Download virus - Angelfire

VIRUS

OBLIGATE INTRACELLULAR PARASITE W/C DERIVE ENERGY
EXCLUSIVELY FROM METABOLISM OF THE CELLS THAT THEY
INFECT

2 STAGES IN VIRAL LIFE CYCLE
A. REPLICATION (INTRACELLULAR)
B. INFECTIOUS (EXTRACELLULAR)
- VIRIONS ARE EXTRACELLULAR VIRAL PARTICLES CONSISTING OF AN
INTERNAL CORE OF NUCLEIC ACID SURROUNDED BY A
PROTEIN COAT (CAPSID)
CAPSID - PROTECT THE NUCLEIC ACID FROM NUCLEASES
- INITIATES INFECTION BY PROVIDING SPECIFIC
RECEPTORS FOR VIRION ATTACHMENT TO
CORRESPONDING SITES ON THE SURFACE OF THE
CELL
- CLASSIFIED INTO:
1. RNA – CONTAINING VIRUS
2. DNA – CONTAINING VIRUS
- VIRAL NUCLEIC ACID FUNCTIONS AS:
1. TEMPLATE ON W/C NUCLEIC ACID ID REPLICATED
2. CONTAINS THE GENETIC INFORMATION
3. CAN MUTATE AND CAN MATE W/ NUCLEIC ACID OF A
HOMOLOGOUS VIRUS BY RECOMBINATION
VIRAL INFECTIONS OF THE NERVOUS SYSTEM
VIRUS
VIRUS
RNA-CONTAINING VIRUSES
PICORNA VIRUS
(Enterovirus)
70 & 71
72 (Hep A)
TOGAVIRUS
ENCEPHALITIS
(Arbovirus)
Western, & Venezuela)
ENCEPHALITIS
REPRESENTATIVE
POLIO VIRUS
COXSACKIE
ECHOVIRUS
ENTEROVIRUS
ENTEROVIRUS
EQUINE
(Eastern,
ST. LOUIS ENCEPHALITIS
JAPANESE
ENCEPHALITIS
BUNYAVIRUS
ENCEPHALITIS
(Arbovirus)
TICK-BORNE
RUBELLA
CALIFORNIA
ORBIVIRUS
(Arbovirus)
COLORADO TICK FEVER
ORTHOMYXOVIRUS
INFLUENZA
PARAMYXOVIRUS
MEASLES (Subacute
sclerosing
encephalitis)
MUMPS
ARENAVIRUS
LYMPHOCYTIC
CHORIOMENINGITIS
RHADOVIRUS
RETROVIRUS
IMMUNODEFICIENCY
RABIES
HUMAN
VIRUS (Acquired
immunodeficiency
Syndrome)
DNA-CONTAINING VIRUSES
HERPESVIRUSES
HERPES SIMPLEX
VARICELLA-ZOSTER
CYTOMEGALOVIRUS
EPSTEIN-BARR VIRUS
(Infectious mononucleosis)
PAPOVA VIRUS
PROGRESSIVE
MULTIFOCAL
LEUKOENCEPHALOPATH
Y
(PML VIRUS)
POXVIRUS
SEROTYPES
ADENOVIRUS
VACCINIA
ADENOVIRUS
ENTEROVIRUS
CONJUNCTIVITIS
DISEASE
70
ACUTE HEMORRHAGIC
71
HAND-FOOT AND MOUTH
72
HEPATITIS A VIRUS
PATHWAYS OF VIRAL SPREAD TO THE CNS
1. BLOOD
2. ALONG THE NERVE FIBERS
VIRUSES HAVE DEFINITE TROPISMS (Predilection)
1 – Herpes Simplex Virus
Peripheral sensory nerves
Gasserian ganglion --- Ophthalmic Zoster
Geniculate ganglion --- Ramsay Hunt Syndrome
Meningss
Brain Parenchyma ----------- Temporoparietal lobes
