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POX AND HERPES
                             VIRUSES
                            Jaime A. Santos




Saturday, May 29, 2010
Poxviruses
                         largest viruses
                     complex symmetry
                double-stranded DNA
              assembled in inclusion
             bodies (Guarnieri bodies)




Saturday, May 29, 2010
Diseases
                         variola (smallpox)
                         vaccinia
                         orf
                         cowpox
                         monkeypox
                         othe animal poxviruses
                         molluscum contagiosum


Saturday, May 29, 2010
Smallpox
                 only infectious disease
                 to have been
                 eliminated by
                 vaccination
                 2 forms: variola major
                 (high mortality), variola
                 minor




Saturday, May 29, 2010
Smallpox vaccination




Saturday, May 29, 2010
Molluscum
         contagiosum
               diagnosis: molluscum
                      bodies
         treatment: cryotherapy or
              electrodesication




Saturday, May 29, 2010
Herpesviridae
                 HSV-1
                 HSV-2
                 VZV
                 EBV
                 CMV
                 HHV-6, 7, 8



Saturday, May 29, 2010
Characteristics

                 large, enveloped, icosahedral
                 encode DNA polymerase
                 latency, persistence
                 very common causes of infection




Saturday, May 29, 2010
HSV 1 and 2
                 HSV-1 more common in oral lesions; HSV-2 in genital
                 lesions
                 majority asymptomatic; skin and mucous membrane
                 lesions, encephalitis, keratitis
                 congenital infection
                 diagnosis: serology, culture
                 treatment: acyclovir and related drugs


Saturday, May 29, 2010
Herpes
                   simplex 1
                     and 2
            2 different viruses related
                  to each other
              latency in nerve ganglia
                         reactivation



Saturday, May 29, 2010
Saturday, May 29, 2010
Saturday, May 29, 2010
Varicella-
           zoster virus
                          chickenpox
                         Herpes zoster
                         (reactivation)
                congenital varicella




Saturday, May 29, 2010
Varicella (chickenpox)
                 self-limiting; incubation 2 weeks
                 milder in children
                 severe in neonates whoe mothers had chickenpox <5
                 days prior to delivery, in adults and in
                 immunocompromised
                 diagnosis often clinical but can be cultured
                 treatment: acyclovir


Saturday, May 29, 2010
Saturday, May 29, 2010
Saturday, May 29, 2010
Epstein-Barr virus
                 infects B lymphocytes - receptor is complement
                 receptor on B cell
                 B cell infection leads to immortalization and polyclonal
                 B cell stimulation
                 transmitted thru saliva
                 causes infectious mononucleosis
                 possibility of inducing transformation


Saturday, May 29, 2010
Infectious
     mononucleosis
             fever, lymphadenopathy,
               hepatosplenomegaly
                 atypical lymphocytes
                    (Downey cells)
                 heterophil antibodies




Saturday, May 29, 2010
Infectious Mononucleosis

                                             Epidemiology:
                                              different in
                                          developing countries

                                                Diagnosis:
                                          atypical lymphocytes
                                        + Monotest for heterophil
                                                antibodies
                                        serology: + IgM anti-VCA
                                             culture: difficult




Saturday, May 29, 2010
Atypical lymphocytes




Saturday, May 29, 2010
EBV infection

                   has been associated with endemic type of Burkitt’s
                   lymphoma and nasopharyngeal carcinoma
                   no practical treatment with antiviral




Saturday, May 29, 2010
Cytomegalovirus
                 very common infection
                 most common cause of
                 congenital viral infection
                 and most common
                 infectious cause of
                 deafness
                 present in body fluids
                 asymptomatic;
                 pneumonia; disseminated
                 in immunocompromised
                 e.g. AIDS
Saturday, May 29, 2010
CMV Involvement




Saturday, May 29, 2010
Congenital CMV
                            asymptomatic to full-blown
                          risk in second pregnancy lower




Saturday, May 29, 2010
Saturday, May 29, 2010
CMV Diagnosis

                                    cytology
                                    serology
                                    culture




Saturday, May 29, 2010
CMV Treatment


                 with ganciclovir
                 limited to life-threatening infection and retinitis




Saturday, May 29, 2010
HHV 6




Saturday, May 29, 2010
Roseola infantum

                                      common exanthem
                                           of infants
                                       relatively benign
                                     fever for about three
                                       days followed by
                                             rashes




Saturday, May 29, 2010
HHV-8
                         has been associated with
                             Kaposi’s sarcoma




Saturday, May 29, 2010
Saturday, May 29, 2010
THANK YOU!



