Viral Infections of the Skin 1b: VZV and all the others

Question 1

Where in the body does VZV establish latency?

Answer 1

Dorsal root ganglia, especially in T2-4

Question 2

Term for recurrence of VZV in usually older people; name 3 possible complications.

Answer 2

Shingles; can lead to keratitis/retinitis, Bell’s palsy, and neuralgia

Question 3

Name the sequelae of VZV that can infect all tissues of the eye, accompanied by long-lasting pain. Damage to what part of the eye will cause blindness?

Answer 3

Herpes Zoster Opthalmicus; retina

Question 4

For what ages should the zostavax or varivax vaccines be offered?

Answer 4

Varivax: ages 1-60
Zostavax: ages >50

Question 5

What is the common epithelial presentation of EBV? In what kind of patients does this usually occur?

Answer 5

Oral hairy leukoplakia; in immunocompromised patients

Question 6

What kind of immune cells does EBV infect?

Answer 6

B cells

Question 7

When they are symptomatic, EBV and CMV can cause very similar mononucleosis infections. Give 3 ways that CMV infections differ from EBV infections.

Answer 7

CMV presents with a petechial skin rash, jaundice, and no sore throat

Question 8

What disease, also called exanthem subitum, is caused by HHV6b and HHV7? What disease does HHV6a cause?

Answer 8

Roseola; none

Question 9

What kind of immune cells do HHV6 and 7 infect?

Answer 9

CD4 T cells

Question 10

What disease presents as 2-3 days of high fever followed by a faint trunk rash? By age 2, 90% of children have already had the infection twice.

Answer 10

Roseola

Question 11

What virus causes the overgrowth of blood vessels under the skin in Kaposi’s sarcoma?

Answer 11

HHV8 / KSHV (Kaposi’s sarcoma herpesvirus)

Question 12

In what 2 kinds of cells does KSHV establish latency?

Answer 12

B cells and endothelial cells

Question 13

List 2 cancer-esque diseases that are linked to Kaposi’s sarcoma.

Answer 13

Body cavity-based lymphoma and Castleman’s disease / hyperplastic lymphadenopathy

Question 14

How do you treat Kaposi’s sarcoma?

Answer 14

Treat the underlying immunodeficiency

Question 15

What is the naked, ssRNA virus that causes hand, foot, and mouth disease? In what patient population is this painful, blistering disease commonly found?

Answer 15

Coxsackie virus; found in preschool aged kids and their parents

Question 16

Term for the Coxsackie virus induced throat infection that causes red-ringed blisters and ulcers on the tonsils and soft palate.

Answer 16

Herpangina

Question 17

Term for the Coxsackie virus induced eye pain, redness, and wetness plusswelling, light sensitivity, and blurred vision.

Answer 17

Hemorrhagic conjunctivitis

Question 18

What is the transmission route of coxsackie virus?

Answer 18

Direct contact, fomites, or secretions (it is highly contagious)

Question 19

What is the transmission route of HPV?

Answer 19

Direct contact

Question 20

List the 4 major poxviruses.

Answer 20

Molluscum contagiosum virus (MCV), monkeypox virus, variola virus / smallpox, vaccinia virus

Question 21

Give 3 ways that the skin rash of molluscum contagiosum virus differs from that of HPV.

Answer 21

MCV lesions are umbilicated (have a dimple in the middle), pale and shiny (not red), and usually appear in clusters

Question 22

How is molluscum contagiosum virus transmitted, and in which 2 populations is it most common?

Answer 22

Direct contact or fomites; common in school-aged children and in HIV(+) patients (it also occurs in sexually active adults)

Question 23

What poxvirus illness, endemic to West and Central Africa, is transmitted by squirrels and monkeys via direct contact or respiratory droplets?

Answer 23

Monkeypox

Question 24

Describe where on the body smallpox vs. VZV rash is found.

Answer 24

Both can affect the face; VZV is mainly on the trunk while smallpox affects the extremities

Question 25

List 4 possible complications of vaccinia virus.

Answer 25

Auto-inoculation of the eyes/face, generalized vaccinia, eczema vaccinatum, and progressive vaccinia (necrosis or gangrene)

Question 26

In what patient population does the potentially fatal progressive vaccinia occur? What 2 treatments are possible?

Answer 26

Immunocompromised patients; can treat with cidofovir or VIG (vaccinia immune globulin)

Question 27

What virus is the cause of German measles?

Answer 27

Rubella or togavirus