Infection caused by human herpes virus type 6

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Home Health from A to Z Useful information Vomiting blood

Date of publication: 04/01/2016

until January 31

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Vomiting is a reflex eruption of the contents of the stomach and, in some cases, the duodenum through the mouth.

Vomit is usually formed from food debris, stomach acid and mucus, but it may also contain bile, blood and pus. Vomiting blood is a really serious symptom.

More about vomiting

Content

• Causes and routes of infection
• Symptoms
• Methods for diagnosing the disease
• Treatment

Cytomegalovirus is one of the types of herpes. Almost every person on earth is a carrier of the herpes virus, and most people become infected with it in childhood.

Most of the time the virus is in a “dormant” state. However, some of its manifestations can be hazardous to health.

Cytomegalovirus enters the body, like all other types of herpes. If a person’s immunity is normal, this virus may not manifest itself in any way for an unlimited amount of time.

Infection caused by human herpes virus type 6

Human herpes virus type 6 (HHV-6) is a DNA virus of the Herpesviridae family of the Betaherpesvirinae subfamily of the Roseolavirus genus. HHV-6 was first isolated in 1986 from peripheral blood B lymphocytes of patients with non-Hodgkin lymphoma, which occurs in patients with HIV infection. The virus belongs to the subfamily of betaherpes viruses, is the closest genetic relative of CMV, there are two variants: HHV-6A and HHV-6B.

Replication of the virus in peripheral blood mononuclear cells occurs relatively slowly and is accompanied by lysis of the host cell. HHV-6, like other herpes viruses, is characterized by the ability to persist and latency in the body of an infected person. The virus exhibits tropism for a wide range of host cells: it was found in lymph nodes, peripheral blood lymphocytes, monocytes, macrophages, kidney cells, salivary glands, and brain. During an acute infection, the pathogen can be isolated from the blood. After infection, HHV-6 infection becomes latent. The place of virus latency has not been studied; it is assumed that the virus remains latent for some time in monocytes and macrophages. The virus infects the salivary glands and is released from them. Detection of the virus in the blood is typical only during the febrile stage of sudden exanthema and, probably, during reactivation of the virus and generalization of infection under conditions of immunosuppression. The pathogenesis of reactivation of infection is unclear.

HHV-6 infection is an anthroponosis. The source of infection is a person suffering from a manifest or latent form of infection, as well as virus carriers. Routes of transmission of infection: airborne droplets, household contact, parenteral, transplacental. Transmission factors are saliva, sputum, blood. The infection is characterized by universal susceptibility.

The high pathogenetic significance of HHV-6 has been shown: it can cause acute skin lesions in young children (sudden exanthema of newborns), fever in newborns with convulsive syndrome, chronic fatigue syndrome (at the same time, recent studies attach greater importance to HHV-7 in the development of this pathology ), mononucleosis-like syndrome; in immunocompromised individuals – cause fever, pneumonia, hepatitis, and central nervous system damage. It has been proven that the virus can also act as a cofactor for HIV. Along with the occurrence of a primary infection, reactivation of the virus is possible: in children intrauterinely infected with HIV-1, primary HHV-6 infection contributed to a more rapid development of clinical manifestations already during the first year of the child’s life. The presence of an active HHV-6 infection in an HIV-infected child may lead to more rapid progression of the underlying disease during the 1st year of life. Cases of pneumonia and encephalitis of HHV-6 etiology in patients with HIV infection have been described. HHV-6 DNA was determined in brain tissues of deceased patients at the stage of AIDS. In patients with HIV infection with severe immunosuppression, HHV-6 damage to the central nervous system, lungs and other organs is possible, but the clinical characteristics of damage to individual organs, the diagnostic sensitivity and specificity of various laboratory markers have not been precisely characterized.

Verification of the diagnosis of HHV-6 infection is carried out only with positive results of laboratory tests.

Differential diagnosis.

Entero- and adenovirus infection, measles, rubella, scarlet fever, pneumonia, otitis media, acute pyelonephritis, meningitis, pneumococcal bacteremia, allergic rashes.