Saturday, May 29, 2010

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Pox herpes

  • 1. POX AND HERPES VIRUSES Jaime A. Santos Saturday, May 29, 2010
  • 2. Poxviruses largest viruses complex symmetry double-stranded DNA assembled in inclusion bodies (Guarnieri bodies) Saturday, May 29, 2010
  • 3. Diseases variola (smallpox) vaccinia orf cowpox monkeypox othe animal poxviruses molluscum contagiosum Saturday, May 29, 2010
  • 4. Smallpox only infectious disease to have been eliminated by vaccination 2 forms: variola major (high mortality), variola minor Saturday, May 29, 2010
  • 6. Molluscum contagiosum diagnosis: molluscum bodies treatment: cryotherapy or electrodesication Saturday, May 29, 2010
  • 7. Herpesviridae HSV-1 HSV-2 VZV EBV CMV HHV-6, 7, 8 Saturday, May 29, 2010
  • 8. Characteristics large, enveloped, icosahedral encode DNA polymerase latency, persistence very common causes of infection Saturday, May 29, 2010
  • 9. HSV 1 and 2 HSV-1 more common in oral lesions; HSV-2 in genital lesions majority asymptomatic; skin and mucous membrane lesions, encephalitis, keratitis congenital infection diagnosis: serology, culture treatment: acyclovir and related drugs Saturday, May 29, 2010
  • 10. Herpes simplex 1 and 2 2 different viruses related to each other latency in nerve ganglia reactivation Saturday, May 29, 2010
  • 13. Varicella- zoster virus chickenpox Herpes zoster (reactivation) congenital varicella Saturday, May 29, 2010
  • 14. Varicella (chickenpox) self-limiting; incubation 2 weeks milder in children severe in neonates whoe mothers had chickenpox <5 days prior to delivery, in adults and in immunocompromised diagnosis often clinical but can be cultured treatment: acyclovir Saturday, May 29, 2010
  • 17. Epstein-Barr virus infects B lymphocytes - receptor is complement receptor on B cell B cell infection leads to immortalization and polyclonal B cell stimulation transmitted thru saliva causes infectious mononucleosis possibility of inducing transformation Saturday, May 29, 2010
  • 18. Infectious mononucleosis fever, lymphadenopathy, hepatosplenomegaly atypical lymphocytes (Downey cells) heterophil antibodies Saturday, May 29, 2010
  • 19. Infectious Mononucleosis Epidemiology: different in developing countries Diagnosis: atypical lymphocytes + Monotest for heterophil antibodies serology: + IgM anti-VCA culture: difficult Saturday, May 29, 2010
  • 21. EBV infection has been associated with endemic type of Burkitt’s lymphoma and nasopharyngeal carcinoma no practical treatment with antiviral Saturday, May 29, 2010
  • 22. Cytomegalovirus very common infection most common cause of congenital viral infection and most common infectious cause of deafness present in body fluids asymptomatic; pneumonia; disseminated in immunocompromised e.g. AIDS Saturday, May 29, 2010
  • 24. Congenital CMV asymptomatic to full-blown risk in second pregnancy lower Saturday, May 29, 2010
  • 26. CMV Diagnosis cytology serology culture Saturday, May 29, 2010
  • 27. CMV Treatment with ganciclovir limited to life-threatening infection and retinitis Saturday, May 29, 2010
  • 29. Roseola infantum common exanthem of infants relatively benign fever for about three days followed by rashes Saturday, May 29, 2010
  • 30. HHV-8 has been associated with Kaposi’s sarcoma Saturday, May 29, 2010