09 - Pathology: Virology - GI, viral exanthem, herpes
Terms
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Rotavirus:
-Symptoms: __1__
-More severe in __2__ -
1. Watery Diarrhea with no Blood or Leukocytes
- Fever
- Vomiting
2. young children -
Pathology of Rotavirus:
-mostly affects the __1__
-replicate in __2__
-excreted in __3__
-detected by __4__ -
1. Small Intestine
2. epithelial cells
3. stool
4. EM or Enzyme immunoassay to detect antigen - EM appearance of Rotavirus
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Spoked-wheel - Describe the symptoms with Calici/Norwalk virus (3)
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1. Watery Diarrhea
2. Abdominal cramps
3. Vomiting
*24-72 hours - About what percent exposed to Calicivirus will have symptoms?
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50%
But all individuals secrete the virus and spread it - Diagnosis of Calicivirus/Norwalk
- CLINICAL
- Histology of Calicivirus
-
SMALL
Star-like appearance - Associated with Infantile Diarrhea and cannot be isolated in the laboratory
- Adenovirus 40 and 41
-
Adenovirus 40/41:
-Symptoms
-Incubation and length of illness -
- Mild Diarrhea - Profound Dehydration
Incubation: 3-10 days
Length: 6-9 DAYS!!! - Diagnosis of Adenovirus 40/41
- CLINICAL
- Incubation period for Measles
- 10 days
- Symptoms of Measles
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3 C's: Cough, Coryza, Conjunctivitis followed by RASH on 4th day!!!
Koplik spots - Cells that are distinctive to Measles
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Warthin-Finkeldey MNGC's in pneumonia - Explain the RASH in Measles
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-Appears on 3rd-4th day
-Red papules that COALESCE
-first starts on Forehead, hairline and then spreads down the body
-includes PALMS AND SOLES - 4 Complications of Measles
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1. Giant Cell Pneumonia
2. Otitis Media
3. POSTINFECTIOUS ENCEPHALITIS
4. SUBACUTE SCLEROSING PANENCEPHALITIS (4-17 years later) - When was Measles vaccine introduced?
- 1968 and has drastically reduced # of cases
- Rubella Incubation period
- 10-21 days
- Symptoms of Rubella infection
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1. Low fever
2. Lymphadenopathy
3. Maculopapular Rash - Where can Rubella disemminate to?
- All organs
- Diagnosis of Rubella
- Serology (IgM)
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Congenital Rubella Syndrome:
-During which Trimerster: 1
-Clinical Triad: 2 -
1. 1st
2. Deafness, Cataracts, Heart Disease, Glaucoma, Mental Retardation - Clinical Symptoms of Mumps
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"MOP"
Meningitis
Orchitis
PAROTITIS - Diagnosis of Mumps
- Serology
- Parvovirus B19 causes:
-
Erythema Infectiosum = "slapped cheeck" - Parvo B19 infects these cells
- Erythroid Precursors that leads to transient anemia
- High risk groups for high morbidity with Parvo B19 infection
-
Sickle cell patients
Thalessemia
Immunodeficient
Pregnant (Hydrops fetalis) - When was Endemic Smallpox eradicated?
- 1979
- Molluscum Contagiosum is caused by this virus
- Poxvirus
- Appearance of Molluscum Contagiosum
- Wart-like lesion with a dimpled center
-
What virus is this? -
Molluscum contagiousum
Poxvirus - Pathology of HPV infected cells is a characteristic CPE termed ________
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Koilocytosis - What is Condylomata Acuminata?
-
HPV warts on genitals - What are Koilocytes?
- vacuolated epidermal cells with shrunken hyperchromatic nuclei
- Herpesviruses cause severe disease in these two groups
-
Neonates
Immunocompromised -
Herpesvirus inclusion bodies - Cowdry Type A (acidophilic) Nuclear Inclusions
- HSV are shed from vesicles within the how many hours after onset of symptoms?
- 24-48
- Smear used for Herpes and what will it show?
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Tzank
MNGC's - Describe Primary infection by HSV
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-Ulcerative lesions of gums, tongue, palate, tonsils
- Fever, Cervical Lymphadenopathy - Decscribe Recurrent Infections with HSV
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-preceded by burning, itching
-Erythema -> vesicles -> ulcers -> crust - VZV is a __1__ infection with the virus residing in the __2__
-
1. lifelong
2. sensory ganglia - Reactivation of VZV =
- Zoster (Shingles)
- Incubation of VZV
- 10-20 days
- Clincial manifestations of Varicella
- Fever, chills -> Vesicular lesions
- Complications of Varicella
-
Bacterial Superinfection
Meningoencephalitis
Pneumonia
Hepatitis -
What causes Secondary Bacteria infection in Varicella - Scratching the lesions
- Histology of Vesicle sample from Varicella
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MNGC's
Cowdry Type A nuclear inclusions - Explain Shingles clinical features
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UNILATERAL vesicular rash
Excruciating pain - CMV is shed in ....
-
pretty much all fluids
-urine, saliva, semen, breast milk - CMV is found in these cells
- Lymphocytes and Monocytes as a latent infection
- Clinical infections of CMV
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Mononucleosis (Monospot -)
Hepatitis - DOC for CMV
- gancyclovir
- Histology of CMV
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Owl's eye nuclear inclusion
Swollen cells (cytomegalic) -
EBV:
-age who is usually asymptomatic
-Age who develop Mononucleosis -
- children
-Older children and adults - Diagnosis of EBV (2)
-
1. Heterophil Ab's (Monospot)
2. EBV specific Antibody - EBV is associated with this disorder that must be differentiated from ACUTE REJECTION
- Posttransplant Lymphoproliferative Disorder (PTLD)
- Histology of PTLD
-
**caused by EBV**
Lymphocytes
-large and atypical
-prominent nuclei
-mitosis
-INDIVIDUAL cell NECROSIS - EBV is also associated with these diseases
-
African Burkitt's Lymphoma
Nasopharyngeal Carcinoma
Hair Leucoplakia in IC'ed
Interstitial Pneumonitis and Hepatitis in PEDIATRIC AIDS PATIENTS - HHV-6 causes this disease
- Roseola infantum (6th disease)
- Clinical features of Roseola infantum
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1. high fever (104 C)
2. neck lymphadenopathy
3. rash after 4 days - HHV-8 is associated with:
- Kaposi's Sarcoma
- Explain histology of Kaposi's sarcoma
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1. small slit-like vascular channels
2. extravasation of RBC's
3. spindle cells -
What are these called?
What causes them? -
Koplik spots
Measles