Viral Infections of the Oral Cavity Flashcards
What are the laboratory investigations for diagnosis of viral infections?
- Viral SWAB (Dacron/ cotton tip) for PCR
- Clotted blood (serum)
What are the Human Herpes Viruses?
- HHV1 = HSV I
- HHV2 = HSV II
- HHV3 = VZV
- HHV4 = EBV
- HHV5 = Cytomegalovirus (oral ulceration in immunocomp)
- HHV6
- HHV7
- HHV8 (Kaposi’s sarcoma associated virus)
What are the clinical features of HSV?
- Gingivostomatitis
- Herpes labialis
- Keratoconjunctivitis
- Herpetic whitlow
- Bell’s palsy
- Genital herpes
How is HSV transmitted?
Direct contact
What lab diagnosis is used for HSV?
PCR (vesicle fluid –> Dacron swab)
What preventative measure can be used against HSV?
ACV 200mg 5x daily
Prevents recurrent infections in difficult cases
What treatment can be used for HSV?
- Aciclovir cream 5% (topical)
- IV therapy for immunocomp & severe
What causes chickenpox?
Varicella (primary infection)
What are the complications of varicella infection?
- Secondary bacterial infections
- Pneumonia
- Congenital, perinatal/ neonatal
What causes shingles?
Zoster (reactivation of VZV; trig n)
What are the complications of zoster reactivation?
- Secondary bacterial infections
- Post-herpetic neuralgia
- Ophthalmic zoster
- Ramsay-Hunt Syndrome (LMN palsy; facial n)
What lab diagnosis is used for VZV?
- PCR (dacron swab & media)
- Clotted blood (serum)
- IgM/ IgG test (susceptibility to Varicella)
What preventative measures can be used against VZV?
- Vaccination
- ACV for immunocomp pts
What treatment can be used for VZV?
- Varicella = IV ACV (severed and immunocomp)
- Zoster = oral ACV 800mg (5x daily)
What are the clinical features of EBV?
- Oropharyngeal lymphadenopathy (mononucleosis “mono”)
- Sore throat
- Malaise
- OHL in HIV infection/ immunocomp
How is VZV transmitted?
Respiratory secretions (vesicle fluid; direct contact, droplet, airborne)
How is EBV transmitted?
Saliva
What lab diagnosis is used for EBV?
- Clotted blood (serum)
- Antibody testing
Name a Coxsackie A disease
Hand, foot and mouth
What population is commonly seen to have a Coxsackie A Virus disease?
Children <5yrs
What are the clinical presentations of hand, foot and mouth disease?
- Usually asymptomatic
- Fever
- Painful blisters on hand, foot and mouth
What are the clinical features of measles virus?
INITIAL (3 Cs)
- Fever
- Cough
- Runny nose (Coryza)
- Inflamed eyes (Conjunctivitis)
LATER ONSET (2-3 days)
- Koplik’s spots (small white spots inside mouth)
- Red flat rash on face –> body
Which virus is associated with H&N cancers?
HPV-16
