Viral Infection Clinical Vignettes Flashcards
A 12-year old girl is seen by her pediatrician with symptoms of vomiting, diarrhea, nausea, stomach cramps, chills, and fever. Symptoms began one day after attending a school dinner and pool partly at a local country club.
Norovirus - Norwalk virus
**Outbreaks of norovirus infection often occur in closed or semiclosed communities, such as long-term care facilities, overnight camps, hospitals, prisons, dormitories, and cruise ships, where the infection spreads very rapidly either by person-to-person transmission or through contaminated food.
**N:ICO:(+)ss
A 25-year-old man is seen in an outpatient clinic with a chief complaint of fatigue, nausea, and vomiting for the past several days. He had noticed that morning that this urine was dark yellow. On physical examination, the patient has a low-grade fever and mild abdominal pain and is jaundiced. He denies intravenous drug use or multiple sexual partners. He attended a Burning Man 3 weeks earlier. He is a cook a the local university dining hall.
Heparnavirus - Hep A virus
**N:ICO:(+)ss
An 18-year old college student is seen in the university health clinic with complaints of sneezing, nasal discharge, nasal congestion, headache, sore throat and cough for 3 days. Physical examination revealed an afebrile, normal-appearing male patient.
Rhinovirus
**N:ICO:(+)ss
A 14-year old girl is seen in a pediatric practice with sudden onset of fever (103oF), headache, stiff neck, and photophobia. She returned home the previous week from summer vacation at a recreational vehicle campsite that featured a campground pool.
Coxsackievirus or ECHOvirus
**N:ICO:(+)ss
A 10-year old boy in Nigeria is seen by a CDC physician with a chief complaint of increasing weakness in one leg. Ten days earlier, he had a minor illness consisting of nausea and vomiting that was followed by a sensation of numbness in his left leg
Poliovirus
**paralytic poliomyelitis
**N:ICO:(+)ss
In July 2003, a 40-year-old male business man contacted his family physician by telephone with complaints of high fever and shortness of breath. He told the physician that 10 days earlier he had retuned from a business trip to Hong Kong and was worried he may have gotten sick there. The man was admitted to an isolation room in the hospital. On physical examination, he had a fever of 101oF, dyspnea, a dry cough, and bilateral lung infiltrates seen on chest radiograph.
Coronavirus
**enveloped HEL +SS RNA
A 58-year-old white male is seen by his primary care physician with complaints of fever, abdominal pain, and dark urine. Past history is significant for injection drug use and alcohol abuse. On examination, he has a fever, hepatomegaly, an is icteric. Hepatitis B (HBV) serology was negative.
Hep C virus
**enveloped ICO +SS RNA
A 67-year-old man from Florida was admitted to the hospital in September with symptoms of high fever, headache, neck stiffness and disorientation. the patient was well until 3 days ago when he developed a mild flu-like illness. He works part time in the evenings for a landscaping firm. West Nile virus IgM assay of the CSF were negative.
St. Louis encephalitis
**enveloped ICO +SS RNA
A 70-year-old man from Minnesota was admitted to the hospital in August 2003 with complaints of fever, nausea, vomiting, headache, confusion, ataxia, and muscle weakness. According the the patient’s daughter, he had been healthy until 2 days ago when he complained of flu-like symptoms including fever, neck stiffness, and vomiting. His history was significant for hypertension. He has no recent travel outside the area, is retired, and is an avid fisherman. An epidemic of dead crows has been reported in the county.
West Nile virus
**enveloped ICO +SS RNA
A 24-year-old medical student is seen by her primary care physician because of sudden onset of fever (104oC), chills, severe headache/pain around the eyeballs, and muscle and bone pain. On examination she has a faint, generalized macular rash. She returned to the US 2 days earlier from a tropical medicine elective in the Caribbean islands.
Dengue virus
**enveloped ICO +SS RNA
A 55-year-old man living on the Eastern Shore of Georgia is brought to the local health department clinic in August with a high fever, stiff neck, severe headache, and lethargy. Interestingly, there have been a number of deaths in horses from encephalitis in the region.
Eastern equine encephalitis - alphavirus
**enveloped ICO +SS RNA
A pregnant 16-year-old female living in Haiti is brought to the hospital in labor. The mother had a flu-like illness with a low-grade fever, maculopapular rash, and lymphadenopathy during the second month of pregnancy. On examination the baby has a blueberry muffin rash and cataracts.
rubivirus - rubella virus
**enveloped ICO +SS RNA
A 35-year-old female became ill with fever and flu-like symptoms after spending 4 months traveling on a medical mission to Nigeria. Her symptoms worsened upon returning to her home in New Jersey, where she sought treatment and was hospitalized for fever (103.6oF), headache, vomiting, and diarrhea leading to severe prostration. Her condition deteriorated and she was intubated and mechanically ventilated
Lassa fever virus
- *prostration, Lassa Nigeria
- *E:Hel:(-)ss
An otherwise healthy 28-year-old male biology graduate student presented to the emergency department with sudden onset of high-grade fever, myalgia, cough, and dyspnea. His condition deteriorated rapidly, with the patient becoming hypoxic and requiring mechanical ventilation. Chest X-ray showed evidence of bilateral infiltrates. Patient history was significant for doing recent small mammal (including mice) field research in a Colorado research forest.
Hantavirus
**Hanta the mouse
**E:Hel:(-)ss
An 11-month old male is seen in a pediatric practice in February with symptoms of a nonproductive cough, nasal congestion, rhinorrhea, fever, and irritability. Physical examination was significant of a temperature of 101.5oF, rhinitis, and wheezing. A chest X-ray revealed pulmonary infiltrates. The child was admitted to the intensive care unit. Nasopharyngeal washings were negative for RSV.
Metapneumovirus
Looks like RSV, but less severe
**E:Hel:(-)ss