2 – Poliovirus
Motor neurons ----------------- Cranial nerves and spinal cord
3 – Rabies Virus
Neurons ------------------------- Cerebellum (Purkinje cells)
Hippocampus (Pyramidal cells)
Spinal cord
PORTAL OF ENTRY
INNOCULATION
ANIMAL BITE
MOSQUITO/TICK BITE
RESPIRATORY ROUTE
MEASLES VIRUS,
ENTERIC ROUTE
TRANSPLACENTAL ROUTE
CYTOMEGALOVIRUS
RABIES VIRUS
ARBOVIRUSES
MUMPS, HERPES SIMPLEX,
CHORIOMENINGITIS VIRUS
POLIOVIRUS, COXSACKIE VIRUS,
ECHOVIRUSES
RUBELLA VIRUS,
INCLUSION BODIES (site where viral components are synthesized and assymbled)
TYPE A)
1 – INTRANUCLEAR -
HERPES VIRUS (COWDRY
CYTOMEGALOVIRUS
PROGRESSIVE FOCAL
LEUKOENCEPHALOPATHY
2 – INTRACYTOPLASMIC -
RABIES (NEGRI BODIES)
VIRUSES W/ PROCLIVITY TO INVADE THE NERVOUS SYSTEM
1 – HUMAN IMMUNODEFICIENCY VIRUSES
(HIV – 1 AND HIV – 2)
2 – HERPES SIMPLEX VIRUSES
(HVS – 1 AND HVS – 2)
3 – HERPES ZOSTER / VARICELLA ZOSTER (VZ) VIRUS
4 – EPSTEIN-BARR VIRUS (EBV)
5 – CYTOMEGALOVIRUS (CMV)
6 – POLIOVIRUS
7 – RABIES VIRUS
8 – SEASONAL ARTHROPOD BORNE VIRUSES
VIRUSES WITH PARTICUALR NEURONS
1. POLIOMYELITIS VIRUSES W/ MOTOR NEURONS
2. VZ VIRUS AND PERIPHERAL SENSORY NEURONS
3. RABIES VIRUS AND PURKINJE CELLS
VIRAL INFECTIONS PRODUCE 2 EFFECTS:
1 – IMMEDIATE EFFECT
2 – DELAYED / SLOW EFFECT
virus
A. Subacute Sclerosing Panencephalitis (SSPE) caused by measles
caused by papova Virus
B. Progressive Mulitfocal Leukoencephalopathy (PML)
Encephalopathy
C. Creutzfeldt-Jacob Disease or Subacute Spongioform
D. Kuru
E. Malignancies caused by HSV II
NEUROLOGIC SYNDROMES CAUSED BY VIRUSES
ENCEPHALITIS
ARBOVIRUS
RABIES
HERPES
POST-INFECTIOUS GROUP
(MEASLES, RUBELLA,
INFLUENZA)
INFECTIOUS
MONONUCLEOSIS
POLIOVIRUS
COXSACKIE
ECHOVIRUS
MENINGITIS
COXSACKIE
ECHOVIRUS
MUMPS
LYMPHOCYTIC
CHORIOMENINGITIS
PARALYTIC
POLIOVIRUS
HERPES VIRUS
POST-INFECTIOUS GROUP
POLIOVIRUS
COXSACKIE
ARBOVIRUS
RABIES
POST-INFECTIOUS GROUP
VIRAL INFECTIONS MAY LEAD TO:
1 – INFLAMMATORY CHANGES
2 – CONGENITAL DEFECTS (Cerebellar agenesis; Aqueductal stenosis)
3 – SYSTEM DEGENERATION
4 – NEOPLASTIC TRANSFORMATION
THE SYNDROME OF ASEPTIC MENINGITIS


