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28 Cards in this Set
- Front
- Back
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Epstein-Barr virus (EBV) overview
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Causes Infectious Mononucleosis(IM)
Linked to Burkitt lymphoma in some areas "Glandular Fever" |
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Infectious mononucleosis
Clinical |
Polyclonal B-cell proliferation and activation
Most subclinical Incubation- 1-2 months Prodrome- 3-5 days Replication- oropharynx Dissemination-Lymphoreticular system, liver, spleen |
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Infectious mononucleosis
Symptoms |
1) Sore throat
2) Symetrical lymphadenopathy 3) Fever on presentation 4) Splenomegaly 5) Petechial lesions at junction of hard and soft palate (palatal exanthem) 6) Hepatomegaly with jaundice and lizer enzyme elevation |
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Infectious mononucleosis
Morph of Agent |
1) Gamma Herpes virus
2) Enveloped 3) dsDNA 4) Latency in B-cells in presence of T-cells 5) EBV-1 and EBV-2 |
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EBV
Epidemiology |
1) Person to person transmission via droplets
2) Virus in saliva "kissing disease" 3) Low contagiousness 4) Asymptomatic in children 5) Peak age 17-25 USA, Africa 90% 1st year 6) Sexual transmission possible |
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EBV
Latency |
EBV genome is replicated with Host chromosome during S phase.
10 viral genes expressed during latency |
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EBV
Diagnosis |
1) Heterophile antibodies(1st week to several months)
2) Atypical lymphocytes 3) Serologic tests for Antibody to Virus used to confirm in infants and children, IgG antibodies are permanent |
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Infectious mononucleosis
Treatment |
1) Symptomatic relief
2) Steroids controversial 3) Infection results in life-long immunity |
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Infectious mononucleosis
Complications |
1) Rash will develop with treatment with ampicillin
2) Splenic rupture (not common) |
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EBV
Role in lymphoproliferative diseases/malignancy |
1) Post transplant lymphoproliferative disease
2) Burkitt lymphoma (c-myc) 3) Non-hodgkin's lymphoma 4) Hodgkin lymphoma 5) Nasopharyngeal Carcinoma |
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Cytomegalovirus (CMV)
Overview |
Most common infection of the fetus and major cause of morbidity/mortality in HIV and Transplant patients.
Produce Characteristic CPE (Cytopathological effects)= Syncytia, and intranuclear/intracytoplasmic inclusions |
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Cytomegalovirus (CMV)
Morphology of Agent |
1) Betaherpesvirus
2) Replicates only in fibroblast cultures. 3) In vivo replicates in Epithelial cells |
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Cytomegalovirus (CMV)
Epidemiology |
1) World wide
2) Endemic 3) Inversely correlates with SES 4) Very young and very old 5) Immunosupressed |
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Cytomegalovirus (CMV)
Transmission |
1) Person to Person( inc. sexual), Fluids, Organs
2) Donor organ |
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Cytomegalovirus (CMV)
Clinical Manifestations |
1) Most people asymptomatic
2) Immunosupressed have symptoms |
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Cytomegalovirus (CMV)
Adult Infections |
1) Mono like illness
2) Heterophile antibody negative 3) Abnormal Atypical Lymphocytes 4) May establish latency |
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Cytomegalovirus (CMV)
Transplacental infections |
1) Greatest risk with primary disease of mother.
2) 90% asymptomatic 3) 10-20% of Mild infection-some level of permanent brain damage |
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Cytomegalovirus (CMV)
Transfusion Transplantation |
1) Reactivation of latent virus in host.
2) Can be fatal |
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Cytomegalovirus (CMV)
With HIV |
25% of AIDS patients with get CMV
1) Retinitis 2) GI Disorders 3) CNS disease 4) Pneumonias |
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Cytomegalovirus (CMV)
Diagnosis |
1) TORCH series for newborns
2)Serology-most common 3)Viral antigen or Viral DNA 4) Histology- "Owl eye" inclusions Suspect if: Symptom of Hepatitis-but negative for hep. Symptoms of IM but no heterophile antibodies |
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Cytomegalovirus (CMV)
Treatment |
Gangcyclovir
Foscarnet Fomivirisen Immunoglobulin |
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Cytomegalovirus (CMV)
Prevention |
Wash Hands
Live, attenuated vaccine developed, not promising |
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Mumps
Morph of Agent |
Paramyxovirus
Neg sense Linear ssRNA Helical nucleocaspid Enveloped Spikes(H and N) |
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Mumps
Clinical |
1) Infection of Salivary glands
2) Fever 3) Painful swelling of Parotid gland 4) Rapid onset 5) Vomiting, CNS symptoms 6) 30% of adult males Orchitis 7) 20% asymptomatic |
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Mumps
Diagnosis |
1) Febrile child with bilateral parotitis
2) Nonspecific prodrome 3) HA assay with infected tissue culture 4) ELISA etc. |
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Mumps
Epidemiology |
1) Humans natural host
2) Aerosol transmission 3) Highly contagious 4) Viral shedding long before symptoms 5) Single serotype |
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Mumps
Complications |
Deafness,
Orchitis Oophoritis Mastitis Pancreatitis Spontaneous abortions |
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Mumps
Treatment |
Symptomatic, no antivirals
MMR-Jeryl Lynn attenuated virus life long immunity |
