VIral Infections Flashcards
The types of Herpes virus disease ( MFP470 )
- Primary Herpetic Gingivostomatitis
- Epstein-barr virus (HH4)
- Recurrent herpes
- Herpes Zoster (HH3)
- Cytomegalovirus (HHV 5)
- Kaposi Sarcoma (HHV 8)
HSV 1 vs 2
They are generally the same however
1 is above diaphragm and 2 is a genital virus
Pathogenesis of Primary HSV1
Oral infection-DIrect contact
Move to trigeminal ganglion via sensory nerves
remains latent
uses the axons of the sensory nerves to travel back and forth to peripheral skin/mucosa
HSV1 most common condition
Primary Herpetic Gingivostomatitis
Adult varient of HSV1
Pharyngotonsillitis in adults
symptoms Primary herpetic GIngivostomatitis
Fever,malaise, painful mouth
Oral symptoms of PHG
small vesicles, ulcerations and enlarged painful gingiva
how does secondary HSV 1 manifest
Re-activation resulting in - Herpes labialis
Triggers for herpes labialis
UV, trauma, Immune deficiency
Prodromal signs of Herpes Labialis
Itching,tingling and erythema
Recurrent herpes simplex virus clinical features
Small cluster of vesicles on vermillion and peri-oral skin
it may present intra-orally on the posterior palate over the greater palatine foramina and occasionally on the gingiva. These vesicles ruptre and ulcerate within 10days
N.B Generally no fever or lymphadenopathy ( unless secondary infection ) - Herpetic whitlow ( hands and fingers )
Herpes labialis vs recurrent aphthous ulceration
Recurrent aphthous ulceration usually forms on non-keratinzed mucosa — no vesicle phase.
Treatment of recurrent herpes simplex virus
Penciclovir
Management of Herpes labialis
Explain to patient the virus stays with them
- infection occurs dur to triggers such as trauma, immune deficiency Excessive UV light exposure
-DIfficulty to treat as resistant to anti-virals may occur
- When patient experiences tingling itching feeling with no ulcer - put patient on penciclovir ( prodromal stage)
With immune compromised patients – systemic medication
Varicella zoster virus pathogenesis
It enters the host via ( air droplets ) the respiratory tract and conjunctiva and replicates at site of entry
or via direct contact with lesions
Primary infection in children presents as chicken pox ( varicella ) — recurrence presents as zoster ( shingles )
Clinical features herpes varicella
Pruritic rash
vesicle pustul crust formation
Herpes zoster ( secondary infection ) pathogenesis
Latent in dorsal root ganglia
Herpes zoster clinical features
Unilateral vesicles that ulcerate
ramsey hunt syndrome
postherpetic neuralgia
Herpangina ( hand foot and mouth disease ) path
Cocksakie A virus
RNA virus of picornavirus family
self limited symptomatic relief
Clinical features of herpangina
Malaise, fever and sore throat
offten diffuse erythema on soft palate fauces and tonsillar areas
bilateral
PHG vs herpangina
PHG is a gingivostomatitis
herpangina is an oropharyngitis
systemic features differentiate it from recurrent aphthous ulceration
Human Papillomavirus varients
over 100
with high risk and low risk types
Brief description of squamous cell papilloma
Benign exophytic papillary growth
Mostly subtype 6 and 11
soft, pedunculated cauliflower-like and painless lesion
simple excision
50-60 years
Diff for squamous papilloma
Traumatic fibroma ( smooth surface and occurs in areas of chronic injury ) and fibro-epithelial polyp
Brief description of verruca Vulgaris
Wart!
type 2 ,4 ,6 ,40
VV of oral cavity results from auto-inoculation from warts on the hands of children.
as with other HPV- viral DNA incoporates into human DNA
Generally in keratinized mucosa
slow growing, painless, exophytic pink to white lesions which consists of sharp, finger like processses
Brief description of condyloma acuminatum
HPV 2 ,6 ,11 ,53 ,54
Sexually transmitted HPV, usually in genital areas.
multiple cauliflower like lesions
Infection of the oral ketinocytes
Generally in non-keratinzed tissue
Multifocal Epithelial hyperplasia description
Type 13 32
hecks disease
appears similar to squamous papilloma
multiple elevated lesions on mucosal surfaces
What is Hecks disease?
Is a HPV associated disorder with HPV type 13 and 32. Many genetic factors area at play
Oropharyngeal Cancer Path
Associated with HPV 16 and 18
This includes carcinomas developing from the soft palate, base of tongue and palatine tonsil area and posterior pharyngeal wall
Patients
who smoke tobacca
have poor lifestyle choices
and partake in excessive alcohol use
Oral hairy leukoplakia associated virus
Epstein-Barr virus
OHL pathogenesis
Associated with immune deficiency
reduced number of CD4+ T-lymphocytes and associated with immune dysfunction
A good indicator of HIV
OHL clinical features
Hyperplastic lesion which characteristic asymptomatic white vertical corrugations on lateral margin of the tongue
DDX of OHL
leukoplakia
Friction keratosis
lichen Planus
chronic hyperplastic candidiasis