bacterial cultures are negative
“fever, headache, signs of meningeal irritation and a predominantly
lymphocytic pleocytosis with normal CSF glucose”




majority of cases are due to viral infections (most common are due to
enteroviral infections caused by echovirus, coxsackievirus and nonparalytic
poliomyelitis) but other bacteria can also produce aseptic meningitis such as
mycoplasma, Q fever, Rickettsia)
rarely fatal
precise pathologic changes are uncertain but are presumably limited to the
meninges
Differential Diagnosis of Viral Meningitis
Important: - recent respiratory / gastrointestinal symptoms
immunizations
past history of infectious diseases
family outbreaks
insect bites
contact with animals
areas of recent travel
presence / absence of epidermis
the season during which the illness occurs
geographic location
Nomenclature and Dosage Forms of Available Antiviral Agents
GENERIC NAME
DOSAGE NORMS
OTHER NAMES
AVAILABLE
Antiherpesvirus agents
Acyclovir
ACV, acycloguanosine
IV, O, T, Ophth*
Famciclovir
FAMVIR
Foscarnet
FOSCAVIR
Ganciclovir
GCV, DHPG
IV, O
Idovuridine
HERPES, STOXIL,
Sorivudine
Trifluridine
Valacyclovir
Vidarabine
Antiretroviral agents
Didanosine
Stavudine
IV,* O*
VIRONTIC
TRADE NAMES
(USA)
ZOVIRAX
FCV
O
PFA, phosphonoforntate
IV, O*
CYTOVENE
IDUR
Ophth
DENDRID
BV-ara-U, brovavir
TFT, trifluorothymidine
Ophth
VALTREX
O
ara-A, adenine arabinoside
IV, Ophth
O
d4T
O
ddl
VIRA-A
VIDEX
ZERIT
_____*
Zalcitabine
Zidovudine
Other antiviral agents
Amantadine
Interferon alpha
(tinterferon alfa)
O
RETROVIR
ddC
AZT, ZDV, azidothymidine
O
O
Injectible
WELLFERON*
Ribavirin
Rimantadine
HIVID
SYMMETREL,
SYMADINE
INTRON A,
ROFERON A,
ALFERON N,
VIRAZOLE
Aerosol.,O,* ,IV*
O
FLUMADINE
*Not currently approved for use in the United States
NOTE: IV-intravenous; O-oral; T- topical; Ophth-ophthalmic
-BIOLOGIC PROPERTIES OF VIRUS APPEAR TO BE THE REASON FOR ITS
EPIDEMIC OR SPORADIC OCCURRENCE
PICORNA VIRUSES – ARE ACID AND HEAT RESISTANT RESULTING TO
FECAL-HAND- ORAL TRANSMISSION DURING SUMMER
MONTHS
TOGAVIRUSES – REQUIRE A MULTIPLICATION PHASE IN MOSQUITOES
/ TICKS BEFORE THEY CAN INFECT PEOPLE
HUMAN EPIDEMIC OCCURS WHEN CLIMACTIC AND OTHER
CONDITIONS FAVOR A LARGE POPULATION OF INFECTED
INSECT VECTORS
- IMMUNITY TO THE VIRUS IS SPECIFIC
- MOST CASES OF VIRAL INFECTIONS ARE SELF-LIMITED
- PRESENT AS EITHER EPIDEMIC OR SPORADIC FORM
- DIAGNOSIS:
1 – SEROLOGICAL TESTS
- COMPLIMENT FIXATION TEST
- NEUTRALIZATION TEST
- HEMAGLITINATION-INHIBITION TEST
POSITIVE (+) RESULT IS A GRADUAL INCREASE IN TITER OF
ANTIBODIES (4-FOLD)
2 – TISSUE CULTURE/INOCUALTION OF BLOOD, FECES, CSF, INTO
SUSCEPTIBLE
ANIMALS
3 – BIOPSY/FLOURESCENCE STAINING OF INCLUSION BODIES
4 – CSF ANALYSIS
HERPES VIRUS




DNA-containing virus
notorious for establishing latent infections
acidophilic inclusion bodies in the nucleus (COWDRY Type A inclusion)
members of the HIV associated with neurologic diseases:
o Herpes simplex virus
o Varicella Zoster virus
o Cytomegalovirus
o Epstein-Barr (EB) virus
SIGNS AND SYMPTOMS
psychotic features
hallucinations
Fever and Headache
seizures
confusion
stupor
delirium
aphasia
coma
(respiratory arrest secondary to herniation due to sever brain swelling during
the first 24-72 hours)
- CSF – is under increased pressure
o pleocytosis (predominantly lymphocytes)
o protein content increased
o glucose levels maybe reduced to slightly <40mg/dL
o presence of red cells, sometimes xanthochromia reflecting the
hemorrhagic nature of the lesions
-
Pathology – intense hemorrhagic necrosis of the frontal and temporal
lobes
Diagnosis – Absolute method – 1 – fluorescent antibody study
2 – viral culture of cerebral tissue
obtained by biopsy
- Polymerase chain reaction assay – detection of HSV antigen
in the CSF
-
HERPES SIMPLEX ENCEPHALITIS





