Virus Name

+ Family

Diseases

Transmis
sion

Method of
Infection

Diagnosis

Treatment

Fun Facts

Parvovirus,
Erythrovirus
(parvovirus
B19)

erythema
infectiosum (slappedcheek rash / fifth
disease) 710 day
incubation; nonspecific flu like
symptoms followed
by indrurated facial
rash;
RBC destruction in
fetus leads to
hydrops fetalis and
death, in adults leads
to pure RBC aplasia
andRA symptoms

Respirator
y Droplets
fomites
vertical
transmissi
on

inoculates nasal
cavity; 6 day
incubation;
viremia; immune
complexes deposit
causing rash; rash
starts on face and
moves
downwards;
B19 infects
erythroid
progenitor cells,
resulting in cell
lysis. The resulting
anemia is only
clinically
significant in
patients with
sicklecell anemia
and may result in
aplastic crisis.

detect viral DNA

-serology and
molecular
analysis

supportive:
RBC
transfusion

can lead to chronic anemia

in immunodeficient pts;
fetuses may develop
hydrops fetalis if in first two
trimesters

Capsid
Naked
ssDNA
linear

Ig transfer
in immunedeficient

only ssDNA virus; smallest

DNA virus
in adults: schoolteacher gets
ill with edema, joint pain,
arthritis
sickle cell patients: aplastic
anemia

Papovavirus,
Papillomavir
us (HPV)

warts, carcinoma

Icosahedral
Naked
dsDNA
circular

Close
Contact;
reservoir human
skin and
genitals.

infects squamous
epithelial cells in
epidermis or
mucous
membranes;
hyperkeratosislead
s to the formation
of warts

1% acetic acid
turns lesions
white

ablation,
spontaneou
s regress

biopsy ; DNA PCR

( serotypes)

HPV
vaccine; 6,
11, 16, 18
(inactivated
subunit) guardasil

lysogenic cycle =
E6 blocks p53; E7
blocks Rb [p53
and Rb normal
block transition
from G1 to S
phase]

Icosahedral
Naked
dsDNA
circular

JC virusprogressive
multifocal
leukoencephalopathy
(PML) in HIV
BK virustransplant
patients, commonly
targets kidney
JC: Junky Cerebrum;
BK: Bad Kidney

Respirator
y Droplets

infects children,
produces mild
illness; immune
system causes
virus to become
latent in CNS

pathological change in
epithelial cells =
koilocytosis (blue sunny
side up eggs)
HPV 1-4 = verruca vulgaris
= cutaneous common wart
HPV 6, 11 = recurrent
respiratory papillomatosis,
anogenital warts
(condyloma acuminata)

buzzword
associated with
HPV / cervical
cancer = postcoital bleeding
Papovavirus,
Polyomaviru
s (JC Virus)

warts can infect larynx; HPV

warts can progress to
cervical cancer; uses host
machinery for most of
replicative functions

symptoms
CNS biopsy
ELISA, PCR

none
available

HPV 18, 16, 31, 33 (+15

from 16, 18) = anogenital
cancers (cervical, vulva,
vaginal, anal)
immunocompromised allows
activation of virus and
demyelination ;
non-enhancing multifocal
brain lesions in white matter

Adenovirus,
Mastadenov
irus

URI, conjunctivitis,
hemorrhagic cystitis,
gastroenteritis

Icosahedral
Naked
dsDNA
circular
Herpesvirus,
HSV-1

common cause of
tonsillitis

Icosahedral
Envelope
derived from
nuclear
membrane
dsDNA
circular

Herpesvirus,
HSV-2
Icosahedral
Envelope
derived from
nuclear
membrane
dsDNA
circular

Herpes labialis (cold

sores) ,
gingivostomatitis
(first sign of HSV-1),
keratoconjunctivitis
(serpiginous corneal
ulcers), temporal
lobe encephalitis
(changes in
personality)

genital or neonatal
herpes
aseptic meningitis

Respirator
y Droplets,
F/O, Direct
Contact

Saliva
vertical
transmissi
on

Sexual
contact

binds via HA;

enters and lyses
mucosal cells of
respiratory tract,
conjunctiva,
bladder, GI tract

serology
ELISA

1* infection
resolves after 2-3
weeks; latent
infection of
trigeminal
ganglion; stress
causes
reactivation and
symptoms

