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GP2 Ch3 Infectious disease and infestations (Measles virus 麻疹病毒 (fever,…
GP2 Ch3 Infectious disease and infestations
Rubella virus風疹病毒
Macular rash黃斑疹
Transmitted by droplets
sore throat
lymph node enlargement
Risk of congenital先天性 disorders when in pregnancy
9-12 weeks
hearing impairment
feature CRS 50%
13-16 weeks
CRS anomalies 30%
hearing loss is prominent than other feature
1-8 weeks:
hearing impairment
other CRS(Congenital rubella syndrome) anomalies80%
cardiac defect
20 weeks
chance of fetal damage are minimal or none
can cause permanent damage in child
Measles virus 麻疹病毒
fever
coryza鼻炎
Maculopapular rash
Koplik spots: small white spots surrounded by erithema on the buccal mucosa
Transmitted by droplets
conjunctivitis結膜炎
Beware of complications並發症
Herpes virus皰疹病毒
Herpes virus III(Varicella Zoster virus)
Chickenpox (varicella)水痘
Primary infection
childhood
may reactivate in later life
Vesicular eruptions
mucosas surfaces first
rapid dissemination in a centripetal distribution向心分佈快速傳播
most dense on trunk and sparse稀疏 on limbs
Shingles 帶狀皰疹( herpes zoster)
Burning discomfort, discrete vesicles
Herpes zoster ophthalmicus
ophthalmic division affected( trigeminal nerve )
varicella zoster virus persists in latent form in the dorsal root ganglion of sensory nerve感覺神經的背根神經節 and can reactivate in later life.
Post herpetic neuralgia帶狀皰疹性神經痛(age)
Herpes virus IV(Epstein-Barr virus)
Infectious mononucleosis傳染性單核細胞
• Fever
• Anginose (tonsillar exudates扁桃體分泌物)
• Cervical lymphadenopathy頸淋巴結腫大
• Macular黃斑, petechial or erythema multiforme rashed may occur
Burkitt lymphoma complicates EBV infection
Hepatomegaly 肝腫大is more common than in EBV
Herpes simplex virus I & II
primary infection
Asymptomatic (mostly)
gingivitis
pharyngitis
balanitis龜頭炎
vulvitis外陰炎
vaginitis陰道炎
secondary infection(after years): Grouped small blisters (cold sore唇皰疹). corner of lips
Whitlow: Grouped blisters in finger.
Herpes virus V(Cytomegalovirus 巨細胞病毒CMV)
CMV infection is persistent
subclinical cycles of active virus replication
persistent low-level virus shedding
most post-childhood infections :subclinical
some adults : infectious mononucleosis-like syndrome
Herpes virus VI &VII
Roseola infantum玫瑰疹
Herpes virus VIII(Kaposi sarcoma virus)
Tumour of lympho-endothelial origin
Classis KS
indolent惰性
Mediterranean or Jewish men.地中海或猶太男性
rare
Endemic KS
sub-Saharan Africa撒哈拉以南非洲
more aggressive
earlier
KS in patients on immunosupressant drugs
AIDS-associated KS
Early mucocutaneous lesions
macular黃斑
difficult to diagnose
Lessions become papular or nodular, and may ulcerate潰爛
Red-purple colour
Lessions become more numerous and larger
Hepatitis virus肝炎病毒
Hepatitis A
Highly infectious and is spread by the faecal-oral route
Jaundice, itching, weakness
Acute liver failure is rare, chronic infection does not occur
chronic infection does not occur
一次感染後，一個人對其餘生都有免疫力
vaccine is effective
Hepatitis B
most common causes of
chronic liver disease
hepatocellular carcinoma肝細胞癌
May cause an acute viral hepatitis (often asymptomatic)
Vertical transmission has a higher risk to get a chronic infection
lead to
cirrhosis肝硬化
hepatocellular carcinoma
drugs do not eradicate根除 hepatitis B infection completely.
低流行地區接受乙型肝炎疫苗接種的人群
Parenteral drug users
Men who have sex with men
Close contacts of infected individuals
Patients on chronic haemodialysis性血液透析患者
Patients with chronic liver disease
Medical,nursing and laboratory personnel
if from mother --> 90% child have
Hepatitis C
Jaundice(rare) appears in end-stage cirrhosis.
Aim : eradicate根除 infection
Most individuals are unaware of the
infection
acute infection
chronic inflammation
fibrosis
cirrhosis
cancer
cancer
cure
no vaccine
Enterovirus腸道病毒
Hepatitis A
Poliomyelitis脊髓灰質炎
Muscles will probably not regain useful function after a month
start in one muscle group --> widespread paresis (respiratory problems)most recover , but some remain paresis麻痺
Bulbar延髓 or high level spinal involvement --> impaired gag 窒息 and cough reflexes.
less common in developed countries
(vaccination)
Herpangina皰疹性咽峽炎 (Coxackie virus)
Ulcers at the posterior mouth
affecting soft palate and uvula
sore throat
neck adenopathies頸部腺病
fever
malaise不適
irritability煩躁
anorexia厭食
vomiting
last 3-4 days and disappear
Hand, foot and mouth syndrome (Coxackie virus)
Affects children ,sometimes adults
symptom
mild fever
malaise
mouth ulcers
anorexia
rash
Red papules --> vesicles in palms and soles.
Erythema infection感染性紅斑 (parvovirus細小病毒）
slapped cheek syndrome (fifth disease)
Caused by parvovirus B19
Transmitted
droplets
touch
blood
Lace-like rash on face, trunk and extremities
Papilomavirus乳頭瘤病毒
Viral warts are extremely common
Genital warts 生殖器疣(condyloma acuminata尖銳濕疣)
clear relationship with cervical and intra-epithelial carcinoma of the genital skin.
生殖器皮膚的宮頸和上皮內癌顯示出明顯的關係
spread by sexual activity
Transmission: direct contact
Moluscum contagiossum傳染性軟疣
Flesh-coloured肉色丘疹 papules up to 5 mm
Facial lesions are highly sugestive of underlying HIV infection高度提示潛在的HIV感染
Sexually transmitted
very rare
Mumps virus腮腺炎病毒
Spread by droplets
Causes
orchitis睾丸炎
pancreatitis胰腺炎
parotitis腮腺炎
oophoritis卵巢炎( less frequently)
meningo-encephalitis腦膜腦炎( less frequently)
swelling of the parotid glands
Systemic viral infection
HIV人類免疫缺乏病毒
Opportunistic Infections
Cryptococcosis隱球菌病
appears when patient weeks
ex:inflammation in gum
Mycobacterium (tuberculosis)
Histoplasmosis組織胞漿菌病
Hairy leukoplakia
Candidiasis(most common)
Pseudomembranous (Thrust)
Angular cheilitis角膜炎
Hyperplastic
Erythematous
Tumoral diseases
Oral Kaposi's sarcoma肉瘤
Non-Hogking lymphoma淋巴瘤
Ulcerative 潰瘍性lesions/Canker sores潰瘍瘡 Periodontal disease
Ulcerative necrotizing periodontitis牙周炎
Ulcerative necrotizing gingivitis牙齦炎
Lineal gingival erythema