VIII- Viral SSTI Flashcards by Haley T

cutaneous warts etiology

from HPV
-can be common (verruca valgaris), plantar (verruca plantaris), flat (verruca plana on face)

transmit: direct contact with wart or contam surface thru an abrasion

HPV 1 oral

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cutaneous warts cytology

hyperkeratotic, painless, exophytic
-koilocytes may be found
-common warts will be in groups usually @hands, elbows, knees
-thickening of skin layers from proliferation induction by blocking p53 and E7

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molluscum contagiosum lesion etiology

molluscum contagiosum virus

transmit: direct contact with lesions, sexual, fomites

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molluscum contagiosum lesions cytology

painless, pearly, umbilicated (looks like has belly button) nodules
-large eosinophilic cytoplasmic inclusions aka molluscum bodies

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HPV life cycle

latent (dormant in ganglion)
lytic (active infection when virus replicates in epithelial tissue)
-reactivation correlated to stressors

virions form in suprabasal layer of skin

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viruses of skin ulcers

HSV

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viruses of purulent lesions

VZV

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skin disease of HSV

primary infection = herpetic gingivostomatitis so lesions outside mouth and in palate

reactivation = herpes labialis aka cold sores

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skin disease of varicella zoster virus

chickenpox

rash/lesions at trunk, face, scalp + fever
-vesicles>pustules>scabs in ‘crops of lesions’ so can see all 3 forms in one area
-can complicate to bacterial infection of lesions or pneumonia, neonatal disease

a herpes virus

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vaccination of chicken pox

2 doses of live attenuated
-grown in tissue culture
-to prevent primary infection so given to kids
-if can’t have live vaccine then passive immunization (prophylatic)

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vaccination of shingles

to protect from reactivation so for 50+
-recombinant zoster vaccine (SHINGRIX) of viral gE protein
-used to have live attenuated but no longer used

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common warts HPV

HPV 2, 3, 10

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plantar warts HPV

HPV 1, 4

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herpes stromal keratitis

from HSV in the eye
-primary infection = conjunctivitis
-recurrent disease = corneal opacity from scar tissue, see dendritic lesions

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herpes simplex encephalitis prez

altered consciousness + hallucinations + ansomia + bizarre behavior

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herpetic whitlow

lesions from HSV on digits so either fingers or toes (like cold sores)

eczema herpeticum

people with eczema at inc risk for widespread lesions

herpes simplex gladiatorum

specifically in wrestlers
-skin to skin spread during matches

herpes antiviral mechanism

inhibit DNA polymerase by phosphoylating thymidine kinase
-acyclovir

herpes zoster

shingles

reactivation of VZV in elderly or immunosup
-feels like paresthesia (needles/pins) > vesicular lesions unilateral + fever + malaise
-can complicate to postherpetic neuralgia: severe pain at site of lesion for months

diagnosing VZV

tzanck smear will be pos in herpes virus infections
-HSV pos too

smallpox lesions

@mouth and extremities (palms, soles) CENTRIFUGAL
-deeply set into skin (bb pelet)
-synchronous evolution from papule to ulcer that scabs, considered contagious until all scabs gone
-variola virus

chicken pox is centripetal

smallpox vaccine

live strain of vaccinia virus (poxvirus family) NOT attenuated or variola
-routine vaccination stopped in 1972
-some adverse/fatal effects like eczema vaccinatum
-also use for postexposure prophylaxis

roseola infantum

high fever for few days > maculopapular rash
-from HHV6 or 7 that reps in T/B cells and oral pharynx, latent in T cells (6)

5th disease/erythema infectiousum

fever + rash starting on cheeks > lace like pattern -slap cheek syndrome bc cheeks are red no vaccine from *B19 parvovirus* that grows within hematopoietic cells in bone marrow

german measles

maculopapular rash starting at face then downward -fainter than measles and not coalesce (more patchy) -fever is more low grade than measles -associated with arthralgia and arthritis | rubella virus

measles prez

1. fever + 3 C's (cough, coryza, conjuctivits) + koplik spots 'grains of sand surrounded by red halo' 2. maculopapular rash starts at hairline downward 3. other symps like anorexia, diarrhea, lymphadenopathy

measles prevention

measles resistance if: documented 2 doses live vaccine, lab evidence of immunity, physician diagnosed measles, birth before 1957 passive immunopprophylaxis if susceptible

congenital rubella syndrome

infection during first trimester of preg = **deafness**, cataracts, glaucoma, heart dz, pigmentary retinopathy -can show purpura, h/smegaly, jaundice respiratory transmission

measles virus

-forms syncitia (giant multinuc cells) -very contagious bc infectious for up to 2 hours on fomites and air, respiratory spread- no direct contact needed

complications of measles

diarrhea otitis media pneumonia some encephalitis, seizures, death

measles vaccine

2 doses of live attenuated in chick embyro fibroblasts > subcut injection -combine with MMR or MMRV

rubella vaccine

live attenuated grown in tissue culture -in MMR/V -major objective is to prevent congenital rubella syndrome

other manifestations of B19 parvovirus

1. aplastic crisis 2. arthralgia, arthritis 3. pregnancy, hydrops fetalis, CHF, anemia