Download Free Medical Human Herpes Viruses PowerPoint Presentation

Human Herpes Viruses PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical PowerPoint presentation titled "HUMAN HERPES VIRUSES" by Dr. D Kalita.

This medical PowerPoint presentation talks about Human herpes viruses which are a group of viruses that belong to the family Herpesviridae. There are eight different types of human herpes viruses, which are named HHV-1 through HHV-8. Each type of herpes virus has a distinct set of symptoms and health effects.

Tags : HUMAN HERPES VIRUSES, Herpesviridae, Dermatology, Dermatology PowerPoint presentation

Published on : Mar 31, 2023 | Views : 2830 | Downloads : 6

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

HUMAN HERPES VIRUSES -1 Dr. D Kalita, Associate professor, Department of Microbiology, AIIMS Rishikesh Date of Class: 26/4/2017 (4PM to 5PM, LT-4)
Slide 2-

01-Apr-23 2
Slide 3-

HERPES VIRUS 01-Apr-23 3
Slide 4-

Introduction to HERPES VIRUS About100 Enveloped DNA viruses affecting Humans and animals Can cause Latent infections – enabling virus to persist within infected hosts and to undergo periodic reactivation. 01-Apr-23 4
Slide 5-

Herpes virus morphology Icosahedral capsid - 162 capsomers - Enclosing the core with dsDNA Nucleocapsid covered by a lipid envelope (derived from modified host cell membrane) Envelope carries surface spikes Tegument (amorphous): between envelope and capsid 01-Apr-23 5
Slide 6-

Herpes virus morphology Enveloped virion 200 nm Naked virion  100 nm Replication takes place in the host cell nucleus Cowdry type A inclusion bodies which is also called Lipschutz bodies 01-Apr-23 6
Slide 7-

CLASSIFICATION 01-Apr-23 7
Slide 8-

Herpes simplex
Slide 9-

HHV 1 & HHV 2 - Morphology 01-Apr-23 9
Slide 10-

HHV 1 & HHV 2 - Pathogenesis 01-Apr-23 10
Slide 11-

Differentiation of HSV1 and HSV2 Monoclonal antibodies Pocks in CAM (HSV2 > HSV1) HSV2 more neurovirulent in lab animals HSV2 is more resistant in vitro to antivirals (e.g.Cytarabine & IUDR) DNA RE studies differentiates (upto strain level) Etc.…………….Ref to a textbook 01-Apr-23 11
Slide 12-

Infections HSV1 Acute gingivostomatitis Herpes labialis (cold sore) Keratoconjunctivitis Eczema herpericum Encephalitis Dendritic keratitis (above waist…………………but…) 01-Apr-23 12
Slide 13-

HSV2 Genital herpes (Penile, Urethral, Cervix, Vulval, Vaginal) Neonatal herpes Aseptic meningitis (Below waist…..but………….) 01-Apr-23 13
Slide 14-

ACUTE GINGIVOSTOMATITIS Acute gingivostomatitis is the commonest manifestation of primary herpetic infection. Pain and bleeding of the gums Ulcers with necrotic bases Neck glands are commonly enlarged accompanied by fever. Usually a self limiting disease lasting around13 days.
Slide 15-

ppt slide no 15 content not found
Slide 16-

HERPES LABIALIS (COLD SORE) Recurrence of oral HSV. 45% of orally infected individuals will experience reactivation. Tingling, warmth or itching at the site initially12 hours later, redness appears followed by papules and then vesicles.
Slide 17-

SYMPTOMS Mild or severe and may include: Sores on the inside of the cheeks or gums Fever General discomfort, uneasiness, or ill feeling Very sore mouth with no desire to eat Halitosis
Slide 18-

HSV – Cold Sore
Slide 19-

HHV 1- Clinical manifestations 01-Apr-23 19 EM of Herpes virus 1
Slide 20-

OCULAR HERPES Cause of corneal blindness. Include the following:- Primary HSV keratitis – Keratoconjunctivitis Dendritic ulcers Recurrent HSV keratitis HSV conjunctivitis Acute necrotising retinitis, chorioretinitis
Slide 21-

KERATOCONJUNCTIVITIS Inflammation of the cornea and conjunctiva. Minor damage to the epithelium (superficial punctate keratitis) to formation of dendritic ulcers.
Slide 22-

Keratoconjunctivitis
Slide 23-

HERPES SIMPLEX ENCEPHALITIS One of the most serious complications of herpes simplex disease. There are two forms:
Slide 24-

