Herpes virus

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  • Created by: Amh
  • Created on: 16-03-16 07:57
What is the name of the herpes family
herpesviridae
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What sort of virus is herpes
dsDNA virus, typically associated with long period of latency
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How many heroesviridae infect humans
8
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where do alphaherpesvirinae cause harm
Rapid replication, lay dormant in nerves
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Where do betaherpesvirinae casue harm
Slower replicators, lay dormant in leukocytes
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where do gammaherpevirinae cause harm
variable replication lays dormant in immune cells
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Which substrains belong to alphaperpesvirinae
Herpes simplex virus 1 HSV1, Herpes simplex virus 2 HSV2, Varicella zoster VZV
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Which substrains belong to betaherpesvirinae
Cytomegalovirus HHV5, Roseolovirus HHV6, Roseolovirus HHV7
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Which substrains belong to gammaherpesvirinae
Epstein Barr virus EBV HHV4, Karposi sarcoma herpes virus KSHV
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How does herpes manifest
highly varied depends onn infection site, viral type, host age, and immune status
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What happens when a severley immunocomprimised person gets infected with herpes
they can develop a severe disseminated disese
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Who is most likely to manifest the disease, and where
Neonates and infants - most likely to effect CNS, or eye anf disseminate if untreated
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Give some examples of herpes HSV1/V2 infections
Encephalitis, Meningitis, Keratoconjunctivitis, herpatic whitlow, eczema herpeticum, HSV pneumonia, genital herpes, oesophagitis, herpes labialis, gingivostomatis
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How does HSV1 commonly present
as cold sores
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How does meningitis differ form encephalitis
normal brain function in meningitis
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Which herpes is most likely to cause meningitis
HSV2 primary infection, or reactivation
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What is mollarets syndrome
recurrent episodes of herpes meinigitis
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Is herpes meningitis reduced with prophylaxis
no
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how does HSV2 commonly present
genital herpes
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what does a HSV1/HSV2 herpes infection typically look like
Watery blisters in skin / mucous membrane of mouth lips or genitals, leasion heal with a scab
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where does HSV1/2 hide
Neurons of cell bodies
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What does varicella zoster typically cause
Chicken pox and shingles
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What complications can arise from Varicella zoster infection
encephalitis, pneumonia, or bronchitis (the pneumonia can be vial or an opportunistic bacteria) mollarets meningitis
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how does cytomegalovirus cause infection
spread via bodily fluids incl saliva, often there is an intial infection, then latency, infection flairs up if immunocomprimised
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What symptoms can cytomegalovirus cause
doesn't often cause symptoms but if it does - they are flu like, sore throat,glandular fever, swollen glands
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How does Roseolovirus hsv6/7 typically present
High fever followed by a rash
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Who does it infect
by the age of 2 90% of people will be infected
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what is the common name for an epstein barr infection
mono -- from mononucleosis kissing disease
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What are the symptoms of mono
A mild cold 4-6weeks after infections (other symptoms include fatigye, fever, lack of appetite rash, sore throat, swollen glands, normally feel better in 2-4 weeks, fatigue can last a month
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How does EBV spread
saliva
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What does HSV8 cause
Kaposi sarcoma - a cancer
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Who is likley to present with HSV8
AIDS patients
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what is herpatic gingivostomatitis
Often a primary presentation of HSV, more severe than labialis, not able to chew or swallow, fever, sore mouth bad breath, presents as pin head vesicles that rupture form yellow ulcerations and swelling
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what is herpesviral encepthalis
viral infection of CNS
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How does herpesviral encepthalis present
decreased consciousness, altered mental state (confused) WBC found in cerebral spinal fluid, fever, abnormalities in temporal lobe
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Which herpes typically causes herpesviral encepthalis
HSV1, and HSV2 10% of time.
