L 81 Mono, CMV, Mumps Flashcards
What are some of the diseases that come from Epstein-Barr Virus?
Infection known as “glandular fever”
Causes infectious mononucleosis (IM)
Burkitt’s lymphoma in some regions
Clinical menifestations of IM
Polyclonal B cell expansion that is checked by T cells. The B cells are producing lots of cytokines and need to be stopped by T cells
Incubation of 1-2 months
Lymphadenopathy in cervical chains
Splenomegaly
Looks like strep throat–headache, fever, malaise, fatigue, sore throat, LAD
Sometimes liver enzymes elevated and jaundice present
Atypical lymphocytes, especially T cells or “Downey cells”
B cells multiply first, but the T cell response creates symptoms
Establishes latency in throat and lymph tissue
EBV epidemiology
Humans only
Kissing disease
Gamma herpesvirus
IM is significant if infection is delayed until the teen years when the more mature immune system reacts more strongly
Latency: genome may continue be expressed in cells for long-term
EBV diagnosis
Downey cells
Heterophile antibodies: using monospot test, these are present transiently whereas antibody to EBV is permanent
Younger patients may not show positive monospot test, need to screen for IgM against viral capsid antigen
IM treatment
Symptomatic relief
Steroids are controversial
IM complications
Will develop rash after treatment with ampicillin
Splenic rupture possible
Chronic infections can lead to blood abnormalities and cancers
EBV and malignancy
Burkitt’s Lymphoma most common malignancy in Africa causing a translocation dysregulation of C-MYC. This is not causatory, but contributory.
NHL in HIV patients and transplant patients receiving cyclosporin A
Hodgkin’s disease
Nasopharyngeal carcinoma
CMV overview
Most common infection of fetus when the mother gets infected
Major morbidity in HIV and transplant patients (this is the troll of transplantation)
Classic cellular sign for CMV
Owl’s Eye
The virus replicates in epithelial cells and others?
CMV Epidemiology
Worldwide, Endemic
Person to Person
Virus in blood, saliva, semen, urine, donor organs
What is a common CMV manifestation associated with HIV?
CMV retinitis
Lesions on the retina caused by CMV
CMV manifestations
Immunocompromised patients and Congenital!!!!
Most infections are thought to be subclinical
Problems usually only arise in immature immune systems or immunocompromised
Mono-like illness but Heterophile-negative, but have atypical lymphocytes. Adult infection presents much later than typical IM patient.
CMV establishes latent infections
CMV complications
90% of cases are asymptomatic or mild, but up to 10% can cause permanent brain damage to patient
CMV and transfusions and transplants
Many transplant patients DIE of CMV
Blood transfusion–2% risk
Kidney, Heart, Liver–70-90% risk
What it the TORCH series used for?
Series used for newborns
Toxoplasmosis, Rubella, CMV, Herpes Simplex
CMV is most common in this group
