Karime
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A 8 yr old girl is seen at ER with fever, myalgia and headache. Physical exam reveals conjunctival injection, facial flushing, and lymphadenopathy and Mild papiledema. CSF shows elevated protein levels as a single finding. The mother said that her dauther is a healthy child, very active and denies any previous flu like or GI symptom. She mentioned that 3 weeks ago the child got a hamster as birthday gift.
The causative agent is an:
1. Naked RNA virus, icosahedral, naked, with SS linear genome.
2. Enveloped RNA virus, enveloped, SS linear genome, helical capsid.
3. Enveloped RNA virus with SS linear genome, helical and bullet shaped structure
4. Enveloped RNA virus, with SS circular genome, helical capside
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| keepgoing
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4 maybe arenavirus.?
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| GoodGirl
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I would go with A, some kind of Picornavirus, no washing hands... could cause aseptic meningitis , even CNS infections, and conjuctivitis they cause too. Like Enteroviruses are common at this age group.
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| GoodGirl
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It's so funny, I was just reading today in ABC Health news, how to not get a pet to a child... and here I go . No pet to my little kiddo .  
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| brainstem
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A??? - by exclusion.
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| GoodGirl
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What kind of exclusion ?
Guess going to bed without finding out the correct answer ?
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| brainstem
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2 - coronaviruses cause common cold
3 - rabies, vesicular stomatitis - wil not present like this
4 - arenaviruses - lymphocytic choriomeningitis - may present, not sure.
1 -picornaviruses - coxsackie A virus can present like this
ans - 1, correct if i am wrng.
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| Karime
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The answer is "4"......very well keepgoing
You can get it by exclusion: 'cos number 1 is picornavirus but there is no clue about enteric or respiratory previous illness. Number 2 coronavirus just common cold, or SRDS in adults, Number 3 Rabies, no 'cos the child wasn't bitten and even more, rabies in rodents is paralytic.
Also note, arenavirus, is an RNA virus, Genoma SS but "circular".
Arenavirus is a genus of virus. The type species is Lymphocytic choriomeningitis virus (LCMV); it also includes the species responsible for Lassa fever.
Lymphocytic choriomeningitis (LCM), is a rodent-borne viral infectious disease that presents as aseptic meningitis, encephalitis or meningoencephalitis.
The virus particles are spherical, enveloped, RNA genome, single stranded, Circular, negative sense. Viewed in cross-section, they show grainy particles that are ribosomes acquired from their host cells. It is this characteristic that gave them their name, derived from the Latin "arena," which means "sandy."
The virus seems to be relatively resistant to drying and therefore humans can become infected by inhaling infectious aerosolized particles of rodent urine, feces, or saliva, by ingesting food contaminated with virus, by contamination of mucus membranes with infected body fluids, or by directly exposing cuts or other open wounds to virus-infected blood. The only documented cases of transmission from animals, have occurred between humans and mice or hamsters.
The virus normally has little effect on healthy people but can be deadly for people whose immune system has been weakened.
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 did i get it right... love you karime 
was in doubt when saw GG saying a,she never gets any qn wrong 
good qns.
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| GoodGirl
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Trophy for you dear KG. What ??? I never got Q wrong? What about the '' Atherosclerosis with lipid profile'' very basic q.  I will never forget that one. 
Karime, thanks for putting it up.
I thought Lass presents as hemorrhagic fever , agree with rodents. The symptoms confused me, will read about it more...
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| GoodGirl
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From eMedicine :
Acquired infection - One third of infections are subclinical.
- One half of the clinical infections have neurologic involvement.
- The typical biphasic disease is composed of a nonspecific flulike illness followed by typical viral aseptic meningitis.
- The first phase includes a fever, a headache, lymphadenopathy, and a maculopapular rash lasting 3-5 days.
- A more severe headache, photophobia, a stiff neck, vomiting, and lethargy follow after approximately 4 days.
- Patients may have a history of rodent exposure 1-3 weeks earlier (often 6-13 d, but may extend to 3 wk).
- Other symptoms commonly seen include more prolonged fevers, malaise, myalgias, nausea or vomiting, a retro-orbital headache, anorexia, weakness, a sore throat, a cough, and seizures.
- Unusual symptoms include orchitis, parotitis, pancreatitis, myocarditis, paresis or paralysis, alopecia, and arthritis (involving the metacarpophalangeal and proximal interphalangeal joints).
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| GoodGirl
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Why the Kaplan p. 439 , Kaplan states in the table : '' Disease : Hemorrhagic fever with 50 % fatality rate '' ?
Is their any hemorrhagic presentation in Lassa ?
You can tell, I'm reading hematology nowdays .
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| keepgoing
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i trust ur knowledge,what if one wrong
great job GG.thanks.keep it up gals.
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| Karime
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Clue here is to differenciate the viral morphology, the child age.
Arena has 2 subtypes, or subspecies: LCMV and Lassa fever virus.
Yesssss, Lassa has another type of presentation.....Hemorrhagic.
But Lymphocytic choriomeningitis virus (LCMV) presents more as an aseptic meningitis...
Thanks for the analysis goodgirl
1 1 1 M M M M M/ . ' M ` . ##-#####-##/ # ##### #/ ############### ############### ! ! ! ! ! / )! ! ! ! !( +---------+ +! ! ! ! !+ +----*----+ +`. .':`. .'+ + .^. : .^. + +:...:*:...:+ +`. .':`. .'+ To Keepgoing
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| Karime
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Hey.....just to clear something:
I just copied and pasted
http://www.asciiworld.com/-Buildings-.html
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| GoodGirl
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I can tell I'm badly hypoglycemic, going to have my lunch now, and later on when my neurons will get all happy, will think about it.
Thanks Karime.
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wow wow thanks karime,im soo glad and u know this is perfect trophy for a doctor as it looks like a syringe .thank u thank u.
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Thanks GG n Karime for covering this topic all right away 
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got the trophy source will steal all GALS contact me if need any
thanks karime for sharing with us,awesome.
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