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48 Cards in this Set
- Front
- Back
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What is an exanthem?
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eruptive disease or fever
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What is an enanthem?
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eruption upon a mucous membrane
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What are the childhood exanthems?
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Measles, rubella, roseola, varicella, Fifth disease
*mumps has no exanthem |
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What are some other viral agents of exanthems?
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HHV-6 (roseola)
enteroviruses (echo and coxsackie) adenovirus EBV Dengue virus Other hemorrhagic fever viruses |
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Measles and mumps are part of which virus family?
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Paramyxoviridae
*Also includes parainfluenza and RSV |
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What is the morphology for mumps and measles viruses?
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Paramyxo
negative ssRNA Enveloped (all neg are env!) Cell mem has key glycoproteins |
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What glycoprotiens are present in the envelope for mumps?
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Hemagglutinin
Neuraminidase Fusion protein |
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How is mumps transmitted?
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Saliva/oral secretions
-communicable 7 days prior to illnes and 9 days after it develops -highest frequency in ages 5-15 -peak season late winter-spring |
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How does mumps virus spread in the body?
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Entry into respiratory tract where it has local replication
Viremia cause spread to target tissues (salivary, CNS, kidneys, etc) |
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Where is mumps virus commonly found?
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commonly found in urine
--> Viruria |
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What are the clinical manifestations of mumps?
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fever
swelling of salivary glands (Esp. parotid) earache or facial pain Intraoral may reveal erythema or edema of Stensen's duct Can be asymptomatic in up to 1/3 |
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How is diagnosis of mumps made?
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Clinical presentation and epidem
Lemon juice causes in increase in salivation and pain (does not occur with adenopathy) |
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What is treatment for mumps?
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No specific treatment.
Live attenuated vaccine (MMR) |
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What are the glycoproteins in the measles virus envelope?
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Hemaggluitinin
Fusion protein (NO Neuraminidase!) |
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How is measles spread?
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Transmision via saliva/oral secreations to respiratory tract or conjunctiva
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When do measles epidemics occur?
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Usually in winter-spring
Often in 1-3 year cycles |
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What is the pathogenesis in measles virus infection?
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Entry into respiratory tract and replicated in resp epithelium
Spreads via blood & lymph to multiple sites including skin In viremia, infects WBC |
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What are the clinical manifestations of measles?
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1. initial = CCCF
2. enanthem 1-3 days later = Koplik spots (esp on buccal mucosa) 3. exanthem = maculopapular appears first at hairline, centrifugal spread to palms and soles |
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What are some complications from measles infection?
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otitis media
pneumonia bacterial superinfection encephalitis RARE = SSPE - rare progressive neuro disease begins 2-10 years p.i. |
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How is diagnosis of measles made?
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Clinical presentation and epidem
Lab: viral culture, IF, serology --> Warthin-Finkeldy cells = replicate in keratinocytes |
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What is treatment for measles?
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Supportive
Vaccine = live attenuated (MMR) Can also give ribavirin or vit A |
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What is the problem with immunization for measles?
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15% of immunized fail to respond
35% are never immunized |
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What virus family is Roseola part of?
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Herpes virus family
HHV-6 |
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What is the morphology of HHV-6?
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Large, enveloped - dsDNA - linear
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When is HHV-6 most common?
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Late fall and early spring
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Who has been infected with HHV-6?
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Nearly 100% of adult are sero+
**Most communicable herpesvirus -->reactivation seen with immunocomp |
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What are the clinical manifestations of HHV-6?
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1. Several days of high fever
2. Resolution of fever is onset of exanthem: irregular macules spread from trunk to face (lasts 2-48h) 3. Complications: febrile seizures |
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What is diagnosis for HHV-6?
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Clinical presentation
Lab = serology, PCR |
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What is treatment for roseola?
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No treatment
NO VACCINE |
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What is the STAR complex?
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Sore Throat - Arthritis - Rash
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Give examples of viruses that exhibit the STAR complex.
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Rubella
5th disease (Parvo 19) Hep B Adenovirus Echo and Cocksackie EBV |
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What is Fifth disease?
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5th exanthem found historically
Parvovirus 19 Also called "slap-cheek disease" |
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What is the morphology for parvovirus 19?
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icosahedral capsid
ssDNA naked |
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How is parvo 19 transmitted?
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Probably respiratory route
30-60& of adults are sero+ |
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What is the primary replication site for parvo 19?
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Nucleus of immature erythrocyte in blood marrow
After replication = viremia --> can cause problem in pregnant women |
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What are the clinical manifestations of 5th disease?
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Mild illness: fever, headache, malaise
- may also have decrease in WBC adn RBC - arthralgias/arthritis may develop Confluent indurated rash on face - lacy pink-red exanthem |
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What is Gloves and Socks Syndrome?
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Papular-purpuric rash on palm of hands
- Differs from slapped cheek because immune responses against parvo 19 appear after onset of skin eruption |
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What are some complications seen with 5th disease?
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Infection of fetus --> hydrops fetalis
Hemoglobinopathy --> anemia Immunocomp --> persitent infection with persistent anemia *implicated in Kawasaki disease |
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How do you diagnose 5th disease?
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Clinical presentation
Confirm with serology, PCR |
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What is treatment for 5th disease?
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No antiviral treatment
NO VACCINE |
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What is Rubella morphology?
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Togavirus family
+ ssRNA - enveloped |
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How is rubella transmitted?
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Oral secretions
*Highest frequency in school-aged children in unimmunized pop |
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Who is the major concern for rubella infection?
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Fetus in pregnant women --> congenital infection
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What is the pathogenesis in rubella infection?
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Entry into respiratory tract, local replication with subsequent viremia
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What are the clinical manifestations of rubella?
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1 - Mild illnes = low grade fever, UR symptoms, lymphadenopathy
2 - Exanthem = maculopapular rash that (like measles) begins on face 3 - Enanthem = Forscheimer spots |
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What are the major complications in rubella infection?
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Most common = arthralgia/arthritis in women
Major complication results from spread of virus to pregnant women and to their fetus --> blue-berry muffin baby |
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How is rubella diagnosed?
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Clinical presentation can be confused with other pathogens = need lab confirmation
Lab = viral culture, serology |
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What is treatment for rubella?
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No specific treatment
Live attenuated vaccine ((MMR) -- essentially developed to prevent fetal infection |
