Herpes Simplex Virus (HSV)

• These study notes cover key information about various bacterial and viral infections, including their characteristics, transmission, symptoms, and treatments.

Herpes Simplex Virus (HSV) -1 and -2

• HSV-1 and HSV-2 fall under this category, also known as Herpes Simplex Virus
• Scene depicts Hermes, the God of Herpes
• Blue background with a boy wearing a blue shirt indicates a DNA virus
• Transmission occurs from mother to child, part of TORCHES complex
• Symptoms include inflamed lips leading to gingivostomatitis and ulcers on mouth like herpes labialis (cold sores)
• Other symptoms include inflamed eyes, keratoconjunctivitis, and snakes on torch indicating snake-like pattern or corneal ulcers during fluorescent slit-lamp exam.
• Neurological symptoms include those relating to the temporal lobe such as encephalitis (necrosis and haemorrhage), confusion, and personality changes, and a crazy look.
• Enveloped viruses feature Hermes wearing a robe
• Herpetic whitlow can occur.
• Genital herpes, with painful ulcers, is represented by gems on a codpiece.
• HSV-1 is latent in trigeminal ganglia, indicated by Hermes wearing a helmet with three gems.
• HSV-2 is latent in sacral ganglia, indicated by Hermes wearing a codpiece
• Aseptic meningitis, which is more common with HSV-2 than HSV-1, can be represented by Hermes wearing a neckbrace
• Robe of dry cowhide signifies Cowdry bodies (intranuclear inclusion bodies)
• The Tzanck smear, showing multinucleated giant cells is represented by a boy playing with a toy tank with a cameo pattern
• Treatment options include violet recycling bin.
• Acyclovir or Valacyclovir can be used for treatment

Varicella Zoster Virus (VZV = HHV-3)

• VZV, also known as HHV-3, is explored, in a scene centered around Zeus
• The scene includes Hermes figurine hanging from tree, part of Herpes virus family
• Respiratory transmission is via a kid squirting water at another kid with his water gun
• Key symptom is a sign saying “All ages welcome!” indicates lesions in different stages of healing all simultaneously
• generalized rash progresses via different stages
• Neurological component of encephalitis in immunocompromised adults is shown by an actor wearing a turban and holding a walking stick
• Lower respiratory tract symptoms include pneumonia esp in adults
• A blue stage and actors wearing blue clothes indicates a DNA virus
• Enveloped viruses feature Zeus presented in a robe
• Mother to child transmission, featuring Torches around stage
• VZV remains latent in dorsal root ganglia, which roots of tree at dorsal part of picture signifies
• Clinical presentation of chickenpox is shown, via chickens below stage
• Signs, in the form of shingles on a roof indicate shingles tiles
• If ophthalmic, herpes zoster ophthalmicus is signified via Other actor is wearing an eyepatch
• Rash with dermatomal distribution is indicated via Disgruntled audience member throwing a rose bouquet resulting in localised rash with dermatomal distribution
• Painful rash is illustrated by Zeus stabbing another actor with a lightning bolt.
• Live attenuated vaccine available for children or elderly over 50 indicated via Signs shaped like needle that says "Live Show" pointing at shade
• In HIV patients their CD4 count must be < 200, which is signified via Shade has sign that says "Max Occupancy: 200
• Neurological complications of post herpetic neuralgia (i.e. persistent pain, even after rash has resolved) are exemplified by disgruntled audience member has lightning tattoo on his chest
• Herpes zoster or shingles manifests via recurrent infection
• Reactivation is due to elderly with walking sticks sitting in the shade show reactivation occurs with stress, ageing or immunocompromised state
• Treatment: use normal recycling bin for acyclovir for zoster or severe varicella

Epstein-Barr virus (EBV = HHV-4)

• EBV also known as HHV-4
• The scene's blue background signifies a double-stranded DNA virus.
• Transmission depicted as drinks on table with girl to kiss guy indicates transmission via saliva and drinks
• Enveloped viruses feature girl wearing a dress
• Fever is indicated by a boy sweating nervously
• Upper respiratory tract symptoms: also drooling from the mouth shows pharyngitis and tonsillar exudates
• He knocks over drink, which spills on knight show he is reacting to pain upon being grabbed by the neck by the knight
• The symptom is accompanied by tender lymphadenopathy
• The spot on the cow is indicated via Spleen-looking spot on cow signifies splenomegaly
• if mistakenly give aminopenicillin (ampicillin/amox icillin), Patient can can develop maculopapular rash due to other customers(asian man whose nose is being pinched by a crab)
• nasopharyngeal carcinoma is associated with asian patients
• Burkitt Lymphoma is implied
• Bar keep’s child has a mouth full of crab => BL presents with large jaw lesion and swelling
• Hodgkin's Lymphoma, contains stern owls sitting among reeds
• Reactive cytotoxic CD8+ T cells can be seen in blood smear as large cells with a lot of cytoplasm and a oval/indented (kidney bean-looking) nucleus
• avoid contact sports as a result of splenic rupture and is signed
• Bar stating "Must B 21" => EBV envelope glycoprotein binds CD21 to infect B cells
• Sleeping archer => EBV remains latent in B cells (B cells secrete antibodies like how archers shoot arrows)
• Monospot test diagnosing IgM antibodies is signified via Star-shaped darts at dartboard clumped at one spot

