Lecture 11 : Clinical Correlations

The following are they main viral infections involving the oral cavity

HSV-1, HSV-2, VZV, Mumps, AIDS, HPV, infectious mono, enteroviruses(herpangina, hand-foot-mouth and acute lymphonodular pharyngitis)

Notation for VZV

HHV-3

Notation for EBV

HHV-4

Notation for CMV

HHV-5

Notation for Kaposi's sarcoma

HHV-8

Most common infection in the oral cavity

HSV-1 - Herpes labialis

HSV-1 is a neutropic virus and resides in

Trigeminal ganglion

This PRIMARY viral infection occurs during 6mo to 5yo of age

Acute Herpatic Gingivostomatitiis

These are the symptoms of a primary HSV-1 infection (Acute Herpatic Gingivostomatitis)

Fever (103-105), chills, nausea, erythematous gingiva, coalescing ulcers, cervical lymphadenopathy

The time at which anti-virals are the most effective for a recurrent HSV infection

Prodromal (up to first three days)

This accounts for 80% of all recurrent HSV-1 infections and is often described as a "cold sore" or "fever blister

Herpes Labialis

Accounts for 15% of all recurrent HSV-1 infections

Palatal Herpes (hard palate)

Accounts for 5% of all recurrent HSV-1 infections

Attached Gingiva

These are the symptoms during the prodromal phase of a recurrent HSV infection

Pain, burning, itching, tingling

These HSV-1 of hard palate and attached gingiva share these characteristics

Size (1-2mm); location(bound-down keratinized epithelium; # (10-15)

All Herpatic Anti-virals work by

Terminating DNA elongation

Primary infection of Varicella Zoster is

Chicken pox

Secondary infection of Varicella Zoster is

Shingles

This virus affects mainly the salivary and mandibular glands in children

CMV

This disease is caused by exposure to EBV and is often associated with fever, pharyngitis, petechiae of the soft palate

Infectious mononucleosis ("kissing disease")

This enterovirus can cause herpangina, hand-foot-mouth disease and acute lymphonodular pharyngitis and is primarily seen in teenagers and children

Coxsackie A

This enterovirus causes Koplik spots and skin rash

Measles

This RNA virus is part of the paramyxovirus family and is known for causing lymphoadenopathy

Mumps

The four big opportunistic infections and neoplasms in individuals with AIDS

Candidiasis, Hairy Leukoplakia (EBV), HSV and Kaposi's Sarcoma(BIG killer)

Except for Types 16 and 18 this virus causes benign neoplasms of the squamous epithelium, and is painless, singular and has finger-like projections

HPV

This virus can cause jaundice and is seen in the floor of the mouth

Viral hepatitis