virus Flashcards
DNA viruses mnemonic –
H -H-A-P-P-P-y Herpesvirus Hepadnavirus Adenovirus Papovavirus Parvovirus Poxvirus
Herpesvirus
Herpes simplex (HSV), varicella-zoster (VZV), cytomegalovirus (CMV), Epstein-Barr (EBV)
Hepadnavirus
Hepatitis B
Adenovirus
Numerous serotypes
Papovavirus
Human Papilloma Virus (HPV)
Parvovirus
- Erythema infectiosum
Poxvirus
Molluscum contagiosum, smallpox, orf, milker’s nodules
Paramyxovirus Measles, mumps Togavirus Rubella Rhabdovirus Rabies Retrovirus HIV, HTLV Picornavirus Enterovirus: coxsackie virus
RNA Viruses
Congenital Cytomegalovirus (CMV) Infection during ? trimester - Highest risk for permanent abnormalities
1st and 2nd
#1 infectious cause of deafness and mental retardation in U.S. Most common congenital viral infection
Congenital Cytomegalovirus (CMV)
TORCH syndrome
“blueberry muffin baby” purpura
• Small for gestational age, microcephaly, retinitis, colobomas, intracranial calcifications
Congenital Cytomegalovirus (CMV)
Epstein-Barr Virus Infects
B lymphocytes
Oral hairy leukoplakia • Slightly raised white plaque on
VIRUS?
lateral surface of tongue with a corrugated
appearance
Epstein-Barr Virus
Exanthem Subitum (Roseola Infantum, ? Disease)
HHV-6, HHV-7
6Th disease
Hand-Foot-and-Mouth Disease
transmission
• Oral–oral and fecal–oral mode
Herpangina ?coxsackievirus
• Group A coxsackievirus
Exanthem Subitum (Roseola Infantum, ? Disease)
fever and rash temporal
spread?
High fever , 4 days later eruption as the fever subsides
Lesions appear first on trunk, then spread to extremities
Hand-Foot-and-Mouth Disease virus
• Coxsackievirus A16 or enterovirus 71
Erythematous papules with grayish vesicle surrounding red areola
Hand-Foot-and-Mouth Disease
- Fever, headache, cervical lymphadenopathy
* Gray-white papulovesicles in oral mucosa that ulcerate (commonly present on tonsillar fauces, palate)
Herpangina
Neonatal Herpes Simplex
Use of scalp electrodes
increase risk of neonatal transmission in HSV-infected mothers
Neonatal Herpes Simplex
In utero infections can rarely occur
are associated with fetal anomalies
microcephaly, encephalitis, intracranial calcifications
(Kaposi’s Varicelliform Eruption)
:
• Atopic dermatitis
• Darier’s disease
• Hailey-Hailey, or severe seborrheic dermatitis
Acyclovir-resistant HSV* – Treatment
*Most commonly due to TK-deficient strains of HSV
• TK-independent fashion
Foscarnet – directly inhibits viral DNA polymerase
• cidofovir – inhibits viral DNA polymerase
(Kaposi’s Varicelliform Eruption)
:
• Atopic dermatitis
• Darier’s disease
• Hailey-Hailey, or severe seborrheic dermatitis
Acyclovir-resistant HSV* – Treatment
*Most commonly due to TK-deficient strains of HSV
• TK-independent fashion
Foscarnet – directly inhibits viral DNA polymerase
• cidofovir – inhibits viral DNA polymerase
Ramsay Hunt Syndrome
• Caused by VZV infection
of the geniculate ganglion
? causes roseola infantum = exanthem
• HHV-6 • HHV-7 – Sixth disease
Kaposi’s sarcoma, Castleman’s syndrome
HHV-8
Human Papillomavirus (HPV) encodes “E” (early) and “L” (late proteins) • E proteins (E1-8): participate in
viral DNA replication
? form virion (the outer shell of the HPV virus)
L proteins (L1-L2): structural protein
Verrucous Carcinoma (HPV-associated) on penis
Giant condyloma of Bushke-Lowenstein
Verrucous Carcinoma on sole of foot
• Epithelioma cuniculatum
• Oral florid papillomatosis
Verrucous Carcinoma (HPV-associated)
Palmo-plantar HPV TYPE