“Acute Inclusion Body Encephalitis”
commonest and gravest form of acute encephalitis
occurs sporadically throughout the year
affecting patients of all ages
2 Antigenic types of HSV (HV Hominis)
1- Type I strain (HSV I)
o causes common herpetic lesions of the oral mucosa
(stomatitis, pharyngitis, and respiratory infections)
o transmitted by respiratory / salivatory contact
o encephalitis results from endogenous reactivation of virus
o virus abode in the trigeminal ganglia
2- Type II strain (HSV II)
o causes genital herpetic infection in adults
o causes acute encephalitis, usually in neonate in relation to
genital herpetic infection in the mother
o in adults, spread is by venereal transmission
CLINICAL FEATURES
Itching / Burning / Tingling
(sensations in the involved dermatome(s))
or
Fever and body malaise
or
Localized pain
(Pleurisy / cholecystitis / Appendicitis)
Appearance of vesicles
(after 48 to 72 hours)
Dry, crusted and scaly
(5 to 10 days)
- Thoracic dermatome (T5 to T10) are the most common sites of zoster infection
Cranial Herpetic Lesions
1 – Ophthalmic Herpes




accounts for 10 to 15% of all cases of zoster
pain and rash are in file distribution of the first division of the
trigeminal N.; the pathologic changes are centered in the Gasserian
ganglion
main hazard is herpetic involvement of the cornea and conjunctiva with
corneal anesthesia and residual scarring
palsies of the extraocular muscles, ptosis and mydriasis are frequently
associated
2 – Ramsay Hunt Syndrome


herpetic infection of the geniculate ganglion of the facial nerve
a facial nerve palsy in combination with herpetic eruption of the
external auditory meatus, sometimes with tinnitus, vertigo and deafness
3 – Herpes Occipitocollaris


herpes zoster of the palate, pharynx, neck and retroauricular region
involving the upper cervical roots and ganglia of the vagus and
glossopharyngeal nerves
EPSTEIN-BARR VIRUS (EBV)



CAUSES INFECTIOUS MONONUCLEOSIS OR “GLANDULAR FEVER”
PATHOLOGIC CHANGES ARE FOUND IN THE LYMPH NODES,
SPLEEN, LIVER, SKIN, AND CNS
SIGNS AND SYMPTOMS:
 FEVER AND HEADACHE WITH ASSOCIATED BODY MALAISE
FOLLOWED LATER BY SORE THROAT
 ENLARGEMENT OF LYMPH NODES IN THE CERVICAL REGION
CYTOMEGALOVIRUS (CMV)

CAUSES CYTOMEGALIC INCLUSION BODY DISEASE – AN
INFECTION THAT OCCURS IN UTERO BY TRANSPLANTAL
TRANSMISSION WHICH MAY RESULT TO STILLBIRTH OR
PREMATURITY


PATHOLOGY
CEREBRUM IS AFFECTED BY A GRANULOMATOUS
ENCEPHALITIS WITH EXTENSIVE SUBEPENDYMAL
CALCIFICATIONS

ASSOCIATED FINDINGS
o = CONGENITAL DEFECTS
o = MENTAL RETARDATION
o = SEIZURES
o = HEPATOSPLENOMEGALY W/ JAUNDICE
o =HEMOLYTIC ANEMIA
o = PURPURIC LESIONS

