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27 Cards in this Set
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______________ Fever, HA, Vomiting, Rash Nuchal rigidity, photophobia, myalgia Normal glucose, Lymphocytosis |
Viral Meningitis |
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Viral meningitis can be differentiated based on ELISA (IgM (acute) or IgG (chronic/reccurent)) or PCR. Which viruses require PCR? |
Enteroviruses EBV VZV HHV6 CMV HSV (West nile virus can be done either) |
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______________ Stiff neck & HA followed by--> Lethargy, Coma, Stupor, Seizures, Facial weakness (cortical dysfxn) & Ataxia, nystagmus, hypotonia, myoclonus (cerebellar dysfxn) |
Viral encephalitis *usually co-occuring w/ meningitis--> meningoencephalitis |
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______________ (+) ssRNA, naked virus transmission: oral-fecal, inhalation children summer, fall clinical presentation: GI sxs followed by meningitis encephalitis, myocarditis, neonatal sepsis, poliomyelitis |
Picornaviradae family: coxsackie B virus Human Enterovirus echovirus |
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_______________ (-) ssRNA, segmented, enveloped transmission: arthropod summer, fall California, Southeastern US clinical presentation: Nonspecific febrile illness, aseptic meningitis, meningoencephalitis (No CSF findings during acute phase) |
California serogroup viruses- Bunyaviridae family: La Crosse virus California encephalitis virus Jamestown canyon virus Snowshoe hare virus |
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______________ (-) ssRNA, enveloped transmission: respiratory school aged children clinical presentation: rash, acute encephalitis (mc) or chronic encephalitis (subacute sclerosing panencephalitis/ SSPE) |
Paramyxoviridae family: (morbillivirus genus) Measles virus |
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Subacute sclerosing panencephalitis (SSPE) occurs about 7 yrs after Measles infection. (mc in those infected before age 2) How does SSPE present? |
insidious onset personality changes poor school performance progressive intellectual deterioration myoclonic jerks (periodic muscle spasms) motor dysfxn: spasticity, tremors, loss of coordination, ocular abnormalities/ blindness |
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_________________ (+) ssRNA, enveloped 6 month - 4 yr latency clinical presentation: insidious onset personality changes, poor school performance, progressive neurological deterioration: seizures, cerebellar ataxia, spastic weakness, retinopathy/ optic atrophy--> frank dementia--> coma spacticity & brainstem involvement--> death (in 2-5 yrs) |
Progressive Rubella Panecephalitis Togaviridae family: Rubella virus |
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______________ (-) ssRNA, enveloped clinical presentation: parotitis, meningitis |
Paramyxoviridae family: Mumps virus |
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______________ dsDNA, enveloped virus transmission: saliva winter Adolescent (16- 21), college exposure clinical presentation: sore throat, white pharyngeal exudate, splenomegaly, meningoencephalitis, focal neurological features, myelitis, Guillain-Barre |
Herpesviridae family: Epstein-Barr virus (EBV) |
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________________ (-) ssRNA, segmented, enveloped virus transmission: mice, rats, hamsters clinical presentation: biphasic sxs, meningeal signs, followed by more prominent HA in 2nd phase (lasts 1-3 wks) |
Lymphocytic choriomeningitis virus (LCMV) |
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_____________ (-) ssRNA, diploid*, enveloped clinical presentation: mono-like sxs that resolve, aseptic meningitis, encephalitis or cranial nerve palsy (rare) |
Retroviridae family: Human immunodeficiency virus (HIV) |
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_______________ dsDNA, enveloped transmission: intimate contact, child-birth neonate clinical presentation: neonatal meningoencephalitis, reactivated latent infection--> viral encephalitis (MCC**)- altered consciousness > fever > HA > disorientation > behavior/ personality changes > seizures Tx: IV Acyclovir |
Herpesviridae family: Herpes Simplex Virus (HSV) |