Neonatal – global involvement and the brain is almost liquefied mortality rate approaches 100%. Focal disease – Temporal lobe is most commonly affected. In children and adults Many arise from reactivation of virus. Mortality rate is high (70%) in untreated
Slide 25-

01-Apr-23 25 Early diagnosis and treatment of HSE is very essential. IV acyclovir is recommended in all cases of suspected HSE before laboratory results are available.
Slide 26-

Herpes Simplex Encephalitis CT Scan Autopsy
Slide 27-

MENINGITIS Most commonly with primary HSV-2 infection; less likely with recurrences of genital herpes Benign, self-limited (contrast with encephalitis) Usually affects sexually active young adults No neurologic sequelae
Slide 28-

GENITAL HERPES Genital lesions may be primary, recurrent Sites: penis, vagina, cervix, anus, vulva, bladder, the sacral nerve routes, the spinal and the meninges. Prone to secondary infection eg. Staphylococcus aureus, Streptococcus group, Trichomonas and Candida albicans.
Slide 29-

GENITAL HERPES Dysuria is a common complaint, Recurrences in 60% . Recurrent lesions in the perianal area  more numerous and persists longer.
Slide 30-

HSV – CONGENITAL/PERINATAL Perinatal infection: ¾ th are due to HSV 2 acquired during delivery Post natal infection HSV-1 acquired from maternal genital, oral or breast lesions or nosocomial infection from other infected babies
Slide 31-

ppt slide no 31 content not found
Slide 32-

HERPETIC WHITLOW A lesion (whitlow) on a finger or thumb caused by the herpes simplex virus. HSV-1 or HSV-2. HSV-1 whitlow is often contracted by health care workers  dental workers and medical workers exposed to oral secretions.
Slide 33-

ppt slide no 33 content not found
Slide 34-

Laboratory Diagnosis Direct Detection Electron microscopy of vesicle fluid - rapid result Immunofluorescence of skin scrappings - distinguish between HSV and VZV
Slide 35-

HHV 1& 2 Diagnosis Multinucleate Giant cells – Tzanck’s smear 01-Apr-23 35
Slide 36-

Laboratory Diagnosis Viral culture (gold standard) Preferred test in genital ulcers or mucocutaneous lesions Highly specific (>99%) Sensitivity declines rapidly as lesions begin to heal Positive more in primary infection (80%–90%) than with recurrences (30%)
Slide 37-

CPE of HSV in cell culture: ballooning of cells. IF test for HSV antigen in epithelial cell.
Slide 38-

Laboratory Diagnosis…cntd Polymerase Chain Reaction (PCR) More sensitive than viral culture; has been used instead of culture in some settings not widely available Preferred test for detecting HSV in spinal fluid (Routinely used in HSE)
Slide 39-

Serology Type-specific and nonspecific antibodies Anti HSV-2 antibody indicates anogenital infection Anti HSV-1 antibody does not distinguish anogenital from orolabial infection IgG, IgM - ELISA 39
Slide 40-

ANTIVIRAL Several antivirals available for treatment of the conditions: Aciclovir (acyclovir), Valaciclovir (valacyclovir), Famciclovir, Penciclovir.
Slide 41-

Varicella zoster
Slide 42-

VARICELLA Primary infection results in varicella (chickenpox) Incubation period : 14-21 days Presents fever, lymphadadenopathy. a widespread vesicular rash. Diagnosis can be made on clinical grounds alone.
Slide 43-

Complications are rare  occurs more frequently and with greater severity in Adults Immunocompromised persons MC complication is secondary bacterial infection. Life threatening complications Viral pneumonia, Encephalititis, Haemorrhagic chickenpox.
Slide 44-

ppt slide no 44 content not found
Slide 45-

NEONATAL VARICELLA VZV can cross the placenta in the late stages of pregnancy to infect the fetus congenitally. Mild disease to fatal disseminated infection. If rash in mother occurs more than 1 week before delivery  sufficient immunity is transferred to the fetus.
Slide 46-

LABORATORY DIAGNOSIS C/Fs of varicella or Herpes zoster are characteristic laboratory confirmation is rarely required. Laboratory diagnosis  for atypical presentations (as seen in immunocompromised patients)
Slide 47-

LABORATORY DIAGNOSIS….cntd Direct detection - electron microscopy (no d/d between HSV and VZV). IF on skin scrapings can distinguish the 2 VZV IgG is indicative of past infection and immunity.  IgM is indicative of recent primary infection. Virus Isolation - rarely carried  requires 2-3 weeks for a results.
Slide 48-