DIAGNOSIS
o PRESENCE OF TYPICAL CELLS
o CYTOMEGALIC CELLS IN STAINED PREPARATIONS OF
URINE / SALIVA
SYNDROMES OF HERPES ZOSTER


called also as “shingles”
affects all ages with higher rates in the elderly





.
readily
characterized clinically by radicular pain, a vesicular cutaneous eruptions,
and less often, by segmental sensory and motor loss
the common agent, referred to as varicell or varicella-zoster (VZ) virus, is a
DNA virus that is similar in structure to the virus of herpes simplex; no
antigenic similarity with herpes simplex virus
chickenpox or varicella infection is a highly contagious zoster infection, on
the other hand it is NOT COMMUNICABLE except to a person who has
had chickenpox infection
higher incidence in immunocompromised individuals and with malignancy
PATHOLOGIC changes consists of the following:
1.) an inflammatory reaction in several unilateral adjacent sensory ganglia of
the spinal or
cranial nerves
2.) an inflammatory reaction in the spinal roots an peripheral nerve
contiguous with the
involved ganglia
3.) a poliomyelitis that closely resembles acute anterior poliomyelitis but is
distinguished by its unilaterally, segmental localization and greater
involvement
of the dorsal horn, root and ganglion
3.) a relatively mild leptomeningitis
RNA-VIRUSES
ARBOVIRUSES
-
“arthropod-borne disease”
includes:
1. Alphaviruses – formerly Group A arboviruses
2. Flaviviruses – formerly Group B arboviruses
3. Bunyaviruses
-
Arboviruses multiply in a blood-sucking arthropod vector (mosquito and ticks)
Birds – is the principal host
People and horses – incidental host. Once infected, it terminates the chain
of infections.
EQUINE ENCEPHALITIS
-
3 distinct types: a) Eastern Equine Encephalitis (EEE)
b) Western Equine Encephalitis (WEE)
c) Venezuela Equine Encephalitis (VEE)
-
RARE HUMAN INFECTION
-
Mortality rate is over 50% - EEE
10% - WEE
0.5% - VEE
MEASLES VIRUS (MYXOVIRUS)
-
CAUSES WIDE SPECTRUM OF NEUROLOGIC DISEASES
1 – subclinical involvement
2 – acute measles encephalitis (postinfectious encephalitis)
3 – chronic subacute sclerosing panencephalitis (SSPE)
Subacute ,easles encephalitis occurs as an opportunistic infection in
immunosuppressed or immunodeficient patients.
- affects mostly children
- disease is characterized by generalized and focal
seizures occasional focal deficits, and a progressive
deterioration of mental function leading to coma and
death in several weeks to 4 to 5 months.
MYXOVIRUS INFECTIONS
MUMPS
-
a disease cause by paramyxovirus with a predilection for the salivary glands,
mature gonads, pancreas, breasts, and the nervous system
-
spread via respiratory droplets
- two sexes are equally susceptible to mumps, neurologic complications are 3x more
frequent in males
-
the symptoms of involvement of NS appear 2 to 10 days after the onset of
parotitis
-
COMPLICATIONS:
1. deafness – most common sequel of mumps
2. orchitis
3. oophoritis
4. pancreatitis
5. thyroiditis
ECHOVIRUS
-
“ENTERIC CYTOPATHOGENIC HUMAN ORPHANS”
-
32 SEROTYPES RECOGNIZED
-
CAUSE – gastroenteritis, macular exanthema, URTI
-
COMMON RECOVERED FROM – feces, throat swabs, CSF
ENTEROVIRUS 70
- can cause epidemic of ACUTE HEMORRHAGIC
CONJUNCTIVITIS (AHC)
- neurologic involvement occurs 2 weeks after
the AHC in the form of polio-like syndrome
ENTEROVIRUS 71
- causes HAND-FOOT and MOUTH DISEASE (HFMD)
RNA (ARBO) VIRUSES
