EXAM 4 Oral Pathology Related Viral Infections Flashcards
(32 cards)
humans are the only natural reservoir for ___
human herpes virus (HHV)
T or F:
all 8 types of HHV cause primary infection and remain latent within specific cell types for life
true
primary latency resides in CD4 T lymphotes
HHV virus is shed in ___ or ___
saliva or genital secretions
what is HHV-8?
kaposi’s sarcoma herpesvirus
- primary infection via sexual contact, especially in homosexual males
- primary infection is asymptomatic in normal immune systems
- also associated with a variety of lymphomas and castleman’s disease
reactivation of HSV is also called what?
secondary, recurrent, or recrudescent infection
what percent of primary herpes virus infections (initial exposure) are asymptomatic?
80%
after initial exposure, the herpes virus is taken up by the ___ and transported to associated ___. what state does this describe?
- sensory nerves
- sensory ganglia
- describes the latent/dormant state
- most common site of latency is the trigeminal ganglion
HSV-1
in the case of symptomatic primary infections, ___ affects clinical presentation.
age
- younger - gingivostomatitis
- 18+ pharyngotonsillitis
what is the most common pattern of primary HSV infection?
- acute herpetic gingivostomatitis
- 90% due to HSV-1
- most cases occur before age 5
describe mucosa affected by acute herpetic gingivostomatitis
- pinhead vsicles
- rapidly collapse and form small, red lesions
- initial lesions enlarge and develop central areas of ulceration covered by yellow fibrin
- adjacent ulcerations coalesce
with acute herpetic gingivostomatitis, can both moveable and attached oral mucosa be affected?
- yes, but this is not the case with recurrences
- in all cases, the gingiva is enlarged, painful, and extremely erythematous
- involvement can spread past the labial mucosa and onto the vermillion and perioral skin
- self inoculation of fingers, eyes, and genitals can occur - leading infectious cause of blindness
what are the initial symptoms of pharyngotonsillitis?
sore throat, fever, headache
what is pharyngotonsillitis caused by?
HSV1 or HSV2
describe the clinical presentation of pharyngotonsillitis
- numerous small vesicles develop on tonsils and posterior pharynx
- rapidly rupture to form shallow ulcerations which coalesce
- diffuse, gray-yellow exudate forms over the ulcers
descrive recurrent herpes simplex
- can occur anywhere along the surface epithelium supplied by the involved ganglion
- most common site of recurrence for HSV-1: vermilion border and adjacent skin of the lips
- herpes labialis
- cold sore
- fever blister - 40% of US have a history of herpes labialis, prodrome (“tingling”) 24h before lesion
___% of US are infected with HHV by age 5
90%
HHV infection can present as an asymptomatic primary infection, or can be ___
a red macular/slightly papular eruption
what is the specific pattern created by HHV6?
roseola
HHV7 produces a similar lesion
HHV recurrences can result in widespread ___ infection
multiorgan
what are some factors that can lead to recurrent herpes?
age, stress, pregnancy, allergies, trauma, illness, ultraviolet light (the only condition to unequivocally induce lesions experimentally), immunosuppression
recurrent intraoral herpes simplex is almost always on what type of tissue?
keratinized, bound mucosa (palate, attached gingiva)
describe the cycle of recurrent herpes simplex intraoral lesions
- pesions begin as 1-3mm vesicles
- rapidly collapse to form a cluster of erythematous macules that coalesce
- damaged epithelium is lost
- central, yellowish area of ulceration
- heals in 7-10 days
___ is a less common HSV1 presentation characterized by infection of the thumb or fingers
herpetic whitlow
___ is a less common HSV1 presentation found in wrestlers or rugby players with contaminated abrasions
herpes gladiatorum or scrumpox
