Viral Infections: Dent 452 Dr. Jumana Karasneh
Viral Infections: Dent 452 Dr. Jumana Karasneh
Viral Infections: Dent 452 Dr. Jumana Karasneh
Dent 452
Lecture 5
Dr. Jumana Karasneh
Viruses
1. Human Herpes Virus (HHV)
2. Enteroviruses
1. Coxsackieviruses (CSV)
3. Paramyxovirus
1. Mumps virus
2. Morbillivirus
1. DNA virus
2. Contracted in early life
3. Transmitted in saliva
4. Latency
5. Reactivated by
immunosuppression
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HSV-1 (HHV-1)
Primary Herpetic Gingivostomatitis
Clinical Picture:
Children 6m-6y affected.
Systemic symptoms
Multiple vesicles anywhere intra
orally, lips & circumoral skin
Recovery 10-14 days
Management
Should exclude leukaemia in children
Supportive & rehydration
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HSV-1 (HHV-1)
Herpetic whitlow
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HSV-1 (HHV-1)
Recurrent Herpes
Clinical Picture:
Usually on lips / nose
Could occur intra-orally on keratinized
fixed mucosa
Tingling sensation for 1-2 days
Crops of vesicles that crust later
Bell’s palsy if facial nerve is affected
Management
Supportive
Topical aciclovir 5 times/day
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VZV(HHV-2)
Chickenpox
Definition:
Infection for 1st time causes Chickenpox
Stay latent in the sensory ganglia
Recurs causing 2 infection Herpes Zoster (shingles)
Diagnosis:
Clinical picture
Management
Supportive
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VZV(HHV-2)
Shingles
Clinical picture:
Unilateral
Most cases involve thoracic only 30%
affect trigeminal
Affect older age group usually
Starts as severe pain then vesicles follow.
Complicated by post-herpetic neuralgia
Management
High doses of systemic aciclovir or
famciclovir
Ophthalmic consultation if Ophthalmic
branch is affected
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EBV (HHV-3)
Infectious mononucleosis
No latent phase
Group A & B with subtypes
Transmitted by direct contact
Group A causes:
Hand, foot & mouth disease
Herpangina
Mild symptoms
Self-limiting condition
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Paramyxoviruse
Mumps virus
Clinical picture:
Mostly bilateral swelling of parotid gland
Unilateral / submandibular less frequently
Pain, fever & malaise
Xerostomia
Trismus
Complications:
Pancreatitis
Encephalitis
Orchitis / Oophoritis
Management
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Paramyxoviruse
Morbillivirus
Clinical picture:
1. Febrile illness & nasal discharge
2. Koplik’s spots
3. Maculopapular rash
4. Conjunctivitis
Complications:
Encephalitis
Pneumonia
Management
Symptomatic
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Human papilloma virus (HPV)
Over 100 type all causing warty growths in skin &
mucosa
Most common is Verruca vulgaris causing common wart
Clinical Picture:
Diagnosis:
Treatment:
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Retroviruses
Human immunodeficiency virus (HIV)
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Retroviruses
Human immunodeficiency virus (HIV)
Clinical features
1. Acute HIV infection
Rapid viral replication
Mimicking glandular fever symptoms
2. HIV infection
Asymptomatic
Last for years
3. HIV disease
CD4+ T cells
Affected with Pneumonia, candida, bacterial, viral & malignancy
4. AIDS
CD4+ T cells > 200 cells/ml
Severe symptoms
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Retroviruses
Human immunodeficiency virus (HIV)
Oral features
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Retroviruses
Human immunodeficiency virus (HIV)
Oral features
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Retroviruses
Human immunodeficiency virus (HIV)
Oral features
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Retroviruses
Human immunodeficiency virus (HIV)
Management
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