- “ARTHROPOD-BORNE” VIRUS
- “RNA-CONTAING” VIRUS
- blood sucking arthropod vector
- mosquitoes and ticks – common vector
EQUINE ENCEPHALOMYELITIS (EEE)
(WEE)
Grp.A Arboviruses
(VEE)
EASTERN EQUINE ENCEPHALITIS – most serious
JAPANESE ENCEPHALITIS
- mosquito – transmitted Flavivirus
(Group B Arbovirus)
- mostly affected are the children
RUBELLA (GERMAN MEASLES)
- TOGA VIRUS not an Arbovirus
POLIOMYELITIS
PICORNAVIRUS
● “PICO” means small
● smallest RNA virus
● nonenveloped multiplying in the cytoplasm of the cells
● 2 Subgroups:
1 – ENTEROVIRUSES – GIT
POLIOVIRUSES
COXSACKIEVIRUSES
ECHOVIRUSES
2 – RHINOVIRUSES – NASOPHARYNX
● cannot be inactivated by most agents
● highly cytocidal
● produce acidophilic inclusion bodies
POLIOMYELITIS
● “INFANTILE PARALYSIS” , “HEINE-MEDIN DISEASE”
● acute generalized disease characterized by destruction of the motor cells in
the spinal cord and brainstem, resulting to flaccid paralysis of the muscles
innervated by the affected neurons
● highly communicable disease
● may occur in sporadic, endemic or epidemic form at any time of the year
 main reservoir of infection is the human intestinal tract
 main route of infection is fecal-oral
 the disease may occur at any age but it is rare before the
age of 6 mos.
 there are 3 antigenically distinct types:
Type I – most often associated w/ paralytic disease
Type II
Type III
● clinically may manifest as:
1 – inapparent infection
2 – minor illness / abortive poliomyelitis
3 – nonparalytic / preparalytic poliomyelitis
4 – paralytic poliomyelitis
A – SPINAL POLIO (ACUTE ANTERIOR POLIOMYELITIS)
- affects ventral horn cells of the SC
(cervical and lumbar levels)
B – BULBAR POLIO
- affects cranial nerve motor nuclei in the BS particularly (IX, X, XI, XII)
C – SPINOBULBAR POLIO
D – ENCEPHALITIC TYPE
● pathogenesis:
A – enteric type
B – virus multiplication
C – viremia thru hematogenous or lymphatics
D – w/in the CNS – virus spreads along nerve affecting BS & SC
● Biphasic or Dromedary Phase
95% - subclinical form (inapparent infection)
5% = 4% - meningitis (aseptic)
1% - paralytic type
● pathological changes:
1 – necrosis of ventral horn cells and cranial nerve motor nuclei
2 – chromatolysis w/ acidophilic inclusion bodies
● laboratory findings
1 – CBC – leucopenia
2 – SEROLOGICAL TEST - ↑ titer of Anb
3 – TISSUE CULTURE – (+)
4 – CSF ANALYSIS - ↑ OP; clear colorless
pleocytosis
↑ protein content
normal sugar
(-) gram stain
5 – ELECTROMYOGRAHY (EMG STUDIES)
*1 – fibrillations
2 – fsaciculations
● treatment
1 – prophylaxis – polio vaccination
SABIN-OPV / SALK VACCINE
(TOPV)
(LIVE ATTENUATED)
2 – symptomatic / supportive treatment
3 – physiotherapy
● prognosis
bulbar – poor
COXSACKIEVIRUSES
- has the same structural and biologic features as the picornaviruses
- 2 Subgroups:
1 – Group A – 24 serotypes
2 – Group B – 6 serotypes
- a number of echovirus and coxsackie virus infections are associated w/
exanthemata
GROUP A INFECTIONS
GROUP B INFECTIONS
ASEPTIC MENINGITIS
ASEPTIC MENINIGITIS
PARALYTIC ILLNESS
PARALYTIC ILLNESS
ENCEPHALITIS
ENCEPHALITIS
HERPANGINA
PLEURODYNIA(BORNHOLM DIS)
HAND-FOOT&MOUTH DISEASE
PERICARDITIS
MYOCARDITIS
MYALGIA
ORCHITIS
- diagnosis:
> established by recovery of the virus from the feces, throat washings
> demonstrating an increase in viral antibodies in the serum
-
muscles
sites of predilection:
