Week 3 Flashcards
(123 cards)
Herpes viruses
3 families, what viruses?
1) Alpha-herpes viruses = HSV1, HSV2, VZV
2) Beta-herpes viruses = CMV, HHV6, HHV7
3) Gamma-herpes viruses = EBV, HHV8 (KSHV)
Herpes Viruses Shared Features
1) shape?
2) envelope?
3) labile or stable?
4) genome?
5) capsid?
1) Spherical
2) Lipid Envelope - derived from host golgi
- Coated with surface glycoproteins for cell-binding, cell-cell spread, and immune evasion
3) Labile, easy to kill in environment → spread requires close contact
4) dsDNA linear
5) icosahedral capsid
Primary infection with herpes viruses typically results in __________ infection in specific cells
Reactivation of herpes virus infection typically results in _________ infection
All herpes virus infections are more severe in patients with ______________
Primary infections → LATENT infection in specific cells
Reactivation → LYTIC infection
Infections more severe in patients with T cell disorders
Features of reactivation infection with herpes viruses
Reactivation → LYTIC infection - can be subclinical (shedding) or cause clinical disease resulting in spread of infection to new hosts
Less severe than initial infection
Alpha Herpesvirus:
HSV1, HSV2, VZV
think NEURONS
Replicate quickly and lyse epithelial cells
Neurotropic (like to infect neurons) and establish latency in neurons
Pathogenesis of HSV1 and HSV2:
1) Invasion through _____________ → replicate in ______ and ______ _______ cells → lyse, provoke inflammatory response → PAPULE
2) Lysis of many cells and production of cytokines → virus-filled fluid collection between dermis and epidermis → _________
3) Leukocytes enter vesicle and transform lesion to ___________
4) Forms a scab = _______________
1) Invasion through BREAK in mucous membranes/skin → replicate in BASAL and INTERMEDIATE EPITHELIAL cells → lyse, provoke inflammatory response → PAPULE
2) Lysis of many cells and production of cytokines → virus-filled fluid collection between dermis and epidermis → VESICLE
3) Leukocytes enter vesicle and transform lesion to PUSTULE
4) Forms a scab = DISEASE RESOLUTION (no virus in there)
Latency reservoir of HSV1
trigeminal ganglion
Can shed without any symptoms
Characteristic disease of HSV1
ORAL lesions
Herpetic gingivostomatitis
Typically due to HSV1
systemic symptoms, multiple painful oral/perioral lesions, tender adenopathy
Occurs in 20% of people during primary infection
Lasts 5-7 days then heals
Responds to antiviral therapy
HSV1 reactivation lesions
Mild tingling/pain for 6-12 hours → tender papule → vesicle formation → crusting/ulcer formation
Triggered by fever and sun exposure
HSV1 infection complications (2)
1) Keratitis
2) Herpes virus encephalitis
Keratitis
typically due to reactivation, involves cornea and can cause scarring
Herpes virus encephalitis
due to reactivation, causes necrotizing encephalitis traveling via trigeminal ganglion
Typically due to HSV1*
Latency reservoir of HSV2
sacral sensory ganglion
Can have asymptomatic shedding
Characteristic disease of HSV2
Genital lesions (sexually transmitted)
Primary infection with HSV2
usually asymptomatic
Headache, painful genital lesion, painful urethritis with tender inguinal adenopathy
Within first year of primary infection with get 3-4 recurrences of lesions/year
Complications associated with HSV2 infection (4)
usually with first episode
1) Viral meningitis (HSV2)
2) Urethritis
3) Candida superinfection
4) Anal and rectal HSV
Diagnosis of HSV1 and HSV2
PCR: detect HSV in late lesions - MOST COMMON
VZV pathogenesis:
initially infects __________ –> spreads to _____ and ________ via _______ and ______ cells
Infection then remains latent in _____________
initially infects upper respiratory epithelium → spreads to lymph nodes and RES (liver/spleen) via dendritic and T cells
Latency reservoir: Dorsal root ganglion
Primary chickenpox:
spread how?
symptoms?
spread via respiratory droplets or direct contact
Mild malaise, low grade fever → papules → vesicles → pustules → scabs (Vesicular rash)
Characteristics of rash present in primary chickenpox?
Characteristic “dew drop on a rose petal” = vesicle on erythematous base
Crops of vesicles at VARYING AGES
On trunk and face - distal extremities spared
Infectious just prior to onset, until scabbing
Complications associated with a primary chickenpox infection
1) Bacterial superinfection of skin lesions
2) Pneumonitis
3) hepatitis
4) **encephalitis (in immunocompromised)
The vaccine for chicken pox is made up of what?
LIVE ATTENUATED vaccine
Reactivation zoster:
clinical presentation (3)
1) Dermatomal rash in distribution of dorsal root nerve where it escaped latency
2) Does NOT cross midline
3) Painful prodrome can precede rash by 3-5 days