Micro Enteric Viruses 2 Flashcards Preview

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Flashcards in Micro Enteric Viruses 2 Deck (25)
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what does coxsackie A cause?

herpangina, hand-foot-and-mouth disease, acute hemorrhagic conjunctivitis


what is herpangina?

-acute febrile illness with small vesicular or ulcerative lesions on the posterior oropharyngeal structures that typically occurs in summer - mild and self-limited - typically children


what causes herpangina?

MC coxsackie A, but also by coxsackie B and other enteroviruses


what is hand-foot-and-mouth disease?

-spread by fecal-oral or contact with skin lesion/oral secretions
-viral invasion of mucus membranes causing widespread apoptosis with characteristic lesion formation (looks like chicken pox which is typically trunk)
-dehydration from refusal to drink/eat with sores


what causes hand foot and mouth disease?

MC coxsackie A, also coxsackie B and other enteroviruses


what is acute hemorrhagic conjunctivitis?

rapid onset painful conjunctivitis usually in young teens - unpleasant but short
-no treatment available


what causes acute hemorrhagic conjuncitivitis?

coxsackie group A24 also enterovirus


acute hemorrhagic conjunctivitis complications

rarely neurological sequelae - poliolike paralysis (1/10,000)


what does coxsackie A typically cause?

herpangina, hand foot mouth disease, acute hemorrhagic conunctivitis


what does coxsackie B typically cause?

viral myocarditis, pleurodynia


viral myocarditis pathogenesis

sequel in 1-4% coxsackie B gastroenteritis, necrosis of myocytes, inflammatory infiltrate interferes with heart function and may progress to CHF and pulmonary edema


what is seen on viral myocarditis exam - adults, infants, children?

-adults: heart failure, chest pain, dysrhythmia, RECENT HISTORY OF FLULIKE ILLNESS
-infants: irritability, lethary, periodic episodes of pallor, fever, hypothermia, tachypnea, anorexia, failure to thrive
-children: lack of energy, general malaise


viral myocarditis labwork

CBC (anemia, lymphcytosis, neutropenia), blood cultures to rule out bacterial infection, C-reactive protein and sedimentation rates (markers of inflammation), creatinine kinase, troponin 1 (myocardial damage)


histologic findings viral myocarditis (can be done on children and adults - not infants or super ill)

-focal or diffuse interstitial infiltrate of mononuclear cells, lymphocytes, plasma cells, eosinophils
-necrosis and diarrangement of myocytes
-fibroblasts in chronic and healing stages


what is pleurodynia

infection of striated muscle in chest (muscle necrosis around lung) - sudden occurrence of lancinating chest pain attacks


what causes pleurodynia?

coxsackie B and other enteroviruses


pleurodynia symptoms

pain is paroxysmal, occurring in attacks separated by min-hr
-between attacks, patients usually have constant, dull pleuritic pain
-usually 3-5 days


pleurodynia exam

3-5 days of fever, malaise, headache, sore throat/rhinitis/dry cough/n/v/diarrhea, pleural friction rub, herpangina or other mild coxsackie symptoms


what is seen on x ray of pleurodynia?

normal! because heart and lung are normal - muscle is abnormal (used for exclusion)


when is pleurodynia life-threatening?



aspectic meningitis pathogenesis

enterovirus breaches CNS, infects leptomeninges and immune response creates inflammation - normally self-limited but must rule out infection by bacteria or fungi


what is the classic tetrad for aseptic meningitis?

fever, meningisumus, irritability, photophobia


aspectic meningitis labwork

CSF: culture, gram stain, acid-fast stain; PCR for viruses; WBC count, protein level, glucose level (normal level for viruses, low for bacteria)


treatment for aseptic meningitis

rest, hydration, analgesics, anti-inflammatories


symptoms of aseptic meningitis in babies/toddlers

fever, cold hands and feet, refusing food or vomiting, fretful, pale/blotchy skin, blank staring, drowsy, stiff neck, high pitched scream