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HSV-1 is more likely in ______________ HSV-2 is more likely in ______________ Where do latent virions reside? |
HSV-1 = sporadic encephalitis *resides in trigeminal ganglion HSV-2 = recurrent benign lymphocytic meningitis *resides in sacral ganglion |
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_____________ dsDNA, enveloped transmission: respiratory winter immunocompromised clinical presentation: skin lesions (as a child) --> reactivation of latent virus--> lesions/rash, meningitis, encephalitis, myelitis, pneumonia Tx: IV Ganciclovir |
Herpesviridae family: Varicella-zoster virus (VZV) *latent virions reside in dorsal root ganglion |
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_____________ dsDNA, enveloped Immunocompromised (HIV +, BMT*) Transmission: person to person Clinical presentation: ocular infection, encephalitis |
Herpesviridae family: Cytomegalovirus (CMS) |
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____________________ dsDNA, enveloped immunocompromised (HIV +, transplant) Clinical presentation: encephalitis |
Herpesviridae family: Human Herpesvirus-6 (HHV-6) |
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_______________ (+) ssRNA, enveloped virus transmission: mosquito bite, touching dead or sick bird summer, fall CSF: neutrophil predominance clinical presentation: mc asymptomatic or fever, HA, & fatigue (possible rash, eye pain) or encephalitis w/ tremors, parkinsonism, & myoclonus, poliomyelitis-like paralysis |
Arbovirus- Flaviviridae Family: West nile virus (WNV) |
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How does the West Nile Virus cause pathogenesis? |
TLR-3 induced secretion of TNF-alpha--> changes permeability of barrier--> allows WNV to cross BBB |
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____________ (+) ssRNA, enveloped transmission: mosquito clinical presentation: mc asymptomatic, meningitis or encephalitis, seizures |
Arbovirus- Flaviviridae family: St. Louis encephalitis virus |
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_______________ (+) ssRNA, enveloped transmission: arthropod clinical presentation: prodrome (malaise, fever, chills, myalgias), followed by recovery OR encephalitis |
Arbovirus- Togaviridae family: Eastern / Western Equine Encephalitis Virus |
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which is more severe, Western or Eastern Equine Encephalitis virus? |
more severe- Eastern (Western disease is more mild) |
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_____________ (-) ssRNA, enveloped transmission: rabid animal (dog, bat) bite (virion in saliva invades motor & sensory nerves) 7 days - 6 yr incubation period clinical presentation: furious type (mc)- hyperactivity w/ hydrophobia & aerophobia d/t spasms of pharyngeal & nuchal muscles--> increasing spasms--> hallucinations, agitation, ANS hyperactivity, seizures, hyperthermia (107) dumb type- paresthesias, weakness, & flaccid paralysis in bitten limb |
Rhabdoviridae family: Rabies virus |
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_______________ (-) ssRNA, naked clinical presentation: abortive myelitis- non-specific febrile illness (2-3 days) aseptic meningitis (non-paralytic)- meningeal irritation + non-specific febrile illness (rapid complete recovery) paralytic- minor illness followed by signs of meningeal irritation + asymmetric flaccid paralysis (no sensory loss, full recovery in few months) if severe--> quadripalegic, respiratory muscle paralysis |
Poliomyelitis Picornaviridae family: Poliovirus |
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_________________ circular* dsDNA, naked virus immunosuppressed (most ppl have, no effect in healthy ppl) clinical presentation: sxs evolve in weeks- months, depend on location of brain damage, clumsiness, progressive weakness, visual, speech, & personality changes |
Progressive Multifocal Leukoencephalopathy (PML) Polymaviridae: JC virus |
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Pathogenesis of PML (JC virus) |
virus destroys oligodendrocytes--> demyelination |
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_____________ (+) ssRNA, enveloped transmission: tick clinical manifestation: (rare) meningitis or encephalitis--> permanent neurological sxs |
Flaviviridae family: Powassan virus |