PCR,
multinucleate
giant cells and
Cowdry bodies intranuclear
eosinophilic
inclusion bodies
on Tzanck smear;
immunofluoresce
nt staining

same as above
causes inguinal
lymphadenopathy
and painful,
vesicular genital
sores; lies dormant
in sacral ganglia

crusted lesions
poor source of
virus for cultures
most sensitive
test for HSV
meningitis in
newborns is HSV
DNA by PCR
same as above
intranuclear
inclusion bodies
(Cowdry bodies)

vaccine only
used in
military (live
viruses)

acyclovir or
valcyclovir
(prevent
breakouts)
trifluridine
(topical);
the virus
thymidine
kinase is
required to
activate the
drug by
phosphoryla
tion.
same as
above

latent viruses remain in

tonsillar adenoids; over 40
serotypes; common cause of
colds and conjunctivitis
at risk: kids, military
barracks, public swimming
pool outbreaks
herpetic whitlow, a painful
hand vesicle common in
healthcare workers
erythema multiforme
typically infects ABOVE waist
dew drops on rose petal
appearance

same as above
people with genital herpes
are at greater risk for HIV
neonatal infection occurs in
utero via transplacentral
transmission
typically infects BELOW
waist
dew drops on rose petal

Herpesvirus,
Varicelloviru
s (VZV)
Icosahedral
Enveloped
dsDNA
linear

Herpesvirus,
Cytomegalo
virus (CMV)
Icosahedral
Enveloped
dsDNA
linear

chickenpox
( unvaccinated child
with asynchronous
rash) , shingles
( elderly with
unilateral vesicular
rash that follows
dermatomes)

cytomegalic inclusion
disease E blueberry
muffin baby);
heterophil-negative
mononucleosis
periventricular
calcifications +
toxoplasmosis leads
to seizures and
retardation

Respirator
y Droplets,
Ruptured
Vesicles

Blood,
Breast
Milk,
Saliva,
Semen,
parenteral,
in utero

virus infects
respiratory tract; 2
week incubation;
viremia; flu-like
symptoms and
rash appearing as
dew on rose petal;
resolves within 2
weeks; viral
reactivation
causes vesicular
rash over
dermatome
remains latent in
dorsal root ganglia
of nerves
infect a diverse
array of cells;
replicates within
and lyses, causing
hepatosplenomeg
aly, deafness;
latent in
mononuclear cells
and reactivates
during
immunocompromi
se
encodes
proteins that
disrupt MHC
class I pwy -->
indefinite
persistence in
monocytes

multinucleate
giant cells and
Cowdry Type A
intanuclear
inclusion bodies
on Tzanck smear
Antigen detection
by PCR

supportive;
acyclovir;
famciclovir,
valcyclovir
vaccine: live
attenuated
VZV

controversial vaccine: (1)

immunity may wane,
leading to more serious
adult infections (2) latent
state from prior infection
can still occur
reactivation is frequent
cause of post-herpetic
neuralgia (pain where
lesions used to be along
dermatome)
unilateral vision loss +
lesions on forehead in
immunocompromised

giant cells with

"Owl's eye"
inclusion bodies
(-) monospot test

ganciclovir
foscarnet
when virus
has UL97
resistance
to
ganciclovir

most common viral cause of

mental retardation in US and
sensorineural hearing loss
can be transferred in utero;
causes newborns to have
petechial rash, low birth
weight, cataracts,
hepatosplenomegaly
blueberry muffin rash
80-90% asymptomatic; 2nd
trimester highest likelihood
to damage

Herpesvirus,
Lymphocryp
tovirus
(EpsteinBarr Virus
EBV)
Icosahedral
Enveloped
dsDNA
linear

infectious
mononucleosis
( Young adult fever
with splenomegaly &
lymphadenopathy);
lymphoproliferative
disease; Hairy oral
leukoplakia
Burkitt lymphoma
/Nasopharyngeal
carcinoma/Hodgkin
lymphoma

Saliva,
Respirator
y Droplets

infects
oropharynx;
viremia; envelope
glycoprotein binds
to and infects B
cells via C3d
complement
receptor (CD21);
remains latent in B
cells and acts as a
B-cell mitogen;
immune response
to infected cells;
lymph nodes and
spleen enlarge;
immune response
controls infected
B-cell proliferation.

