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VIROLOGY, Neonatal Enterovirus Infection, Viral Encephalitis (HSV-1), Ix: …
VIROLOGY
Diagnostic tools
- Bloods - clotted/EDTA
- Swabs - Throat, genital, skin
- CSF
- Stool
- Urine
- Biopsy
- Antigen detection
-Eg viral proteins
- PCR
-Detects nucleic acids
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- Antibody detection
-IgM for recent infection - (6-8 weeks)
-IgG for past infection-Forever/immunity
Key Concepts
- Respiratory -> eg Influenza
- Fecal-oral -> eg Enterovirus
- Contact -> eg HSV
- Vector -> eg Arbourvirus
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Hepatitis B Markers
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- HBsAg:
-Marker of active infection
- Anti-HBs:
-Indicated immunity ( via vaccine or recovery)
- Anti-HBc:
-IgM: Acute infection or exacerbation
-Total antibody: Chronic or past infection
- Anti-HBe:
-Seroconversion marker indicating reduced replication
Viral Syndromes
1) Neonatal Enterovirus
DDx:
- Bloods
- CSF swab
- Throat swab
- Stool sample
Symptoms:
- Sepsis
- Meningitis
- Myocarditis
- Hepatitis
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2) Measles
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Symptoms:
- Rash
- cough
- Conjunctivitis
- Koplik's spots
Clinical features:
- Incubation period: 10-14 days
- Prodrome: Nasal discharge, red eyes, fever
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TREATMENT pearls
- HSV Encephalitis: IV aciclovir is life saving
- Enteroviruses in Neonates: IVIG
- Needle stick injury
-HBV: Vaccinate or Immuniglobulin
-HIV: PEP within 72 hrs
- Measles: Immuniglobulin or MMR vaccine
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Ix:
- CSF sample (HSV-1, HSV-2, VSV, Enterovirus, Parechovirus),
- Blood sample (HSV-1 & HSV-2)
- MRI
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