Viral Illnesses (non-AI)

Pt presents with nasal congestion, runny nose, sore throat, but presents with no fever or just a low grade fever

Rhinovirus

Pt presents with a URI infection. They have a sore throat, fever, and conjunctivitis

Adenovirus

What is a less common presentation of adenovirus

keratoconjunctivits and hemorrhagic cystitis

presents as a mild URI/ lower URI, but can progress to cough, wheezing, or crackles (bronchiolitis) esp in infants

Respiratory syncytial virus (RSV)

RSV vaccine is recommended for

adults over 75, at risk 50-74 yr olds, nursing home residents, and pregnant women

Explain RSV prevention in Infants

Maternal RSV vaccine at 32 wks (sept-jan), infant monoclonal antibody (infants less than 8 months entering first RSV season)

HPV 6 & 11 are associated with

genital warts

HPV 16 & 18 are associated with

cervical, anogenital, or oropharyngeal cancers

HPV prevention Gardasil 9 recommendation/dose

children 11-12, adults 27-45; 2 doses at 0, 6-12 months (<15), 3 doses 0,1-2, 6 months (>15)

presents with dendritic corneal ulcer

Herpes Keratitis

patient presents with painful group vesicles around the mouth

herpes simplex 1

Esophagitis is a common complication in immunocompromised individuals who have

HSV-1

Can asymptomatic HSV-2 be trasmitted

YES

which HSV is commonly associated with genital warts

HSV-2

Grouped vesicles on an erythematous base, preceded by burning or tingling

Herpes Zoster

What is a complication of herpes zoster that results in neuropathic pain persisting more that 90 days after rash onset

postherapeutic neuralgia

How can postherapeutic neuralgia be treated

gabapentin/pregabalin

presents at ipsilateral facial paralysis, ear pain, vesicles of the ear/auditory canal. Localized around CNVII

Ramsey Hunt

How can shingle be prevented in children

varicella vaccine, 2 dose series, 1st at 12-15 months, 2 at 24mo-6yrs

Shingrix is a shingles vaccine that is recommended to who

adults over 50, immunocompromised over 19

a child was treated with aspirin for a viral disease presents with vomiting, lethargy, and altered mental status. can results in encephalopathy and hepatic isfunction

Reyes Syndrome

What virus causes the epstein barr virus

Human herpes virus 4

what is the pathogenesis of epstein barr

infect B lymphocytes and establishes a lifelong latency

patient presents with fever, profound fatugue, pharyngitis, tonsillar enlargement, posterior cervical lymphadenopathy, palatal petechiae

Epstein Barr Virus (EBV)

a patient who has EBV was treated with amoxicillin/ampicillin what symptom did they likely develop

maculopapular rash

a patient comes in with enlarged tonsils, posterior cervical lymphasemopath. Upon physical exam you notice enlargement of the liver and spleen

Epstein Barr Virus (EBV)

what is the first line testing for Epstein Barr Virus (EBV)

monospot

what is an imporant aspect of treatment for pts diagnosed with Epstein Barr Virus (EBV)

activity restriction for 3 weeks

what causes cytomegalovirus

human herpes virus 5

how can cytomegalovirus be transmitted

vertical transmission, bodily fluids

patient comes in with pharyngitis, cervical lymphadenopathy, upon testing their monospot is negative

cytomegalovirus

what are some common signs of advanced CMV in immunocompromised patients

Retinitis (floaters, blurred VA, VF defects), esophagitis (odynophagia/dysphagia), Colitis (abd pain), pneumonitis (fever, cough, hypoxia)

a baby born with no signs of illness at birth presents with petechiae/purpura on the face, jaundice, hepatosplenomegatoly, and sensorineural hearing loss

congenital cytomegalovirus infection

What is the most common cause of febrile seizures

Roseola (HHV-6)

child presents with an abrupt high fever over 103F that has lasted 3-5 days, but resolved abruptly. How pt has a maculopapular rash that started on the trunk and has spread to the neck and extremities

Roseola

How is CMV diagnosed

using IgG/IgM, congenical using saliva or urine PCR within 21 days of birth

how is CMV treated

gangciclovir, valganciclovir

what causes Erythema infectiosum

parvovirus B19

Patient presents with bright red cheeks that were followed by a lacy reticular rash on the trunk and extremities. The rash recurs with heat, exercise, sunlight, or stress

