Viral infections Flashcards
WHat are the Most common Herpes viruses?
HSV
What is the pathogenesis of Herpes Simplex virus infection?
Viral seeds a ganglion
Spreads via peripheral nerves
What is caused by HSV-1?
Herpes Labialis
Immcomp: Genital, liver, lung, eye, CNS
What is caused by HSV-2?
75-80% of recurrent genital herpes infections.
What is charicteristic of Primary vs Reactivation of HSV infection?
Primary: Sudden, Asymptomatic, painful lesions
Reactivation: Systemic S and S, Local Lymphadenopathy
Prodromal Symptoms: Pain, burning, tingling, pruritis
What are the opthalmologic manifestations of HSV?
Necrotizing Retinitis
HSV Keratitis
What are the CNS Manifestations of Herpes?
Herpes Simplex Encephalitis (temporal lobe)
Aseptic Meningitis
Molaret Syndrome:(recurrent meningitis associated with reactivation of HSV)
Transverse myelitis/Sacral autonomic Dysfunction
Bell’s Palsy
What are the visceral infections of HSV?
HSV Esophagitis
HSV Tracheitis
Pneumonitis, Hepatitis rare
What is seen in HSV infection of immunocomprimized?
More frequent recurrence
Disseminated infection
Visceral infection = High mortality
How is HSV diagnosed?
Clinical Diagnosis
Culture/PCR
Tzanck Smear (multinucleated giant cells)
What is the Tx of HSV?
Acyclovir
Foscarnet, Gancyclovir
Eye infections- Topical antivirals
What are the traits of Varicella Zoster infection?
Highly COntageous
More serious in adults
Aerosolized droplets from nasopharynx or direct contact from vesicle fluid
How do you know that someone with Varicella Zoster is no longer contageous?
All their Sores are crusted over
What are the risk factors for Varicella Pneumonia?
Smoking, pregnanacy, immuosupression
What is the Tx of Varicella?
VZV less suceptible to Acyclovir than HSV but still first line
WHo should recieve the VZV vaccine?
Ongoing risk of exposure immsupressed Pts in household Women of Childbearing age Post exposure prophylaxis in non-immune Pts of children with pox Outbreaks with intense exposure
WHat are the different manifestations of Herpes Zoster infection?
Cutaneous Acute Neuritis and Post-Herpetic Neuralgia Ocular: Acute retinal necrosis Oticus(ears) CNS Pneumonitis Hepatitis
What is the Tx for Zoster?
Acyclovir #1
Valacyclovir
Famcyclovir
Vaccine to avoid shingles
What will happen if you give aspirin to a Zoster patient?
Reye’s Syndrome
What is the manifestation of EBV in adolescents and adults ?
Children?
Infectious Mononucleosis
Subclinical
What are the malignancies associated with EBV?
Lymphoproliferative disorders Duncan Syndrome Burkitt's Lymphoma Nasopharyngeal CA Hodgkin's dis T-cell lymphoma Nasal Lymphoma
What is the the Tx of EBV?
Supportive Care
Avoid Contact sports
Steroids when there’s airway obs, aplastic anemia, fulminant hepatitis
What is seen on microscopy of CMV?
Owl Eye inclusions