Obligate Intracellular Bacteria : Rickettsia

• General Rickettsia overview:
• Tennis court depicts Inside stadium
• These are intracellular obligate parasites
• The organisms fail to synthesise CoA, NAD+, which is shown via Coach’s shirt and bottle
• The organisms have crowd dressed in white: poor gram staining
• Diagnosis: The tennis balls being light pink: weakly gram staining
• Morphology: Tennis balls are kinda flattened coccobacillary shape
• Treatment options include doxycycline
• Symptoms include the triad:
  • (early infection)Tennis player holding head Headache
  • Tennis player sweating: Fever (early infection)
  • Red bumps on floor of courtrash (early infection)
• Bright red strings, tennis rackets and net, show vasculitis leading to damage causing petechiae / larger haemorrhagic lesions to blood vessels
• Specific Rickettsia prowazekii details:
• Symptoms are spread by Gameplay that involves spreading out starting at trunk outwards
• the fact that Players dressed have rash sparing hands/feet/head
• The organisms are associated with overcrowding
• Spread via Lice is a Weir looking ball
• Treatment involves doxycycline indicated by Sponsorship

Rickettsa Rickettsii

• Location inside of stadium
• obligatory intracellular organism
• Unable to synthesise CoA and NAD+, indicated via Coach's shirt and bottle
• Weird-looking holds represent spread by ticks of Dermacenter stadium specifically dermacentor ticks
• Climber at the bottom has no rash right away ( non immediate incubation period of 2-14 days)
• Second has rash on hands and feet (extremities) begin on extremities
• Top has rash everywhere (rash eventually spreads centrally)
• headaches (Climber holding head)
• Fever (Climber sweating)
• Joint pain (climber in pain)

Coxiella Burnetti (Q fever)

• obligate intracellular organism (inside locked barn)
• the Walnut bag containing animal feces (contains spores)
• Gram stain are Red
• The cycle occurs because Ram kicks up the spore dust.
• the Airborne spores are inhaled (Farmer breathes in them)
• Ram pristine white NO rash
• Q Fever ( Q fever rams horns)
• Cow has Liver like spots (Hepatitis)
• Undulating fever of farmer (Farmer sweaters)
• farmer cough and also hits the head (Pneumonia and headache)
• farm scene is location for Rifampin

Spiral Bacteria: Leptospira Interrogans

• Leptospira Interrogans = Surfer in Surfer Oasis
• spiral bacteria (spiral leash with question mark)
• zoonotic infection with animal urine (Yellow waves)
• whale in the Oasis, a manifestation of Weil's disease.
• blood tube with blood is hematogenous spreads and affects multiple systems
• Kidney = flying floats with red and blue stripes= Kidney issues
• Liver =Yellow tinted
• Conjunctiva =Surfer using red sunglasses

Borrelia Burgdorferi : Lyme Disease

• bows and arrows (archers), northeastern areas where competition takes place = northeast USA
• vector lives on mice and deer = White-footed mouse and white-tailed deer roaming in forest
• vector= "Wanted" poster of tick
• Archery with Lime colored clothes =Lyme disease
• treatment: Minocycline
• various phases of archery (stages of infection) : erythema chronicum with bulls eye rash
• Migrans ( archery competition involves forest): other archer breaking into cold sweat, with history patient having trip in forests : migratory arthritis (knee of swinging target) : cranial nerves and heart issues (holding helmet with heart on it)

Treponema Pallidum

• Location is at astronomy building: primary syphilis
• galaxy with spiral stairs =spiral bacteria, and Galaxy's observatory that has a Paled sign
• Poked in private (STD)
• Darkfield to see organism
• VDRL = test for it
• FTA-abs = to confirm it + Computer
• condyloma = planetary object

Heliobacter Pylori

• Pilot of Helicopter =Heliobacter Pylori
• curly moustache=sprial
• red suit is gram
• blue ring is oxidase +
• ammonia =ammonia
• propplers show flagella that helps propel
• bullet holes = duodenal ulcers (bullet holes through helicopter)
• the Helicopters logo is a crab logo=higher risk of adenocarcinoma.
• Ammo boxes but full=PPI
• tissues with muscus means it may contain MALT
• triple Therapy = CAO and mao

Campylobacter Jejuni

• Guy roasting Chicken, Campylobacter
• Campylobacter =Jejuni
• curvy moustache = spiral shape
• gram : red
• blue ring= oxidase +
• Chicken: reservoir of campylobacter
• Guy roaster :
• Guillain barre = 2 guys playing tugs on a bears foot- paralysis
• bears found bacteria (invasive)
• stool sample is dysentery = bloody and diarrhea
• Reactive is by Reactive Arthritis : guys laughing and joking with knee rubbing and problems