Herpes B virus: Difference between revisions
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==Background== | ==Background== | ||
*Cercopithecine herpesvirus 1 (commonly referred to as B virus) | |||
*Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters | *Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters | ||
*Fatal Encephalomyelitis in Humans: 80% | *Fatal Encephalomyelitis in Humans: 80% fatal without treatment | ||
*Most common transmission by bite, but very few cases | *Most common transmission by bite, but very few cases | ||
*Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research | *Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research | ||
==Clinical Features== | |||
{{Herpes viruses}} | |||
==Clinical Features<ref name="BVirus Group">[http://cid.oxfordjournals.org/content/35/10/1191.long Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard JK, Chapman LE; B Virus Working Group. Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1). Clin Infect Dis. 2002 Nov 15;35(10):1191-203. Epub 2002 Oct 17.]</ref>== | |||
*Vesicular Herpetic Lesions | *Vesicular Herpetic Lesions | ||
*Nonspecific Flu-like Illness | *Nonspecific Flu-like Illness | ||
| Line 12: | Line 15: | ||
*CNS - poor coordination, respiratory depression | *CNS - poor coordination, respiratory depression | ||
*Encephalitis - late stage of the disease | *Encephalitis - late stage of the disease | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Rabies]] | *[[Rabies]] | ||
| Line 17: | Line 21: | ||
*[[Cat-scratch disease]] | *[[Cat-scratch disease]] | ||
*[[Herpes simplex virus]] | *[[Herpes simplex virus]] | ||
== | |||
==Evaluation== | |||
*Clinical | *Clinical | ||
*PCR specificity and sensitivity at nearly 100% for serologic | *PCR specificity and sensitivity at nearly 100% for serologic | ||
*PCR wound samples less reliable | *PCR wound samples less reliable | ||
*All symptomatic should be tested | *All symptomatic should be tested | ||
==Management== | ==Management== | ||
*Consider [[rabies]] prophylaxis for all | |||
===Asymptomatic Prophylaxis (Acute Exposure)=== | |||
#<20 minutes clean and irrigate | |||
#Antiviral prophylaxis | |||
#*14 day course of PO [[valacyclovir]] 1gm three times daily OR | |||
#*14 day course of PO [[acyclovir]] 800mg five times daily<ref name="CDC">[http://www.cdc.gov/herpesbvirus/ B Virus (herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/herpesbvirus/ Page last reviewed: July 18, 2014. Accessed April 3, 2015.]</ref> | |||
#*Indications | |||
#**Penetrating (especially head, neck, torso) | |||
#**Fluid on mucosa | |||
#**Blistering Monkey | |||
===All non-CNS symptomatic=== | |||
*Admit and treat | |||
*Antiviral | |||
**[[Acyclovir]] IV 12.5-15mg/kg every eight hours OR | |||
**[[Ganciclovir]] IV 5mg/kg every 12 hours<ref name="CDC"></ref> | |||
**Acyclovir IV 12.5- | |||
**Ganciclovir IV 5mg/kg every 12 hours | |||
===All CNS Symptomatic=== | |||
* | *Admit and treat | ||
*[[Ganciclovir]] IV 5mg/kg every 12 hours<ref name="CDC"></ref> | |||
==Disposition== | ==Disposition== | ||
*Asymptomatic Discharge | *Asymptomatic Discharge | ||
| Line 49: | Line 55: | ||
==See Also== | ==See Also== | ||
*[[Mammalian bites]] | |||
==External Links== | ==External Links== | ||
[http://www.cdc.gov/herpesbvirus/ CDC: B Virus] | |||
==References== | |||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
Latest revision as of 21:13, 12 July 2023
Background
- Cercopithecine herpesvirus 1 (commonly referred to as B virus)
- Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
- Fatal Encephalomyelitis in Humans: 80% fatal without treatment
- Most common transmission by bite, but very few cases
- Consider in Patients with Exposure, especial penetrating bites, to Macaque Monkeys in the wild or research
Herpes Virus Types
- HHV-1: Herpes Simplex Virus-1
- HHV-2: Herpes Simplex Virus-2
- Herpes B virus
- Varicella zoster virus
- Varicella (Chickenpox)
- Herpes zoster (Shingles)
- Herpes zoster ophthalmicus
- Herpes zoster oticus (Ramsay Hunt syndrome)
- HHV-6 (Roseola infantum)
- HHV-8 (Kaposi’s sarcoma)
- Epstein-Barr virus
- Cytomegalovirus
Clinical Features[1]
- Vesicular Herpetic Lesions
- Nonspecific Flu-like Illness
- Lymphadenitis
- Site of inoculation - pain, numbness, itching
- CNS - poor coordination, respiratory depression
- Encephalitis - late stage of the disease
Differential Diagnosis
Evaluation
- Clinical
- PCR specificity and sensitivity at nearly 100% for serologic
- PCR wound samples less reliable
- All symptomatic should be tested
Management
- Consider rabies prophylaxis for all
Asymptomatic Prophylaxis (Acute Exposure)
- <20 minutes clean and irrigate
- Antiviral prophylaxis
- 14 day course of PO valacyclovir 1gm three times daily OR
- 14 day course of PO acyclovir 800mg five times daily[2]
- Indications
- Penetrating (especially head, neck, torso)
- Fluid on mucosa
- Blistering Monkey
All non-CNS symptomatic
- Admit and treat
- Antiviral
- Acyclovir IV 12.5-15mg/kg every eight hours OR
- Ganciclovir IV 5mg/kg every 12 hours[2]
All CNS Symptomatic
- Admit and treat
- Ganciclovir IV 5mg/kg every 12 hours[2]
Disposition
- Asymptomatic Discharge
- Symptomatic Admit
See Also
External Links
References
- ↑ Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard JK, Chapman LE; B Virus Working Group. Recommendations for prevention of and therapy for exposure to B virus (cercopithecine herpesvirus 1). Clin Infect Dis. 2002 Nov 15;35(10):1191-203. Epub 2002 Oct 17.
- ↑ 2.0 2.1 2.2 B Virus (herpes B, monkey B virus, herpesvirus simiae, and herpesvirus B). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/herpesbvirus/ Page last reviewed: July 18, 2014. Accessed April 3, 2015.