A. SPINAL CORD – ventral horn cells
1 – LUMBAR – origin of lumbosacral plexus
2 – CERVICAL – origin of brachial plexus
C3 C5 – supplies the diaphragm (phrenic nerve)
INTERCOSTAL N.
SPINAL ACCESSORY NERVE ( C.N.XI)Spinal segment supplies the trapezius and sternocleidomastoid
B. BRAINSTEM – lower medulla
1 – DORSAL N. OF VAGUS (C.N.X)
2 - HYPOGLOSSAL N.
3 – NUCLEUS AMBIGUUS (C.N. IX,X,XI)origin of motor fibers to the larynx and pharynx; recurrent
laryngeal nerve
RABIES
● HYDROPHOBIA
● LYSSA
● RAGE
> acute viral disease transmitted by the bite of a rabid animal
> Signs and Symptoms:
● restlessness, hyperesthesia, convulsions,
● laryngeal spasms, widespread paralysis
● almost invariably – death
> Etiology:
● enveloped bullet shaped RNA virus present in the saliva of infected animal
● BITE → virus replicates in muscle cells → sensory → motor nerves (axonal
transport) → CNS involvement (limbic system)
> Incubation Period:
● average: 1-3 months
● facial wounds → shortest incubation
> Pathology:
● Generalized Encephalitis, Myelitis
● CNS – perivascular infiltration with lymphocytes
● NEGRI BODIES – cytoplasmic eosinophilic inclusion w/ central basophilic
granules
● NEGRI BODIES contain rabies virus antigen
● BABES NODULES – rod cell formation; proliferative changes of microglia
> Incidence:
● 15% incidence among individuals bitten by rabid dog
> Manifestations:
● numbness in region of bite
● apathy, drowsiness, HA’S, anorexia
● excitability → generalized convulsions
● spasmodic contractions of pharynx and larynx → hydrophobia
● fever
● respiratory paralysis
● death
> Diagnosis:
● characteristics symptoms after the bite
● brain biopsy
> Course:
● invariably fatal in 2-5 days
> Treatment: non-specific; entirely prophylactic
1. Passive Immunization
● HRIG (Human Rabies Immune Globulin)
2. Active Immunization
● Human Diploid Cell Vaccine
● Equine Rabies Antiserum
● Duck Embryo Vaccine
ECHOVIRUSES
ECHO – “ENTERIC CYTOPATHOGENIC HUMAN ORPHANS”
> There are about 33 serotypes can cause:
GASTROENTERITIS
MACULAR EXANTHEMA
UPPER RESPIRATORY INFECTIONS
ECHO VIRUS 9 – petechial rash may be confined with
Meningococcemia
> Clinical Manifestations:
1 – ASEPTIC MENINGITIS
2 – NONPARALYTIC POLIOMYELITIS LIKE DISEASE
3 – CEREBELLAR ATAXIA
4 – OCULOMOTOR N. PARALYSIS W/ PUPILLOMOTOR FIBER
5 – ECHOVIRUS – induced meningoencephalitis
- persistent CNS infection in children w/ agammaglobulinemia associated
with a dermatomyositis-like syndrome
> Diagnosis:
- recovery of virus from feces, throat swabs & CSF
Nomenclature and Dosage Forms of Available Antiviral Agents
GENERIC NAME
FORMS
Antiherpesvirus Agents
Acyclovir
Famciclovir
Foscarnet
OTHER NAMES
TRADE NAMES
DOSAGE
AVAILABLE
ACV, acycloguanosine
FCV
PFA, phosphono-
OVIRAN
IV,O,T,Ophth
FAMVIR
OSCAVIR
O
IV,O
Ganciclovir
Idovuridine
Sorivudine
Trifluridine
Valacyclovir
Vidarabine
Antiretroviral Agents
Didanosine
Stavudine
Zalcitabine
Zidovudine
Other antiviral Agents
Amantadine
Interferon alpha
(interferon alta)
Ribavirin
Rimantadine
Forntate
GCV, DHPG
IDUR
STOXIL
DENDRID
BV-ara-U,brovavir
TFT, trifluorothymidine
ara-A, adenine
Arabinoside
ddl
d4T
ddC
AZT, ZDV,
Azidothymidine
SYMADINE
ROFERON A
WELLFERON
VIRAZOLE
CYTOVENE
HERPES,
IV,O
Ophth
--*
IROPTIC
IV,* O*
Ophth
VALTREX
VIRA-A
O
V,Ophth
VIDES
ZERIT
HIVID
RETROVIR
O
O
O
O
SYMMETREL,
O
INTRON A,
Injectible
ALFERON N,
FLUMADINE
Aerosol,
O,* IV
O