Cau 95: nhom Virus Herpes

Cac Herpes vr gay nhiem khuan cho ng bao gom:

1/ Herpes simplex (HSV)

*) khnag gay benh: Vr HSV gay nhieu ben canh lsang # nhau.Nh.trug co the nguyen phat or tai hoat, nh.trung nguyen phat xay ra o nhug ng ko co KT chog lai vr HSV. Trai lai trog nhiem trug tai hoat ton thg xay ra o nhug b.nhan da co KT chog lai vr nay.

Ca 2 typ vr (vr herpes typ 1 va vr herpes typ 2) gay nh.trung cac tbao bieu mo va tao cac nh.trung tiem tang o tbao tkinh.

+ vr typ 1 (HSV-1) thg gay cac nh.trung o mieng va mui nhu viem mieng, viem loi, eczema do vr herpes, viem ket mac mat sung hoa, viem nao

+ vr typ 2 (HSV-2) gay cac ton thg o dg sduc nam cung nhu nu, gay nh.trung herpes o tre so sinh khi dua be sinh qua dg sduc ba me dang bi nh.trung HSV dg sduc.

Ca 2 typ gay nh.trung co quan nhu viem thuc quan, viem phoi, viem phoi, viem gan xay ra tren co dia b.nhan suy mien dich

*) phong: nhieu vacxin da dc thu nghiem nhug hien nay chua co loai vacxin nao dc dua vao su dung. nen tranh txuc voi b.nhan bi nhiem vr herpes dg s.duc

*) dtri: hien nay co nhieu thuoc chog vr HSV huu hieu va co san de dtri nh.trug vr herpes tai cho hoac toan than. nhug thuoc nay gom vidarabin, acyclovir va cac dan chat cua thuoc nay nhu famciclovir, valacyclovir la thuoc thg dung

2/ Vr thuy dau - zona

a/ Thuy dau: ng la o chua duy nhat, benh thuy dau la hau qua cua nh.trug nguyen phat vr VZV, benh rat thg gap o tre em, it khi gap o ng lon. vr xam nhap vao dg ho hap tren ptrien tai cho gay nhiem vr mau de phan tan den cac co quan, da, tkinh...

- ton thg o da, tbao bieu bi sug fog tao fog nc, kem dau hieu toan than voi sot, met moi. benh khoi sau 10 ngay den 2 tuan, ton thg o da ko de lai seo. cac bien chug gom nh.trug da, boi nhiem phoi do vk, viem nao.

b/ benh zona: day la 1 hinh thuc tai hoat cua 1 nh.trung tiem tang vr VZV ma ng benh bi mac phai trc day. benh xay ra le te o ng lon. benh bhien o da boi ton thg phong nc dinh thanh chum va fan bo theo vung cac day tk bi a/huog, ton thg viem dc tim thay o cac re hach tk bi nh.trung, thg gap la re tk co, lug, day tk so nao

bhien to thg viem nao, viem mag nao tuy co ty le thap

*)phong: - dung vacxin sog giam doc luc chog benh thuy dau-zona cho ng b.thg va nhug ng co nguy co cao.

- co the dug globulin mien dich chog thuy dau-zona (VZIG) cho tre em <15t bi

suy mien dich chua mac thuy dau, co txuc voi ng benh

*) dtri: han che boi nhiem vk o ton thg da, niem mac = vsinh, khang sinh

- dtri varicella - zona voi cac thuoc chog vr: acyclovir, Vidarabin

- dung Interferon co nguon goc tu bach cau ng

3/ Cytomegalovirus (CMV)

-Cac ca the co nguy co lay nhiem cao nhu bi nhiem o tky chu sinh, bi dan ap mien dich, phai nhan mau hoac bi ghep co quan.

- trog tu cug me, thai nhi co the nhiem CMV do vr truyen tu me qua nhau thai. nhung tre em nh.trung ko co tr.chung co the xh cac bat thg ve nghe, thi giac, ptrien tam than v.dog ve sau

- nhug b.nhan bi AIDS, CMV gay cac nh.trung lan toa va gay tu vog cho nhug b.nhan nay

*) phong: chua co vacxin phog benh dac hieu, chu yeu ktra ng cho co quan trc khi ghep

*) dtri: Dung ganciclovir va foscarnet de dtri voi lieu cao.

5/ Epstein-Barr virus (EBV)

*) dich te hoc: vr dc thai ra tu dg mui den 18 thag sau khi bi nhiem trug tien phat. B.nhan va ng lanh mag vr co khnag lay nhiem. su truyen benh chu yeu qua nc bot khi hon, ko truyen qua ko khi tho, benh co the truyen qua truyen mau

*)benh o ng: - EBV gay benh tag bach cau don nhan nhiem khuan thg gap o thieu nien va ng tre.

bhien met moi, chan an, sot, viem hog va hach Lympho lon. benh thg khoi sau 3-4 tuan.

- bien chug hien khi xay ra: thg nag va lien he den nhieu co quan (mau, he tk, gan, tim, phoi)

- EBV con gay cac benh ac tinh gom u Lympho Burkitt, ug thu hau hog va nhieu u lympho bao B

*)Phong: chua co vacxin phog benh huu hieu

*)dtri: Acyclovir, interferon va a propiolacton uc che su sao chep EBV trog phog thi nghiem.