Indications for examination

• Maculopapular rash (exanthema) in combination with lymphadenopathy after a short fever;
• enlargement of the occipital, posterior cervical and/or parotid lymph nodes;
• research after contact with a patient with sudden exanthema or other infection caused by HHV-6 or suspected of these nosological forms;
• differential diagnosis of exanthema diseases;
• immunodeficiency states;
• chronic fatigue and a decrease in performance by more than 50% with a duration of about 6 months in the absence of other diseases that cause similar symptoms;
• symptoms of congenital infection, developmental defects in newborns.

Etiological laboratory diagnostics include identification of the pathogen in cell culture, detection of viral DNA, determination of specific IgM, IgG antibodies to HHV-6 antigens.

Material for research

• Blood plasma, CSF, leukocyte fraction of blood, saliva - DNA isolation, identification of the pathogen in cell culture;
• blood serum - determination of AT.

Comparative characteristics of laboratory diagnostic methods.

Detection of the pathogen in cell culture is currently not used for routine diagnosis of infection caused by the HHV-6 virus due to the complexity, duration of execution and the need for certain research conditions.

The main method of differential diagnosis of infection is the detection and determination of the concentration of HHV-6 DNA by PCR. When testing whole blood to diagnose infection, DNA quantification is preferred to differentiate between latent and active infection, since the virus may be present in the white blood cells of healthy individuals. Detection of viral DNA in plasma but not in whole blood confirms the presence of an active infection. The results of determining HHV-6 DNA in a quantitative format allow for dynamic monitoring: based on the increase in concentration in peripheral blood, leukocytes, CSF, saliva, establish the activity of the infectious process, identify reactivation, and evaluate the effectiveness of the therapy.

To identify specific IgM and IgG antibodies to HHV-6 antigens, ELISA is mainly used. Determination of IgG antibodies can be performed in qualitative and quantitative format. Detection of IgM antibodies makes it possible to establish a diagnosis of a current primary HHV-6 infection; the results of determining IgG antibodies in a quantitative format allow for dynamic observation and assessment of the state of post-infectious immunity to HHV-6.

Indications for the use of various laboratory tests (herpes type 6 - analysis).

Indicators of active infection are the presence of HHV-6 DNA and IgM antibodies. IgM antibodies appear in the blood 4–7 days after the onset of the disease and persist for several months. IgG antibodies appear in the blood on days 7–10 of the disease and persist throughout life, therefore, to establish the fact of primary infection, quantitative determination of IgG antibodies over time is necessary. Determination of virus-specific IgG antibodies can be used in screening studies to determine the presence of immunity to HHV-6.

Features of interpretation of laboratory research results.

Detection of a specific fragment of HHV-6 DNA in patient biomaterial samples (blood plasma, CSF, scrapings from the mucous membrane of the oropharynx) allows one-time testing to confirm the fact of HHV type 6 infection.

The detection of specific IgM antibodies, markers of the acute phase of the disease, indicates a primary infection or reactivation of the infection. A single detection of IgG antibodies is not unambiguous evidence of a primary infection.

Causes and routes of infection

The main cause is the HCMV-5 virus, which is transmitted from person to person. In children older than several months and adults, infection occurs almost asymptomatically and for the most part does not pose a particular health hazard.

But a child can become infected with this virus even before birth, i.e. in this case we are talking about a congenital virus. And then cytomegalovirus can cause serious damage to the body. developmental defects , serious disorders in the nervous system and digestive system, in the cardiovascular and musculoskeletal systems may occur Smirnova, E.V. Rossikhina, N.S. Dyupina The role of cytomegaloviruses in obstetric pathology and neonatology // Vyatka Medical Bulletin, 2010.

The virus penetrates the placenta, so it affects children even at the stage of intrauterine development, and can be transmitted during childbirth and breastfeeding.

The main routes of infection, which with a 98% probability lead to the disease:

• Blood transfusion - infection occurs during: organ transplantation;
• blood transfusion;
• using non-sterile syringes for intramuscular and intravenous injections.

1.General information

First of all, a few general words should be said about those situations when a person sees his own blood outside the body. If this is a medical procedure (for example, blood sampling for clinical analysis), or a superficial scratch (which, however, must also be aseptically treated to avoid infection), or menstrual blood in women (without any deviations from the established cycle) - worry, Of course it's not worth it.

