Viral STI II Flashcards
(42 cards)
What are the symptoms of initial genital infection OR primary infection of herpes?
lesion progresses from macules, papules, vesicles, pustules, to ulcers
Fever, inguinal adenopathy, malaise
Common lesion sites: vulva, cervic, peritonium, penis, thighs, buttocks
What are the characteristics of recurrent lesions of herpes?
3-5 discreet lesions
vulvar irritation
prodrome
heal in 7-10 days
less severe
Highest risk of neonatal herpes infection is infants born to mothers _______
experiencing primary infection
What are the presentations of neonatal herpes infection localized to the skin, eye, and mouth?
Not lethal
Present 10-11 days following birth
Recurrences in first 6 months
What are the consequences if neonatal herpes infection localized to skin, eyes, and mouth not treated?
Blindness
Microcephaly
Spastic Quadriplegia
What are the presentation of neonatal herpes infection with encephalitis +/- skin lesions?
Symptoms: seizures, lethargy, tremors, bulging fontanel
Survivors often neurological impairment
What is the presentation of neonatal herpes infection that is disseminated?
Lesions in visceral organs and skin
Seizures, respiratory distress, jaundice
Very lethal
Complications - HSV pneumonitis, DIC
How do we prevent neonatal herpes infection?
Examine for lesions
C sections
Treat with antivirals
What are the characteristics of herpes simplex virus?
Herpesvirus
enveloped
dsDNA
Encodes many of its own enzymes for genome replication
What are the steps of herpes infection? x4
- HSV attack
- Replication in epithelial cells (lesion, cold sore)
- transport to neuron
- Latency in ganglia (sacral - genital herpes, trigeminal ganglia - cold sores)
What are steps of herpes reactivation? x3
- Trigger to nerve cell body- virions production
- Transport to epithelium
- Virus replicates
What are the two forms of herpes? What are they associated with?
HSV-1 and HSV-2
HSV-1 - oral lesions
HSV-2 genital lesions
For primary infection of herpes simplex, when do each of the two forms occur?
HSV-1 - before age 4
HSV-2 - onset of sexual activity
How is herpes transmitted?
Contact with lesions
Saliva
Sexual transmission
How do we diagnose herpes simplex virus?
Clinical appearance of ____
1-2mm diamete in groups, _________
lesions
painful!
vesicles to pustules to ulcers
What virological tests can we use to diagnose herpes? x4
PCR to detect genome
Immunocytochemistry to detect antigens
dendritic lesion in eye
Tzanck smear
How are oral, genital, neonatal, and ocular herpes treated?
Oral - no antivirals
Genital - primary is oral antiviral, recurrent is long term oral antiviral treatment
Neonatal - IV antiviral
Ocular - topical antiviral
Anti-herpetic drugs DO NOT act on the ________ stage of infection
latent
What are the treatment goals for herpes?
Shorten time to lesion healing
Increase time between outbreaks
What drug can we specifically use to treat herpes?
Acyclovir - nucleoside analogue
Famciclovir and valacyclovir work similarily
What is the mechanism of resistance to acyclovir for herpes treatment?
Mutation to thymidine kinase - reistant (TK- virus)
What drugs do we use if a patient is resistant acyclovir for herpes?
Foscarnet
What are the symptoms of genital warts?
Hyperkeratotic, firm, exophytic papules
1mm-2cm diameter
Itching, pain, burning where lesion is
Cervical warts - exophitic, endophytic, flat
What is the presentation of Respiratory papillomatosis/laryngeal papillomas?
Nodules on ciliated and squamous epithelial junction of larynx
Symptoms - altered cry, hoarse, stridor
