Viral infections
Biju Vasudevan, Rajesh Verma in Dermatological Emergencies, 2019
The hemorrhagic fevers are a group of zoonotic viral infections that range in severity from a mild, self-limited febrile illness to a severe, life-threatening disease. The most important disease with dermatological involvement is dengue fever. Dengue, also called breakbone fever, is an acute illness with fever and two or more of the following symptoms: headache, retro-orbital pain, myalgia, arthralgia, rash, and hemorrhagic manifestations. Fever and other symptoms may subside after 3–4 days, and the patient may recover completely, or the fever may return with an eruption within 1–3 days. Skin eruptions appear in 80% of patients during the remission period of the fever. This timely appearance is diagnostically important because differentiating from malaria, yellow fever, or influenza is difficult by just looking at the skin lesions. The eruption consists of a centrifugal macular, maculopapular, scarlatiniform, or petechial eruption, characteristically starting from the dorsum of the hands and feet and spreading to the arms, legs, and torso. The face is rarely involved. Lesions may become confluent, with small round islands of sparing, the “white islands in a sea of red” [23], and last 2 hours to several days. Laboratory tests usually reveal a characteristic thrombocytopenia and leukopenia with pathological values of transaminases.
Public Health and Viruses
Patricia G. Melloy in Viruses and Society, 2023
In 2014, an Ebola outbreak started in Guinea and spread to two neighboring West African countries of Sierra Leone and Liberia. Ebola causes a hemorrhagic fever and is spread by bodily fluids. Once the Ebola outbreak began to move into more populated areas, the WHO declared it a public health emergency of international concern (an alarm sounded before a pandemic), and scientists and physicians from around the world were mobilized to help in the fight against the virus. International efforts on the ground in these countries were able to stop the virus from spreading worldwide. These efforts included healthcare workers and public health support from other countries, and the implementation of public health measures like increasing awareness of how to handle Ebola patients as well as those who died from the disease. Aggressive contact tracing and quarantining also helped put a stop to the virus in 2016, although 11,325 people died (Zimmer 2011; CDC 2022b).
Viral and Rickettsial Hemorrhagic Fevers: Laboratory Investigation of the Hemorrhagic State
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
In summary, there appears to be no shortage of documented lesions capable of contributing towards the bleeding state in viral hemorrhagic fevers. If there is any degree of pathogenetic similarity among the various hemorrhagic fevers, functional damage to the endothelium with its subsequent effects could account for many of the observations made in human subjects and in experimental animals. However, other mechanisms may also play a role, the relative importance of which probably varies, depending on the pathogen involved and the stage of the disease. A summary of literature dealing with different mechanisms of bleeding in the various viral hemorrhagic fevers is presented in Table 3.
Managing thrombosis and cardiovascular complications of COVID-19: answering the questions in COVID-19-associated coagulopathy
Published in Expert Review of Respiratory Medicine, 2021
Toshiaki Iba, Jerrold H. Levy, Jean Marie Connors, Theodore E. Warkentin, Jecko Thachil, Marcel Levi
Virus infection is known to induce viral hemorrhagic fevers. COVID-19 is a mysterious virus infectious disease which is frequently associated with hypercoagulability and a high incidence of thromboembolic complications. The accumulated evidences have revealed besides localized proinflammatory consequences of severe lung damage, multiple other factors are involved in the pathophysiology of CAC, including cytokine storm, perturbed autoimmune system, platelet activation, fibrinolytic shutdown, and endothelial damage. Although the above pathophysiology is considerably overlapped with that seen in sepsis-associated DIC, the risk of VTE is higher, and the complications of arterial thrombosis and vascular diseases are unique feature of CAC. Perhaps, other than the host immune responses, unknown mechanisms still exist in CAC and further research is necessary.
Purtscher-like Retinopathy Associated with Crimean-Congo Hemorrhagic Fever: A Case Report
Published in Ocular Immunology and Inflammation, 2022
Duygu Yalinbas, Erman Bozali, Ayse Vural, Husne Kocak, Haydar Erdogan
Crimean-Congo hemorrhagic fever is one of the most severe viral infectious diseases for humans. The disease has a widespread geographical distribution, especially Africa, the Middle East, Europe, and Asia. The incidence of CCHF has been increased recently, and outbreaks of disease are crucial for world health in terms of epidemic potential, high mortality rate, nosocomial infection possibility and treatment, and prevention difficulties.11 The pathogenesis of CCHF consists of endothelial dysfunction, vascular leakage, and capillary fragility. Endothelial damage causes activation of the coagulation cascade, thrombocytopenia, and bleeding.12 Increased myeloperoxidase expression in leukocytes could lead to lysis of leukocyte. Recently, higher IL-1, IL-6, and TNF-α have been reported in CCHF patients.13 Also, the necrosis of liver cells leads to the elevation of liver enzymes.11
Recent advances in the development and evaluation of molecular diagnostics for Ebola virus disease
Published in Expert Review of Molecular Diagnostics, 2019
John Tembo, Edgar Simulundu, Katendi Changula, Dale Handley, Matthew Gilbert, Moses Chilufya, Danny Asogun, Rashid Ansumana, Nathan Kapata, Francine Ntoumi, Giuseppe Ippolito, Alimuddin Zumla, Matthew Bates
Viruses from the family Filoviridae can cause viral hemorrhagic fevers (VHFs), including Ebola virus disease (EVD) and Marburg virus disease (MVD) [1]. There are five known Ebolavirus species, namely Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, Bundibugyo ebolavirus, and Reston ebolavirus, represented by the following viruses, respectively, Ebola virus (EBOV), Sudan virus (SUDV), Taï Forest virus (TAFV), Bundibugyo virus (BDBV) and Reston virus (RESTV) [2]. There is also one newly proposed ebolavirus isolated from insectivorous bats, Bombali virus (BOMV), as yet not known to cause human disease [3]. There is only one known marburgvirus species, Marburg marburgvirus, with two known viruses, Marburg virus (MARV) and Ravn virus (RAVV) [2]. There is a third genus within the Filoviridae called Cuevavirus that is not linked to VHF in humans.
Related Knowledge Centers
- Arenavirus
- Filoviridae
- Flaviviridae
- Rhabdoviridae
- Zaire Ebolavirus
- Rna Virus
- Bunyavirales
- Hantaviridae
- Hantavirus Hemorrhagic Fever With Renal Syndrome
- Orthohantavirus