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Viral Infections

Infectious Disease

Clear vulvar vesicles, inguinal LAD = Herpes virus (Genital)
Viral arthritis: most common agents Hep B & C, rubella, & parvovirus (parvo can be confused with RA)
Viral arthritis: findings Nondestructive; usually self-limited; No specific tx, except supportive
Raccoons, bats, skunks: may carry: Rabies; give Ig, Rabies vaccine if animal is not caught and tested
Agents of Viral Meningitis (aseptic): Enterovirus (ECHO, Coxsackie A & B), HSV-2; possibly mumps
EBV is what kind of virus? Human Herpesvirus (HHV 4): enveloped DNA virus
EBV S/S Fever, sore throat, posterior LAD, 50% splenomegaly
Non-enveloped icosahedral virions: HPV
HPV serotypes 1-4 skin warts; 11 laryngeal; 6 & 11 anogenital; 16 & 18 assoc w/CIN
HSV remains latent within: dorsal root ganglia; HSV-1 in trigeminal n.; HSV-2 in sacral root ganglia
Orthomyxovirus = influenza (strains A, B, C)
VZV incubation = 10-20 days; esp contagious day before rash appears
HIV MOA Infect cells w/T4 Antigen (esp CD4 helper inducer lymphs); CCR5 & CXCR4 chemokine receptors help viral entry. Also infect B lymphs & macrophages.
AIDS definition CD4 <200 or indicator dz; 4 stages
Infant w/jaundice, HSM, low plt, periventricular CNS calcifications, MR, purpura = CMV
CMV complications include: retinitis (if CD4 <50), esophagitis, odynophagia, pulmo in BMT (85% fatal), encephalitis
College student with pharyngitis, big tonsils, anterior cervical LAD, splenomegaly, elevated atypical lymphocytes = EBV (mononucleosis)
HIV pathology HIV-1 causes AIDS. HIV-2 slower progression.
CDC Classification of HIV A1-A3, B1-B3, C1-C3. A: Asymptomatic. 1: CD4 >500. 2: 200-499. 3: <200.
Mean time from exposure to HIV to symptoms suggesting AIDS is: 10 years
Findings highly specific for HIV infection Hairy leukoplakia of tongue, disseminated Kaposi sarcoma, cutaneous bacillary angiomatosis
Hand-foot-mouth Dz organisms Usually Coxcaskie A16 (enveloped RNA virus). Also Coxsackie A5 & A10 and Enterovirus 71
Enterovirus 71 causes 4 forms of HFM Dz: HFM/herpangina, CNS dz (hypoventilation, limb weakness), pulmonary edema, convalescence
Mumps etiology Paramyxovirus (enveloped single-stranded RNA virus). Droplet & urine transmission. 14-21 day incubation. Virus replicates in lymphoid tissue.
Mumps target tissues Salivary glands, pancreas, testes, ovaries, CNS
Most common cause of pancreatitis in children Mumps
Rabies organism Single-stranded RNA virus in rhabdovirus group
Most common infective vectors of rabies in US Raccoons, skunks, bats, coyotes, foxes
Rabies pathology Incubation 3-7 weeks (may be 10 days to years). Via bite/saliva. Travels thru nerves to brain, multiplies, travels via efferent nerves to salivary glands
Rabies prodrome 2-10 days of pain at bite. ST, fever, HA, N/V, temp sensitivity.
Rabies CNS stage Typically delirium alternating with calm. Painful laryngospasm (hydrophobia). May be paralytic and resemble GBS.
RSV organism Pneumovirus in paramyxovirus family: enveloped single-stranded virus
RSV pathology Produces fusion of human cells in tissue cx (syncytial effect). Droplet / secretions transmission (fall to early spring) -> resp epithelium -> lower airways. 2-8 day incubation.
Most common cause of pediatric PNA and bronchiolitis RSV
RSV clinical features Tachypnea, hypoxemia, hypercapnia, interstitial infiltrates & pulmo collapse on CXR.
Common complication of RSV Strep pneumo AOM
SARS clinical features Persistent fever (>38C), rigors, cough, SOB, rales, rhonchi, HA, ST; watery diarrhea in late dz; malaise & delirium in elderly. Low WBC/lymphs, possibly mild DIC. SaO2 <95%
West Nile fever pathology Flavivirus (arbovirus). Mosquitos are vectors, birds are reservoir. Outbreaks late summer-early fall
West Nile fever clinical features Incubation 2-14 days. 20% have flulike symptoms for 3-6 days. 30% maculopapular rash face & trunk. Stiff neck, AMS, 10% flaccid paralysis, 5% seizures.
West Nile fever clinical features by age Younger patients: febrile syndrome. Adults: aseptic meningitis. Elderly: greatest mortality
West Nile meningitis or encephalitis are: Reportable diseases
Created by: Abarnard