HERPES ZOSTER (Shingles) Manifestation of recurrent infection following a primary attack of chicken pox. Caused by varicella zoster Unlike herpes labialis repeated recurrences of zoster are uncommon. Infection typically affect adult of middle aged group
Slide 49-

Pain precedes the rash (vesicles). Severe pain, and commonly occurs on the trunk on one side. The trigeminal nerve is affected  15% of cases
Slide 50-

Lesions localized to one side, along distribution of nerve (e.g. any divisions of the trigeminal nerve up to the midline) Malaise can be severe. Regional lymph node are enlarged and can be life-threatening in HIV disease.
Slide 51-

TREATMENT Only in severe cases : Oral acyclovir 800 mg five times daily for 7-10 + analgesic.
Slide 52-

RAMSAY HUNT SYNDROME Involvement of facial nerve with VZV Facial nerve palsy Vesicles in external auditory meatus Vesicles on palate Symptoms :dizziness, loss of taste. Usually self limiting condition  rarely permanent facial weakness may remain.
Slide 53-

Clinical case scenario A 21 years old female presented with a complaint of malaise and loss of appetite X 1 month and sore throat and fever (especially in afternoon) since 5 days. O/E: Cervical lymphadenopathy+, Mild hepatosplenomegaly+. CBC showed Absolute Mononuclear lymphocytosis (mostly atypical lymphocytes). Her serum was tested by Monospot where IgM was positive. Diagnosis? 01-Apr-23 53
Slide 54-

Diagnosis Human Herpes Virus 4 (HHV-4) / Epstein Barr virus infection Infectious mononucleosis / Glandular fever/ Kissing’s disease 01-Apr-23 54
Slide 55-

HHV 4 Ebstein Barr virus - EBV 01-Apr-23 55
Slide 56-

EBV or HHV-4 1964 – Epstein, Barr and Achong – identified a new type of herpes virus EB virus affecting B lymphocyte lineage. CD 21 receptors necessary for acquiring EBV infection 01-Apr-23 56
Slide 57-

EBV EPIDEMIOLOGY Source of infection: Saliva of infected persons – Not highly contagious, droplets and aerosols not effective in disease transmission Intimate oral contact (as in kissing) – predominant mode of transmission – hence the name ‘Kissing disease’ 01-Apr-23 57
Slide 58-

EBV – Clinical spectrum Infectious mononucleosis EBV associated malignancies: Burkitt’s lymphoma Lymphomas in immunodeficient persons e.g. AIDS & transplant recipients Nasopharyngeal carcinoma in East Asia/China 01-Apr-23 58
Slide 59-

Infectious mononucleosis Glandular fever Acute self-limited illness Usually seen in non-immune young adults following primary infection with EBV Incubation period: 4-8 weeks. 01-Apr-23 59
Slide 60-

Infectious mononucleosis (EBV) 01-Apr-23 60
Slide 61-

01-Apr-23 61
Slide 62-

Infectious mononucleosis Ampicillin Rx may lead to develop maculopapular rash May associate sub-clinical Hepatitis Complications: Hematological, Neurological, Cardiac & Pulmonary conditions and Splenic rupture Spontaneous resolution occurs in 2-4 weeks 01-Apr-23 62
Slide 63-

Lab diagnosis of EBV Leukopenia followed by leukocytosis in later stages with atypical lymphocytosis (Abnormal mononuclear cells) Paul – Bunnell test: Standard diagnostic test for Heterophile antigen detection Monospot test 01-Apr-23 63
Slide 64-

Lab diagnosis of EBV cont.. Differential agglutination test: Differential absorption of Agglutinins with Ox red cells and Guinea pig kidney cells Immunofluorescence ELISA 01-Apr-23 64
Slide 65-

Lab diagnosis of EBV cont… IgM antibody to VCA (Viral Capsid Antigen) indication of primary infection EB Nuclear Antigen (EBNA) is also a useful marker of primary infection Ab to Early antigens (EA) high in EB-associated lymphomas 01-Apr-23 65
Slide 66-

Case scenario A 27 years old male a K/C/O HIV/AIDS presented to Ophthalmology OPD with Progressive diminution of vision X 3 months. CD4 counts<100 cells/mm3. Fundus examination: Fluffy retinal infiltrates+ Multiple hemorrhages+ Serological tests positive for IgG antibodies and PCR were positive for DNA (Herpes group). Diagnosis? Rx 01-Apr-23 66
Slide 67-

DIAGNOSIS CMV retinitis made Patient was started on Ganciclovir. Note: Patient did not take Anti-HIV medications regularly. …to be initiated urgently 01-Apr-23 67
Slide 68-

Thanks …..to be continued to next class 01-Apr-23 68