1
Common
2, 4
Flat
3, 10
Butcher’s
7
13, 32
Oral focal epithelial hyperplasia
5, 8, 9, 12, 14, 15, 17, 19-26
Epidermodysplasia verruciformis
6, 11
Anogenital; Bushke-Lowenstein tumor
High risk anogenital/cervical; Bowenoid papulosis
16, 18, 31, 33-35
measles virus, a
paramyxovirus
- High fever
- “3 C’s:” Cough, Coryza, Conjunctivitis
- Koplik’s spots
Measles
Molluscum Contagiosum
a poxvirus
paravaccinia virus, a poxvirus of the genus Parapoxvirus
Milker’s Nodule
• Transmitted to humans from infected cows
•
Milker’s Nodule
Contagious Pustular Dermatitis, Contagious Ecthyma
orf virus (OV)
Caused by, a poxvirus of the genus Parapoxvirus
Milker’s Nodule orf virus (OV)
papule/nodule on the dorsal index finger
Milker’s Nodule orf virus (OV)
orf virus (OV) ? stages, each lasting
6, 6 days:
- red papule
-nodule with erythematous center, white middle ring, and erythematous halo
– red, weeping nodule
– crust with black dots on surface of nodule
– small papillomas
– lesion crusts flattens, and ultimately resolves
- ) Papular
- ) Target –
- ) Acute
- ) Regenerative
- ) Papillomatous
- ) Regressive
(Fifth disease) –
Parvovirus B19 Infection
• Children: Erythema Infectiousum
• Adults:Parvovirus B19
Acute arthropathy with fever and
adenopathy; may develop a lacy, reticular macular eruption
Children:Parvovirus B19
slapped cheK
Papular purpuric “gloves and socks” syndrome
AW Fever and oral erosions
Parvovirus B19
Parvovirus B19 in patients with sickle-cell disease and other chronic anemias
• in immunocompromised patients
• Aplastic crisis
Severe chronic anemia
Parvovirus B19 Pregnancy: Hydrops fetalis, spontaneous abortion
(highest risk in
first half of pregnancy
*TORCH Syndrome causes
hepatosplenomegaly, thromboyctopenia microcephaly deafness chorioretinitis low birth weight, congenital heart disease;
*TORCH Syndrome
– Toxoplasmosis – – Other (syphilis, bacterial sepsis) – – Rubella – – CMV – – HSV –
Rubella
most severe when acquired in ??trimester
1st
Dermal extramedullary erythropoiesis
Blueberry Muffin Baby
few cases have a prodromal rash of macules, papules, or petechiae
“swimming-trunk” distribution, which is pathognomonic
Smallpox
Smallpox Caused by
variola, a poxvirus
Smallpox favor the trunk over the head and extremities
false
Smallpox on light microscopy
Diagnosis: Guarnieri’s bodies
cytoplasmic eosinophillic inclusions
- Erythema multiforme-like eruptions
- Bacterial superinfection – S. aureus, group A beta-hemolytic streptococci
- Accidental inoculation – eczema vaccinatum may develop if inoculated onto dermatitic skin
Smallpox Vaccination Complications
Smallpox following vaccination of a pregnant woman
Congenital vaccinia –
Generalized/ Progressive vaccinia – children with vaccinia
isolated IgM deficiency are especially prone
Varicella (Varicella-Zoster-Virus) Distinguishing Features (Compare to Smallpox) • prodrome • distribution • “Dew drops on a rose petal” – • evolution (
Absent or mild Centripetal vs centrifugal different stages of evolution vs synchronous papules, deep-seated vesicles, pustules, central umbilication
Rapid vs two weeks
Congenital Varicella syndrome - when?hypoplastic limbs, ocular
and CNS abnormalities
• First 20 weeks of gestation:
5 days before and 2 days after delivery:
Neonatal Varicella
Neonatal Varicella at 5 to 10 days of age because of inadequate
treat with
transplacental delivery of maternal antivaricella antibodies;
VZIG + IV-acyclovir