monospot test (+)

detects
heterophile
antibody
anti-EBV IgM ;
Downey type II
atypical
lymphocytes
reach 70% in the
blood ;
Heterophile
antibody positive
(IgM antibosies
that recognize the
Paul Bunnell
antigen on RBCs)
reactive
lymphocytosis of
CTL seen on
blood smear
(atypical or
Downey)

acyclovir in
severe
cases

high risk for splenic rupture

and should avoid contact
sports (causes
splenomegaly)
rash occurs in few cases,
more likely if ampicillin
given
more severe in better
sanitation and infected later
in life

Hepadnavirus
,
Orthohepadn
avirus,
Hepatitis B
Virus

acute and chronic

hepatitis

Blood,
Sex, Birth

Icosahedral
Enveloped
partially
dsDNA,
circular

travels to
hepatocytes;
completes partial
dsDNA genome;
CTL response
damages liver
cells
intranuclear and
cytoplasmic
replication
uses reverse
transcriptase to
form DNA
intermediate; NOT
a retrovirus
because it does
not integrate into
host genome

Poxvirus,
Orthopoxvirus
, (Smallpox
Virus)
Complex
Enveloped
dsDNA linear

rash beginning as
macules, evolving to
vesicles 5-17 day
incubation ;
prodrome of 2-4
days, followed by
rash starting on face
and spreads laterally
in 24 hrs.

Respirator
y Droplets

infects URT;
penetrates
mucosa and enters
bloodstream; 1*
viremia infects and
multiples within
organs; 2* viremia
focal infections
largest DNA virus
all smallpox
lesions are at the
same stages of

HBsAg (active
infection)
HBeAg
(infectivity)
[symptomatic
when HBeAg
detectable]
Anti-HBc Ab
(positive during
window period
and previoud
infection but not
if immunized)
Anti-Hbe Ab
(negative if
immunized)
Anti-HBs Ab
(indicates
recovery /
immunization)
abnormal liver
function
past detection in
vesicular fluid
Guarnierni
inclusion bodies
are sites of viral
replication in
cytoplasm
dumbell shaped
core

pegylated
IFN-a
lamivudine
vaccine:
recombinant
HBsAg

needle stick exposure;

vaccine given early at birth;
strength of immune
response determines clinical
course of infection
5-10% chronic; newborns
have 90-95% chronic; ALT
normal in early nenotal
Hepatitis: ALT > AST
Alcoholic: AST > ALT
does not actively
obstruct MHC I antigen
presentation to CD8 T
cells

vaccine:
liveattenuated
because
virus has
been
eradicated,
vaccines
only in
military

last case of Smallpox in

Somalia in 1977
eradicated because:
(1) only 1 serotype (2) no
carrier state (3) no animal
reservoir
makes own envelopes rather
than taking from host
replicates in cytoplasm:
contains special DNAdependent RNA polymerase

healing
( synchronous
rash) unlike
Varicella

Poxvirus,
Molluscipoxvir
us,
(Molluscum
Contagiosu
m)
Complex
Enveloped
dsDNA linear

molluscum
contagiosum

Casual
Contact

pearly skin papules /

nodules (fleshcolored, domeshaped, umbilical
skin lesions) often
seen on trunk, axilla,
antecubital +
popliteal fossa

infects and
replicates in
epidermal cells;
large eosinophilic
inclusion bodies;
molluscum bodies
enlarge infected
cells forming
dome-like
structure

clinical
presentation and
skin biopsy;
eosinophilic
cytoplasmic
inclusion bodies

self-resolves
in 6-12
months;
ritonavir,
cidofovir in
the
immunocomprimise
d

CMV

HIV

Herpes / VZV

unlike varicella or HSV, MCV

limited to epidermis and
does not establish dormancy
makes own envelopes rather
than taking from host
replicates in cytoplasm:
contains special DNAdependent RNA polymerase

largest DNA virus

MOST
COMMON
VERTICALLY
TRANSMITT
ED
INFECTIONS

autoinoculation via
scratching is common

Syphillis

(+Parvoviru
s)

(+Hepatitis B)