Erythema Infectiosum

a patient presents with cough, coryza (nasal discharge/irritation), and conjunctivits. They also noticed white/blue lesions on the buccal mucosa. this is followed by an erythematous maculopapular rash that begins at the hairline/face and spreads downward

Measles (Rubeola)

How is measles diagnosed

rRT-PCM & measels IgM

there is measles post-exposure prophylaxis that should be given in what time frame

within 72 hours of exposure

patient presents with a barking seal-like cough, inspiratory stridor, horseness, and URI symptoms

Parainfluenza (Croup)

Parainfluenza virus is the most common cause of

Croup

presents as Mild URI symptoms, fine pink maculopapular rash that starts on the face and spread to the expremities. upon PE you notice petechiae on the soft palate (forchheimer spots)

Rubella (german measles)

what is important to note about rubella and pregnancy, when are they at the greatest risk

infection during pregnancy can lead to miscarriage, fetal death, or congenital rubella syndrome; greatest risk during 1st trimester

what are some consequences of congenital rubella syndrome

Sensorineural hearing loss, eyes (cataracts, glaucoma), cardiac (PDV, pulmonary artery stenosis), blueberry muffin rash (petechie/purpura), possible microcephaly/developmental abnormalities

What causes mumps

paramyxovirus

presents as tender swelling of the parotid gland(s) and pain with chewing. prodrome of fever, headache, myalgias, fatugue, anorexia

mumps

how is mumps diagnosed

buccal swab rRT-PCR

MMR vaccine dose and timing

2 doses; 1st 12-15mo, 2nd 4-6yrs

pateinst presents with fever and acute testicular pain, tenderness, and swelling that occurs 4-8 days after mumps infection

orchitis

what is the most common neurologic complication of mumps

aseptic meningitis

self limited acute watery, non-bloody diarrhea. may or may not have vomiting

viral gastroenteritis

fever and vomiting followed by profuse, non-bloody diarrhea; primarily occurs in infants and young children

Rotavirus

Rotavirus vaccine

live virus vaccine, 2-3 dose series, 1st dose prior to 15wks, 2-3rd dose prior to 8 months of age

abrupt onset of N/V/D with headaches, myalgias and sometimes a low grade fever. outbreaks occur at all ages

Norovirus

prevention of norovirus

soap and water handwashing

presents as prodrome of fever, malaise, headache, N/V. Pain and paresthesia at the bite/ exposure site. can progress to encephalitis

Rabies

rabies can cause laryngeal spasm triggered by attempt to swallow water, this is called

hydrophobia

what is the histology finding with rabies

Negri bodies

explain PEP for a person bit by an animal with rabies who has never been vaccinated

HRIG (human rabies immunoglobulin) injected around the wound and remaining IM; followed by a 4 doses of rabies vaccine on days 0, 3, 7, 14

explain PEP for a person bit by an animal with rabies who has been vaccinated

no HRIG; vaccine 2 doses days 0,3

what are some common sources of rabies

bats, dogs, skunks, foxes

what causes poliomyelitis

poliovirus

in 1-5% can lead to nonparalytic disease/ aseptic meningitis. in less than 1% can cause acute asymmetric flaccid paralysis

polio

patient presents with acute asymmetric flaccid weakness/ paralasis. they have decreased muscle tone, absent reflexed, but sensation is usually preserved

polio

how is polio diagnosed

stool specimen RT-PCR

new progressive weakness and fatigue, muscle and joint pain, muscle atrophy. Pt has a history of a polio infection

post-polio syndrome

what is the vector for the Zika virus

Aedes mosquito

how can zika virus be transmitted

vertical and sexual

presents as a low grade fever, maculopapular rash, arthralgia, nonpurulent conjunctivits. history or travel to south america and africa

Zika

can cause microcephaly, severe brain CNS abnormalities, eye/hearing abnormalities

congenital zika syndrome

what are some neurologic consequences of the zika virus

guillian-barre, encephalitis, myelitis

What are viral illnesses that must be legally reported to state and local public health agencies

MMR, Rabies, poliomyelitis, Hep ABC