Viral infections Flashcards
meningitis (no cutaneous lesions)
varicella zoster (reactivation, shingles)
meningitis - young children
parecho virus
meningitis - plus or minus parotitis
mumps
meningitis enterovirus (Non specific flu like symptoms)
poliovirus
meningitis other
HSV 2
encephalitis - retrovirus
HIV 1 + 2
encephalitis - herpes
vzv
hsv1
hhv6
immunocomprimised
ebv/cmv
encephalitis - rare
rabies
encephalitis - equine borne, eastern, western, venezualan
togavirus
encephalitis - tick borne - west nile and europe
Flavivirus (Japanese B)
infection of spinal cord
HIV
myelitis and reticulitis
VZV/CMV ( secondary to HIV?)
infections of spinal cord, drg and brainstem
poliovirus and HTLV1/2
mildest infection
enterovirus (often self limiting)
most severe infection
HSV
can cause paralytic polio, faecal oral
enterovirus
aseptic meningitis caused by…
enterovirus
aseptic meningitis due to… (3)
inflamm eg SLE/sarcoid
chronic inflam eg BMT/chemo/agammaglobulinaemia
partially treated bacterial meningitis
aseptic meningitis most common in…
under 40s - babies
aseptic meningitis features (6)
no altered neuro function sore throat nandv headache neck stiffness photophobia
aseptic meningitis presentation - neonates (5)
irritable fever off food abnormal LFT normal CSF
aseptic meningitis complication
fulminant multi organ failure
CSF changes enterovirus - white cells
very elevated lymphocytes
CSF changes enterovirus - protein
0.45-0.9
CSF changes glucose enterovirus
1.0-1.7 below serum
enterovirus CSF changes could indicate… (3)
tb
lymphocytic leukaemia
abcess
enterovirus management
symptomatic
good prognosis
may be recurrent if HSV
sporadic encephalitis causes (3)
hsv1/2
EBV
VZV
hsv location
temporal lobe
ipsilateral olfactory nerve
(unilateral oribtofrontotemporal) diffuse in children
cowdry a inclusions (nuclear DNA)
hsv1/2
infection in utero/parturition - genital infection shedding
HSV2
HSV1
HSV2
which recurrs more often?
HSV2
winter and spring sporadic encephalitis
VSV
sporadic encephalitis along sensory nerves to ganglia
vsv (shingles)
rare respiratory spread of sporadic encephalitis
VZV
GBS complication
vzv
opthalmalgic trigeminal pain, dysaesthesia before rash, persistent pain
VZV
CSF pleocytosis and inc protein
EBV
complications of ebv (7)
aseptic meningitis encephalitis gbs bells palsy transverse myelitis acute cerebellar syndrome
lymphoma can develop if immunocomprimised
EBV
EBV - easy or difficult to recover?
difficult
post infectious encephalitis - rare (5)
measles, mumps, rubella, chickenpox, influenza
chronic progressive encephalitis (2)
hiv
rabies
sspe
pml
SSPE symptoms
dementia, motor disturbance, cerebellar ataxia, myoclonic jerks, seizures, focal retinopathy
SSPE age
7-8y/o (3:1 M:F)
PML virus
papovavirus
PML pathology
kills oligos, transforms astrocytes, white matter necrosis
PML inital infection
GI/resp
PML virus found in…
urine and throat
PML symptoms
visual, motor, cognitive and speech probs - death in 3-6months
PML treatment
no cytosine arabinoside
no JCV antigen
no serology
must restore immunocompetence
Epidemic encephalitis characteristics (3)
seasonal
tick borne?
mosquitoes?
detect vzv/hsv by…
pcr
detect enterovirus/arbovirus by…
csf
CNS SOL manifestations of hiv
toxoplasmosis, lymphoma, PML, tuberculoma
CNS diffuse manifestations of hiv
cryptococcal, meningitis, acute infection, dementia
sspe virus
measles