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% fetal without treatment | *Fatal Encephalomyelitis in Humans: 80% fetal 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== | ==Clinical Features== | ||
*Vesicular Herpetic Lesions | *Vesicular Herpetic Lesions | ||
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*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]] | ||
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*[[Cat-scratch disease]] | *[[Cat-scratch disease]] | ||
*[[Herpes simplex virus]] | *[[Herpes simplex virus]] | ||
==Diagnostic Evaluation== | ==Diagnostic Evaluation== | ||
*Clinical | *Clinical | ||
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*PCR wound samples less reliable | *PCR wound samples less reliable | ||
*All symptomatic should be tested | *All symptomatic should be tested | ||
==Management== | ==Management== | ||
*Asymptomatic Prophylaxis Treatment | *Asymptomatic Prophylaxis Treatment | ||
**Treat if high risk for transmission: | **Treat if high risk for transmission: | ||
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*[[Rabies]] Treatment | *[[Rabies]] Treatment | ||
==Disposition== | ==Disposition== | ||
*Asymptomatic Discharge | *Asymptomatic Discharge | ||
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==External Links== | ==External Links== | ||
==References== | ==References== | ||
Revision as of 02:03, 12 September 2015
Background
- Cercopithecine herpesvirus 1 (commonly referred to as B virus)
- Zoonotic Endemic in Macaque Monkeys-mild symptoms like blisters
- Fatal Encephalomyelitis in Humans: 80% fetal 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
Clinical Features
- 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
Diagnostic Evaluation
- Clinical
- PCR specificity and sensitivity at nearly 100% for serologic
- PCR wound samples less reliable
- All symptomatic should be tested
Management
- Asymptomatic Prophylaxis Treatment
- Treat if high risk for transmission:
- Penetrating (especially head, neck, torso)
- Fluid on mucosa
- Blistering Monkey
- Discuss with patient
- Treat if high risk for transmission:
Treatment <20 minutes clean and irrigate Prophylaxis: 14 day course of PO Valacyclovir 1gm three times daily 14 day course of PO Acyclovir 800mg five times daily
- All non-CNS symptomatic: Admit and treat
- Acyclovir IV 12.5-15 mg/kg every eight hours OR
- Ganciclovir IV 5mg/kg every 12 hours
- All CNS Symptomatic Admit and treat
- ganciclovir IV 5mg/kg every 12 hours
- Rabies Treatment
Disposition
- Asymptomatic Discharge
- Symptomatic Admit
See Also
External Links
References
- 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.
- 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.