Viral Infections Flashcards
Who are viral infections common in
Children and immunocompromised
What does HSV 1 cause orally
Herpes
Oral ulcers
What does herpes varicella zoster cause orally
Shingles
What does Epstein Barr virus cause orally
Hair leukoplakia
Lymphoma
What does HHV-8 cause orally
Kaposi sarcoma
Presentation of primary hermetic gingivostomatitis
Acute gingivitis
Oral ulceration
Crusting of lips
Submandibular lymphadenopathy
Malaise
Fever
Widespread multiple ulcers
Diagnosis of PHG
Based on clinical signs and symp
Differential for PHG
Erythema multiforme
Herpetiform recurrent apthous stomatitis
Herpangina
Hand foot and mouth (cocksaki)
Management of PHG
Primarily supportive
Chlorhex MW
2% lidocaine MW
Paracetamol
High fluids
Resolves in 7-10 days
PHG antivirals
Not routinely used unless severe or immunocompromised
Acyclovir 200mg 5TD
What are trigger factors for HSV1
Stress
Exposure to UV light
Cold weather
Flu
Period
Pregnancy
Trauma
Immunsuppression
% of herpes labialis
30-40%
Features of herpes labialis
Pro drome burning in 40-60%
Initiates as vesicle
Erupts to leave erosion
Crusts after 48 hours
Heals in 7-10 days
Recurrent episodes
Treatment of herpes labialis
Topical aciclovir 5%
Penciclovir 1%
Reduce duration doesn’t prevent
Systemic
Aciclovir 200-400mg 5TD 5-7 days
Valaciclovir 1g TDS 3-5 days
Features of oral herpetif ulcer
Multiple small ulcer
Prodromal burn
Local trauma
Palate most frequent
Features of heroes zoster (shingles)
Headache malaise and fever
Small vesicles or ulceration confined to sensory nerve distribution
Burning and allodynia
When would you need urgent referral of shingles
If ophthalmic nerve involved
Management or HHV - 3 herpes zoster
Antivirals - systemic aciclovir 10 days 800mg 5TD
Valacyclovir 1g every 8 hours for 10 days
Early antivirals to avoid post herpetic neuralgia
What are complications of herpes zoster
Post hermetic neuralgia
Ramsay-Hung syndrome
Meningitis
Presentation of EBV (HHV4)
Headache
Fever
Malaise
Myalgia
Lymphadenopathy
Fatigue
Where does EBV replicate
Acquired in saliva
Replicates in mucosa and salivary glands
Spreads to B lymphocytes and blood
What is EBV associated with orally
Hairy oral leukoplakia
What is OHL associated with
Immune deficiency secondary to HIV
Organ transplant
Immunocompetent
Dx of OHL
Benign
Painless white patch
Vertical folds or ridges involving lateral briefer of tongue
Can’t be scraped away
Investigation for OHL
Biopsy and histopathology
Management of OHL
Exclude immunocompromised
Monitor
Systemic antivirals will resolve but will recur when med stopped
What is Kaposis sarcoma caused by
HHV 8
Oral manifestation of HIB or immunosuppression
What can kaposis sarcoma mimic
Amalgam tattoo
How do you diagnose kaposi sarcoma
Clinical appearance and histopathological findings
Management of kaposis sarcoma
Intralesional injections of chemotherapeutic drugs
Chemotherapy or local radiotherapy
