📖 General Pathology
HERPES ZOSTER (Shingles)
General PathologyHERPES ZOSTER (Shingles)
An infection with varicella-zoster virus primarily involving the dorsal root ganglia and characterized by vesicular eruption and neuralgic pain in the dermatome of the affected root ganglia.
caused by varicella-zoster virus
Symptoms and Signs
Pain along the site of the future eruption usually precedes the rash by 2 to 3 days. Characteristic crops of vesicles on an erythematous base then appear, following the cutaneous distribution of one or more adjacent dermatomes
Eruptions occur most often in the thoracic or lumbar region and are unilateral. Lesions usually continue to form for about 3 to 5 days
Geniculate zoster (Ramsay Hunt's syndrome) results from involvement of the geniculate ganglion. Pain in the ear and facial paralysis occur on the involved side. A vesicular eruption occurs in the external auditory canal, and taste may be lost in the anterior two thirds of the tongue
Paroxysmal nocturnal haemoglobinuria (PNH).
General PathologyParoxysmal nocturnal haemoglobinuria (PNH).
Feature:
- Acquired RBC rnembrane defect rendering it susceptible to complement lysis.
- Features of intravascular haemolysis.
- Blood picture of haemolysis anemais with pancytopenia.
- Ham’s acid serum test (lysis at 37COin acid pH) + ve
Acute viral hepatitis
General PathologyAcute viral hepatitis
Clinical features. Acute viral hepatitis may be icteric or anicteric. Symptoms include malaise, anorexia, fever, nausea, upper abdominal pain, and hepatomegaly, followed by jaundice, putty-colored stools, and dark urine.
In HBV, patients may have urticaria, arthralgias, arthritis, vasculitis, and glomerulonephritis (because of circulating immune complexes). Blood tests show elevated serum bilirubin (if icteric), elevated transaminases, and alkaline phosphatase.
The acute illness usually lasts 4-6 weeks.
Pathology
(1) Grossly, there is an enlarged liver with a tense capsule.
(2) Microscopically, there is ballooning degeneration of hepatocytes and liver cell necrosis.
Fulminant hepatitis
General PathologyFulminant hepatitis
Fulminant hepatitis leads to submassive and massive hepatic necrosis.
a. Etiology. HAV, HBV, HCV, delta virus (HDV) superinfection, HEV, chloroform, carbon tetrachloride, isoniazid, halothane, and other drugs (acetaminophen overdose) all may cause fulminant hepatitis.
b. Clinical features include progressive hepatic dysfunction with a mortality of 25%-90%.
c. Pathology
(1) Grossly, one sees progressive shrinkage of the liver as the parenchyma is destroyed.