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2 nd Lecture

2 nd Lecture. Parvovirus B19 or Erythrovirus B19 Erythroviruses belong to the  family Parvoviridae (small DNA viruses) non-enveloped , icosahedral virus that contains a linear SS DNA genome

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2 nd Lecture

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  1. 2nd Lecture

  2. Parvovirus B19 orErythrovirus B19 • Erythroviruses belong to the  family Parvoviridae (small DNA viruses) • non-enveloped, icosahedral virus that contains a linear SS DNA genome • It is classifiedas erythrovirus because it invades red blood cell precursors in the bone marrow Viral Myocarditis

  3. Transmission • The virus is primarily transmitted by respiratory secretions; but also vertical and through blood transfusion. • Parvovirus B19 causes infection in humans only

  4. Fifth disease • Fifth disease or erythema infectiosum (fifth pink-red infectious rash) or slapped cheeks disease. •  incubation period: four to fourteen days • Symptoms: fever, runny nose, headache then a red rash appear in the face and may spread to other parts. • In adults, parvovirus B19 may lead to autoimmune arthritis due to formation of circulating virion-antibodies complexes

  5. Child showing signs of erythema infectiosum 16-month-old with erythema infectiosum The "slapped cheek" appearance typical of fifth disease

  6. Most patients have normal erythropoiesis (production of red blood cells) during the infection; but sickle cell anemia and hereditary spherocytosis patients develop dangerous reticulocytopenia (aplastic crises).

  7. Family: Picornaviridae • Genus: Enterovirus • Non enveloped, linear, positive-sense ss RNA viruses. • Two groups: A &B • Enteroviruses are transmitted predominantlyvia fecal-oral route Coxsackievirus Coxsackievirus

  8. Group B, and to a lesser extent Group A was the main viral causes of acute myocarditis, and pericarditis • The virus invades the pharynx or gut wall to the lymphatics and then to the blood • Invasion of striated muscle, heart or pericardium takes place across small blood vessels and results in acute inflammation of the myofibrils • causing chronic myocarditis, and dilated cardiomyopathy Coxsackievirus group (B) and (A)

  9. Symptoms include: fever, headache, sore throat, GIT disturbance, chest and muscle pain • group A tend to infect skin and mucous membranes, causing herpangina, acute hemorrhagic conjunctivitis, and hand foot and mouth disease • Group Btend to infect the heart, pleura and pancreas, causing pleurodynia, myocarditisandpericarditis. • Both group A and B can cause upper respiratory tract disease, and aseptic meningitis.

  10. Other viral infections could be complicated by myocarditis and pericarditis: HIV,  Rubella virus, Cytomegalovirus, and Human herpes virus 6 infections

  11. Syphilis • Caused by: Treponema pallidum. • Transmission: sexually, transplacental, vertical, blood transfusion • Bacteriology: • Thin spirochaete, gram negativewith axial filaments (endoflagella) • Can not be cultivated in vitro; sero-diagnosis Bacterial Myocarditis Treponema pallidum

  12. Pathogenesis of myocarditis happens in the tertiary syphilis • anti-Cardiolipin antibodies in patient serum; • aortic lesions, and Heart failure, • Cell mediated hypersensitivity

  13. Borrelia burgdorferi:  Gram negative, spirochete. • Lyme disease is a zoonotic, vector-bornedisease transmitted by ticks of the genus Ixodes • The microbe is transmitted from lymph nodes through lymphatic vessels and blood stream to cardiac muscle and CNS • Weeks to months after the tick bite the second stage begins with myocarditis, cardiomyopathy, meningitis, and neuropathies Lyme disease: Borrelia burgdorferi Borrelia burgdorferi

  14. Other bacteria that involved in bacterial Myocarditis are • Brucella • Corynebacterium diphtheriae • Neisseria gonorrhoeae • Haemophilus influenzae • Actinomyces • Vibrio cholerae • Leptospira • Rickettsia Other Bacterial Myocarditis

  15. Aspergillosis • Aspergillosis develops mainly in individuals who are immunocompromised • The most common forms are allergic bronchopulmonary aspergillosis, pulmonaryaspergilloma, and invasive aspergillosis Fungal infection Aspergillusfumigatus Pulmonary aspergillosis

  16. Trichinella spiralis • Is a nematode , infect rats, pigs, bears and humans, and is responsible for the disease trichinosis • Humans typically become infected when they eat improperly cooked pork or Trichinella infected meat • FemaleTrichinella worms live for about six weeks, and in that time can produce up to 1,500 larvae • Larvae may migrate with blood to cardiac muscle causing myocarditis Parasitic Myocarditis

  17. Suspected on the basis of electrocardiographic (ECG) results, elevated C-reactive protein (CRP) and/or Erythrocyte sedimentation rate (ESR) and increased IgM (serology) against viruses known to affect the myocardium • Markers of myocardial damage (Troponin or Creatine kinase cardiac isoenzymes) are elevated • A small tissue sample of the endocardium and myocardium is taken, and investigated by a pathologist by light microscopy and (if necessary) Immunochemistry and special staining methods Diagnosis of Myocarditis

  18. extensive eosinophilic infiltrate involvingthe endocardium and myocardium myocarditis at autopsy in a patient with acute onset of congestive heart failure (Necrosis and infiltration)

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