But any other appearance of blood, even in small or barely noticeable quantities (any signs of hemorrhage, bleeding ulcers, “leaking” effusion, etc.) is in all cases a serious situation, requiring consultation, examination and medical intervention, and often ( depending on a number of circumstances), assistance should be provided not just “in the near future,” but on an urgent or emergency basis.

This is especially true for massive blood impurities in urine, feces or expectorated sputum: such phenomena never arise “just like that” - this is a symptom, and in medicine it is considered one of the most formidable.

Coughing up blood, tasting or having blood in the mouth can have many different causes.

Some of them may not pose an immediate threat to life and health. But this is one of those cases when it is definitely better to make a mistake like a “false alarm” by visiting or calling doctors “in vain” than to waste precious time and bring the situation to a critical or irreversible point.

A must read! Help with hospitalization and treatment!

Symptoms

If the infection develops in children during the neonatal period, it may be accompanied by symptoms:

• enlarged lymph nodes;
• tonsillitis;
• labored breathing;
• impaired swallowing and sucking reflexes;
• prematurity;
• strabismus;
• jaundice of newborns. Source: R.Zh. Seisebaeva, A.E. Almaganbetova, F.N. Kasymbekova, E.S. Ataibekova, G.M. Abdrakhmanova Epidemiology of congenital cytomegalovirus infection // Bulletin of KazNMU, 2021, No. 1.

Cytomegalovirus can develop asymptomatically, which is the most dangerous. Due to the asymptomatic course of the infection, children may develop changes in the skull skeleton, lack of body weight, and mental development disorders.

Acquired infection (when a child becomes infected at an older age) can occur with the following symptoms:

• enlarged lymph nodes (especially in the neck);
• lethargy, drowsiness;
• temperature increase;
• pain in muscles and joints.

Most often, the infection goes away without any specific treatment when infected at an older age than infants. But if the symptoms of infection do not go away after 2 months, consult a doctor immediately!

Treatment

Drug therapy is used when a child is infected as a newborn or in severe cases of the disease. Treatment is not aimed at completely getting rid of the virus, which is physically impossible, but at reducing its activity. Antiherpetic drugs are most often used for treatment. To draw up a treatment plan, contact your pediatrician.

Sources:

1. A.I. Smirnova, E.V. Rossikhina, N.S. Dupin. The role of cytomegaloviruses in obstetric pathology and neonatology // Vyatka Medical Bulletin, 2010.
2. R.Zh. Seisebaeva, A.E. Almaganbetova, F.N. Kasymbekova, E.S. Ataibekova, G.M. Abdrakhmanova. Epidemiology of congenital cytomegalovirus infection // Bulletin of KazNMU, 2021, No. 1

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

2. Reasons

The most common cause of hemoptysis is diseases of the respiratory system. Here it should be remembered that a cough is a repeated spastic contraction of the respiratory muscles with forced exhalation (inhalation may be difficult and incomplete), most often caused by inflammatory, mechanical or chemical irritation of the upper respiratory tract - trachea, bronchi, larynx, as well as nasopharyngeal or pleural receptors.

Accordingly, infectious and inflammatory processes lead among the causes:

• tuberculosis;
• “smoldering” suppuration in pathologically distended incompetent bronchi (chronic bronchiectasis);
• some specific types of bacterial (less often viral) pneumonia;
• abscessing inflammatory process in the lungs;
• clinically significant bronchitis, acute or chronic.

The second most common group of causes are tumors, both malignant neoplasia in the lungs and benign formations in the bronchi (for example, adenoma).

Other reasons include:

• pulmonary thromboembolism (in turn, which can occur under the influence of various factors - thrombophlebitis, surgery, etc.);
• some types of severe cardiac pathology (rheumatism, congenital or acquired defects);
• trauma and/or foreign body in the lungs;
• diseases of the upper gastrointestinal tract;
• some genetic, autoimmune, idiopathic diseases (cystic fibrosis, Wegener's granulomatosis, hemorrhagic diathesis, pulmonary hemosiderosis, etc.).

Finally, some sources emphasize that from five to fifteen percent of cases of coughing up blood remain etiologically unclear, i.e. the cause is not identified even with a comprehensive examination.

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