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what is herpes labialis
cold sores
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What is Keratoconjunctivitis/keratitis
infection of epithelial cells on surface of eye, and retrograde infection of cornea nerves, primary infection is sweilling of conjunctiva and eyleids, accompanied by itchy white lesions
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What is a more severe presentation of keratitis
stromal jeraitics of metaherpetic ulcer
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whihc hsv1 commonly causes keratitis
hsv1/2
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what is herpatic whitlow
abscess on the ends of fingers
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how does ECZEMA HERPETICUM present
a rare disseminated infection, normally presents in individuals who have have atopic dermatis, can be fatal
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Which herpes can cause herpatic whitlow
HSV1/V2
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Is a herpetic whitlow a primary or secoundary infection
secoundary
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what is Herpes oesophagitis
a viral infection of oesophagus caused by herpes
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who gets Herpes oesophagitis
immunocomprimised; chemo patiens, AIDs, organ transplants recipiants
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what are the symptoms of Herpes oesophagitis
painful to swallow, hiccups, fever wigth loss, upper GI bleeding
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How do you diagnose a HSV infection
PCR dor HSV DNA presens is very sensitive, or you can swab the lesion, for meningitis/encephalitis you can do PCR of CSF
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What can serology tell us
The prior exposure to disease
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What is the treatment for the virus
Antivirals; aciclovir/valacivlovir, can be given orally or cutaneously
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How would you treat severe disseminated disease/ encephalitis
IV antivirals
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What percentage of people in industrialised countries will have HSV3 varicella zoter by 20
90%
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What is the apthogenesis of HHV3
infection of nasopharyngeal mucosa and subsequent vireamia,incubatino period of 2wks, prodroma coryzal symptoms, rash,
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When are you infectios with a HHV3 rash
48 hours to rash - to vesicle crusting
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where does HHV3 stay laten
Dorsal root ganglia
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What are some complicatinos of hhv3
disseminated -> pneumonia, more ssevere in pregnant women, congenital varicella symdrome, or near to delivery the neborn can have severe dissem disease
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When does VZV PNEUMONITIS occur
mainly in adults who smoke
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How do you diagnose VZV
clinical - rash and history, swab vesicle of fluid, look at csf to check if neurological symptoms, check blood if diseminated
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Which antibodies do we look for in vzv serology
IgG to check for seroconversion
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what is the treatment for chicken pos
aciclovir given to adults
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What is the treatment of shignles
aciclovir or valaciclovir
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is there a vaccin for hsv3
yes given in the us, in the uk it is only given to healthcare workers
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Where does hsv4 stay latent
memory b cells
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How many people are infected with HSV4 by 25
95%
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What are some rare complications of hsv4 that occur in immunocomprimised
Thromocytopenia, haemolytic anaemia, encephalitic, meningitis, Guillain-Barre, myocarditis, pericarditis, hepatits
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What else is EBV/HSV4 associated with
Burkits lymphoma, nasopharyngeal carcinoma, MS, chronic fatigue syndrome
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How is it diagnosed
Atypical lymphocytes LFT derangement, serology for EBV IgG IgM
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how is HHV5 transmitted
bodily fluids
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what are the clinical feautures of HHV5
After birth usually asymptomatic, but infectious mononucleosis syndrom and mild hepatis can ocue
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What can congenital CMV lead to
Cytomegaic inclusion disease which leads to jaundice, verebral calcification and developmental delay
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Which diseases can CMV cause in immunsurpressed patients
retinitis,oesphagitis, colitic, pneumonitis, hepatitis
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What does serology for CMV show us
IgM is not reliable for acute infections, IgG indivated that the person has come across CMV,
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What do we use to test fro cmv
PCR of blood levels, urineor saliva of babies, levels in organs
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what is the treatment for end organ damage in immunosurressed patents
CMV DNA polymerase inhibitors 1st ganiciclovir 2nd foscarnet
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How do you treat severe retinitis
iv ganciclovir
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where do alphaherpesvirinae cause harm

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