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Viral Infectious diseases (Glandular fever, HPV, CMV)

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Viral Infectious diseases (Glandular fever, HPV, CMV) Done by: Hisham Al-Hammadi Glandular fever (Infectious Mononucleosis) Caused by EBV (90% of cases). – PowerPoint PPT presentation

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Title: Viral Infectious diseases (Glandular fever, HPV, CMV)


1
Viral Infectious diseases (Glandular fever, HPV,
CMV)
  • Done by Hisham Al-Hammadi

2
Glandular fever (Infectious Mononucleosis)
  • Caused by EBV (90 of cases).
  • Associated with the presence of atypical
    mononuclear cells in the blood.
  • Is not uncommon in young children but is often
    asymtomatic or atypical.
  • EBV infects up to 95 of the worlds population

3
Clinical features
  • Incubation period in adolescent is 30-50 days,
    shorter in children.
  • Infection is usually asymptomatic in infants and
    young children.
  • Early symptoms consist of malaise, fatigue,
    fever, headache, sore throat and nausea.
  • Hepatosplenomegaly and enlarged L.N are usually
    present.
  • Sore throat is accompanied by pharyngitis with
    tonsillar enlargement.
  • Petechial hemorrhage in the soft plate.
  • Maculopapular skin rashes (3- 15).
  • 80 develop rashes if treated with ampicillin or
    amoxicillin.
  • The course of the illness is variable but in most
    cases symptoms subside within 2-4 weeks.

4
Diagnosis
  • Lymphocytosis with atypical lymphocytes.
  • EBV-specific antibodies.
  • Monospot test to detect presence of heterophile
    antibodies (false negative common in children.
  • Differential diagnosis
  • CMV infection, toxoplasmosis, hepatitis A,
    lymphoma, and leukemia.

5
Complications
  • The most feared complication is splenic rupture.
  • Swelling of the tonsils oropharyngeal lymphoid
    tissue may cause airway impairment.
  • Hepatitis with clinical jundice.
  • Aseptic meningitis or encephalitis.

6
Treatment
  • There is no specific treatment.
  • Supporting bed rest are indicated.
  • Avoid contact sports for one month (risk of
    splenic rupture)
  • Acyclovir may have some beneficial effects in
    life threatening EBV infection.
  • Corticosteroids can be used for respiratory
    distress resulting from tonsillar hypertrophy.

7
Human Papillomavirus (HPV)
  • Over 50 different types have been identified.
  • The different HPV types typically cause disease
    in different anatomic sites (about half of HPV
    types have been identified in genital tract).
  • Mode of transmission
  • Sexual contact (genital, oral warts).
  • Skin to skin contact (plantar, hand warts).

8
Clinical features
  • Lesions of the skin are proliferative, popular,
    and hyperkeratotic.
  • They may be single or multiple and are usually
    localized to a limited anatomic area.
  • Common warts genital warts, laryngeal warts
    (recurrence common)
  • Dysplastic changes of the utrine cervix (usually
    without symptoms).
  • Respiratory papillomatosis may present with
    hoarseness, dyspnea, stridor, or cough.
  • Diagnosis
  • Clinical
  • PAP smear
  • ELISA, PCR
  • Application of 3 acetic acid to infected
    epithelium may show whitening (acetowhite change)
  • Genital warts can be distinguished from condyloma
    lata of secondary syphilis by syphilis serology.

9
Treatment
  • Most cutaneous warts will resolve spontaneously
    and may not require treatment.
  • Treatment usually involves surgical removel or
    physical or chemical destruction of abnormal
    tissue using cryotherapy, laser vaporization,
    trichloroacetic acid, podophyllotoxin.
  • Interferon has been used in some cases of genital
    and respiratory papillomas.
  • Recurrence rate is high.

10
Cytomegalovirus (CMV)
  • Is the most common congenital viral infection.
  • Mode of transmission
  • Sources of CMV include saliva, milk, cervical
    vaginal secretions, urine, semen, stools, and
    blood.
  • The spread of CMV requires very close contact
    because it is very labile.
  • Transmission occurs by direct person to person
    contact, but indirect transmission is possible
    via contaminated fomites.
  • Vertical transmission.
  • Organ/ blood donation.

11
Clinical features
  • Infection acquired early and usually
    asymptomatic.
  • Congenital disease (severity ranging from rash
    and hearing loss to microcephaly and mental
    retardation).
  • CMV mononucleosis syndrome fever splenomegaly,
    abnormal LFTs, lymphocytosis
  • Can affect a number of organs causing retinitis,
    hepatitis, pneumonitis, esophagitis etc
  • Diagnosis
  • culture
  • cytology
  • serology
  • antigen detection, PCR

12
Treatment
  • No vaccine or antiviral therapy is available for
    prevention or treatment of congenital CMV
    infection
  • ganciclovir has been used to treat
    life-threatening CMV infections in
    immunocompromised hosts.
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