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case 15: leukemia > virology: herpes virus > Flashcards

virology: herpes virus Flashcards

1
Q

When is the best to get infected with herpes viruses

A

Early life due to milder disease

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2
Q

What is the structure of herpes virus

A

dsDNA enveloped with complex genome

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3
Q

What is the pathophysiology of most herpes viruses

A

Primary infection into latency then reactivation

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4
Q

What does HSV 1 & 2 cause

A

Infects at the skin or mucous membrane causing lesion/vesicle forming painful shallow blisters

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5
Q

Where does HSV 1 & 2 cause infections

A

HSV 1: oral
HSV 2: genital

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6
Q

How does an infection get reactivated

A

Due to a stressor like sunlight, stress, febrile disease, menstruation & immune-suppression

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7
Q

Where does HSV hide

A

Doral root ganglion in sensory neurons

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8
Q

How is HSV 1 & 2 transmitted

A

Direct contact with lesion due to virus shedding (can be asymptomatic shedding)

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9
Q

What is the symptoms of primary HSV 1 & 2 infection

A

Mostly asymptomatic but gingiva-stomatitis, eczema herpeticum, traumatic inoculation, conjunctivitis, keratitis, genital herpes

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10
Q

How long after HSV 1 & 2 infection does lesions appear

A

1-3 days post exposure at the site of inoculation

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11
Q

What is clinical features of secondary infection with HSV 1 & 2

A

Lesions are more mild & heals quicker
Cold sores, genital herpes, keratitis & recurrent aseptic meningitis

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12
Q

What is 3 life threatening complications of HSV 1 & 2

A
  1. Neonatal HSV infection
  2. HSV encephalitis
  3. Disseminated infection
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13
Q

How does neonatal HSV infection occur

A

Maternal primary genital herpes causing generalised HSV infection

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14
Q

What is the symptoms in neonatal HSV infection

A

Sepsis syndrome 3-5 days post delivery with very subtle vesicles

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15
Q

What is the laboratory diagnosis for HSV 1 & 2

A

PCR or microscope of lesions
Encephalitis: CSF
Generalized: blood
Blistering lesions: swab of lesion

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16
Q

What is used to diagnose past infections in HSV 1 & 2

A

IgG

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17
Q

What is Varicella virus

A

Chicken pox the primary infection

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18
Q

What is the symptoms of Varicella

A

Mild febrile illness with generalized vesicular rash & aseptic meningitis

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19
Q

How is Varicella transmitted

A

Highly infectious (aerosols, droplets or vesicle fluid)

20
Q

What is the five complications of Varicella

A
  1. Secondary infection of skin lesions
  2. Pneumonia: interstitial pneumonitis (primary infection
  3. Post infectious encephalomyelitis: self limiting
  4. Stroke: replicates in endothelial cells of CNS blood vessels (commonest stroke cause in children)
  5. Haemorrhagic varicella: fulminant infection in immune-compromised patient with haematological malignancies
21
Q

What is the two complications with Varicella in pregnancy

A
  1. Congenital varicella syndrome: skin scaring or hypoplasia of limbs
  2. Peri-natal varicella: virus cross placenta few days before born & no antibodies transferred (prophylaxis infected <7days before birth)
22
Q

What is the Zoster infection

A

Shingles the secondary infection

23
Q

What is the clinical appearance of Zoster virus

A

Vesicular eruption dermatomal

24
Q

What is Zoster virus complications

A

Post herpetic neuralgia, encephalitis, myelitis, multi-dermatomal rash, strokes & retinitis

25
What is the laboratory diagnosis for Varicella Zoster virus
Clinically apparant IgG for past infections PCR with vesicle fluid or CSF
26
What is the treatment for Varicella Zoster virus & mechanism of action
**Acyclovir:** nucleoside analogue that interferes with DNA polymerase & chain termination
27
What is the post exposure guidelines of Varicella Zoster
**Immune-compromised, neonate <6 months, pregnant:** ZIG/acyclovir **Health adult, child >1 year <72hrs post exposure:** varicella vaccine /acyclovir
28
What is the pre-exposure guidelines for Varicella Zoster virus
Varicella vaccine
29
What is the three clinical syndromes in CMV
1. Primary infection in adulthood 2. Congenital infection 3. CMV in immune-suppressed patients
30
What is the most common cause of congenital abnormalities
CMV
31
What is the complications of congenital CMV
1. No ill effects but shed virus 2. Delayed onset or symptoms 3. Congenital infection syndrome
32
What does CMV in immune-suppressed individuals cause
CMV end organ disease Interstitial pneumonia, retinitis, GIT ulceration or encephalitis
33
What is the laboratory diagnosis for CMV
IgG for past exposure Viral load in blood
34
What is the treatment for CMV
Ganciclovir/valganciclover
35
What is EBV
Primary infection at oro-pharyngeal epithelium with B cell latency & reactivation with asymptomatic shedding in saliva
36
What is the primary infection of EBV
Infectious mono-nucleosis
37
What is infectious mono-nucleosis
Benign lymph proliferative disorder of B lymphocytes
38
What is EBV treatmet
**Self limiting** immune response clear most infected B cells
39
What is the symptoms of EBV
Fever, rash, malaise Generalized lymphadenopathy Sore throat, tonsils Hepato-splenomegaly
40
What is the diagnosis in acute infectious mononucleosis
+ monospot & VCA with - EBNA
41
What is the diagnosis in past infectious mononucleosis
+ VCA IgG & EBNA with – VCA IgM
42
What is the complications in EBV
Cancer in B-lymphocytes or epithelial disorder
43
What is the treatment for EBV if not self-limiting
Reduction in immunosuppression **Rituximab:** mono-clonal antibody to CD20 that removes EBV transformed B cells
44
What does HSV 6 cause
Roseola infantum
45
What is HSV 8
Primary infection asymptomatic with latency in B/endothelial cells & reactivation& shed in body fluids
46
How is HSV 8 transmitted
MTCT or sexual

case 15: leukemia (11 decks)

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