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Treatment: Acyclovir for treatment for kids 12+ and immunocompromised individuals Varicella vaccine for kids - live attenuated immunocompromised) that get chicken pox have an increase likelihood of pneumonia and encephalitis (also sometimes in kids) Tzank smear shows multinucleated giant cells (also diagnoses HSV) Lesions are in different stages of healing. Chicken pox - due drop on a rose rash (vesicular lesion) Treatment- avoid contact sports b/c of risk of splenic rupture Associated with oral hairy leukoplakia in those with HIV (non-cancerous) - can't scrape it off the tongue like candida Also associated with nasopharyngeal carcinoma - often in Asians Endemic or african -> Large jaw lesion in Jaw with swelling non-Hodgkin's lymphoma (ex: Burkitt's lymphoma) Reed-Sternberg cells that look like owl eyesĢ. Associated with B-cell lymphoma in those with immunosuppression EBV remains latent in B cells (CD21 = marker or B cells) - EBV binds to CD21 to infect B cells If treat mono with amoxicillin/ampicillin (b.c you think it's strep) -> can develop maculopapular rash Strep pharyngitis is more common in kids and mono is asymptomatic in a young age, but more likely symptomatic in teens Splenomegaly due to T cell-proliferation Reactive cytotoxic CD8+ T cells seen on blood smear (Downy or atypical cells) Transmitted through saliva - kissing disease Acyclovir or valcyclovir to prevent breakouts. Used to use Tzank smear to show MULTINUCLEATED giant cells Can cause aseptic meningitis in adolescents and adults Erythema multiform - small target lesions seen on backs of hands and feet that move centrally (1-2 weeks after infection) Dew drops on a rose petal appearance rash ASSOCIATED WITH TEMPORAL LOBE ENCEPHALITIS. Can cause KERATOCONJUNCTIVITIS of eyes -> can see Serpiginous corneal ulcers on fluorescein slit lap exam First presents as gingivostomatisis- Infalmmation of lips and gums. generally confined to upper half of body. IntraNUCLEAR inclusion bodies (COWDRY BODIES)
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E6 protein associated with proteolysis of p53 (Cell cycle checkpoint at G1-> S phase) Immunosupression shows an increased risk of cervical cancer Koilocytes cells are suggestive of cancer. Pap smears decreased incidence of cancer - samples cervical cells from transformation zone. Causes cervical cancer - symptom = postcloital diagnosis. Anogenital cancer (ex: cervical, vulvar, ) - Squamous cell carcinoma.
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Laryngeal papillomatoses = recurrent respiratory papillomatosis. Verruca vulgaris = cutaneous common wart (common on hands and feet) Negative monospot test (can look like mono otherwise)
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Foscarnet - used when there is the UL97 mutation that makes it resistant to gancyclovir Common is CMV retinitis (pizza pie retinitis). Organ transplant patients can develop CMV pneumonia #1 cause of sensorineural hearing loss in kids #1 cause of mental retardation from fetal viral infection. IN utero can also lead to hydrops fetalis -> CHF, edema, abortion 2nd trimester CMV infection -> most likely transmission. But many develop progressive hearing loss. Note: congenital CMV is more likely to be asymptomatic (80-90%). Most common fetal viral infection - blueberry muffin rash, hepatosplenomegaly and jaundice, sensorineural deafness, periventricular calcifications, ventriculomegally, mental retardation and seizures CMV is latent in mononuclear cell (B and T cells and macrophages) Part of herpes virus family (can all remain latent in cells)