean I want to poke my eyes out)
Viral infections causes arthralgia
Alphaviruses (Togaviridae)
Chikungunya virus (East Africa, India, Southeast Asia, and Philippines Caribbean and in 2014 nd United States)
O’nyong-nyong virus – East Africa
Ross River virus – Australia, New Zealand, and South Pacific islands
Mayaro virus – South America
Sindbis virus – Europe, Asia, Africa, Australia, and Philippines
Barmah Forest virus – Australia
Parvovirus
Rubella
Viral Hep- HAV, B and C
HTLV
Causes of guillain Barre Syndrome
(not complete)
Viral:
Zika, (dengue and chik more rarely)
CMV, EBV
VZV
HEV
Post vaccine phenomeom
Bacti: campylobacter, mycoplasma, h.influenzae
Note GBS is is an acute, immune-mediated polyradiculoneuropathy typically occurring 2–8 weeks after viral or bacterial infection. Motor function is usually affected, beginning distally and progressing proximally over an up to 4-week period. Areflexia, sensory disturbances, and cranial nerve involvement may also occur (then called miller- fischer).
Neurological presentations of VZV (to be completed)
post-infectious cerebellitis (young children)
Encephalitis
Vasculopathy (typically linked to shingles but can occur before shingles presents. Intrathecal antibodies can be used for diagnostics.
A patient presents with a suspected Acute flaccid paralysis, and enterovirus D 68 infection. Which samples should you prioritise for testing
Respiratory swabs
D-68 is mainly a respiratory infection
Does not stay long in poop
(in reality to request CSF, blood and poop also, but the resp is the money shot)
Cause of nephropathia epidemica.
Puumala
Clinical syndromes associated with HTLV
List 8
ATLL- occurs in approx 5% (can be acute/chronic/smouldering or lymphomatous)
TSP
HAM
Uveitis
Dermatitis
Joint pain
Bronchiectasis
Sjögren’s syndrome, rheumatoid arthritis, fibromyalgia and ulcerative colitis
How does Acute T-cell Leukaemia or Lymphoma present (ie HTLV associated)
Hypercalcaemia
Lymphadenopathy
Hepatolsplenomegally
The acute and lymphatous types are more agressive
What are the clinical features of HAM/TSP
2% lifetime risk if infected with HTLV
Lower limb signs
Causes spasticity (extensor plantars, increased tone, hyperreflexia, clonus)
Muscle weakness
Back pain
Bladder and bowel dysfunction
Clinical syndromes associated with EBV infections
Infectious mononucleosis
MS
X linked lymphoproliferative disease (https://www.niaid.nih.gov/diseases-conditions/x-linked-lymphoproliferative)
PTLD
Nasopharyngeal cancer
Gastro cancer
Chronic active EBV
PTLD develops due to excessive B cel growth caused by immunosupression
Occurs in 1-10 percent of SOT patients
Presentation of WEE
Positive single stranded RNA virus
Fever
5% mortality culex
Argentina, uraguay
List differentials for Measles
Viral: HHV6
HHV6
Parvovirus
Rubella
Primary HIV
Travel Related: Dengue, Chik, Zika
Scarlet fever
Syphilis
Encephalitis in someone from europe
Travel related:
Toscana (group 2 phlebevirus)
West Nile (Group 3, flavi)
Usutu (Group 2, flavi)
?Rabies (Group 3)
LCMV (Group 3 or 2 depending on strain)
Borna virus (group 3)
Non travel related: HSV1-1, VZV, enterovirus
In Europe A total of 104 human cases of USUV infections were reported (between 2012 and 2021- as per EDCD) , with neurological manifestations in 11 cases
Note USUTU and WNV are very similar- in birds and equids
Encephalitis in traveller from Australia- what tests would you do
Common tests
-exclude non-infectious
Bloods: HIV, Syphylis
LP (standard, biocem)
-HSV 1/2, VZV, entero, parecho
Travel related: Murray Valley, West nile (Kunjin)Hendrah (none since 1994)
Immuncompromised: CMV, HHv6/7,
Encephailitis in traveller from America
HSV, VZV, ENTERO, PARECHO
Travel:
WNV
EEEV
WEEV
La cross
St Louis
I’m sure there are more
What percentage of encephalitis is non-infectious?
30%
Symptoms of west nile
80% asymptomatic
Worse outcome in elderly
https://www.cdc.gov/westnile/resources/pdfs/West_Nile_Virus_Diagnostic_Algorithm_Print-Only.pdf
PTLD managament
Discuss at MDT, transplant organ assessment
RIS- then re-assess after 3-4 weeks
4 weekly 375 mg/m2 (if no remission then give CHOP, if yes then 4 x3 weekly 375 mg/m2)
TBE is a biphasic illness T/F
True
25% of those infected get neurological disease
NEEDS COMPLETING
Complications of shingles
Post herpetic neuralgia, paresis (motor
weakness), facial palsy and ‘herpes zoster ophthalmicus’, -eye associated dermatome, which may result in keratitis, corneal ulceration, conjunctivitis, retinitis, optic neuritis and/or glaucoma.
Risks increase with age
Disseminated disease in immunocompromised (with a case fatality rate reported to be between 5 and 15%, and most deaths being attributable to pneumonia)
The risk of shingles is also increased in individuals with certain conditions, including systemic lupus erythematosus, rheumatoid arthritis, diabetes and Wegener’s granulomatosis
Cancers associated with HBV
Liver
GI- orl, stomach, colorectal pancreatic
Lymphoma
Describe clinical syndromes assoc with HHv8 (incomplete)
Endemic (more KS like) subsaharan africa and mediteranean
Epidemic (HIV assoc)
MCD, KS, PEL
Inflammatory cytokine sydrome
HLH
Describe HLH grading systems (2 types) incomplete
Fever
Splenomegaly
Two cytopenias
High triglycerides
High ferritin (>500, typically over 2000)
EEG findings for HSV encephalitis
PLEDS- Periodic lateralized epileptiform discharges (aka periodic discharges), diffuse or focal slowing
Presentation of kyasaunar forest
Group 3
After an incubation period of 3-8 days, the symptoms of KFD begin suddenly with chills, fever, and headache. Severe muscle pain with
vomiting, gastrointestinal symptoms and bleeding problems may occur 3-4 days after initial symptom onset. Patients may experience
abnormally low blood pressure, and low platelet, red blood cell, and white blood cell counts.
After 1-2 weeks of symptoms, some patients recover without complication. However, the illness is biphasic for a subset of patients (10-
20%) who experience a second wave of symptoms at the beginning of the third week. These symptoms include fever and signs of
neurological manifestations, such as severe headache, mental disturbances, tremors, and vision deficits.
The estimated case-fatality rate is from 3 to 5% for KFD.
Spinal cord neurology causes
VZV
Enterovirus
HTLV
Chik
Parvovirus presentation in congenital infection
Hydrops- fetal heart failure, anemia, effusions (extravasion of fluid, polyhydramnios)
Myocarditis
Echogenic bowel
Dental loss
