210.2 📚 國考版

210.2.0.1 必背 — Adenovirus

• Multiple serotypes, multiple syndromes
• Pediatric URI, conjunctivitis (EKC 8/19/37), gastroenteritis (40/41), HC (11/21/35), pneumonia (3/4/7 military)
• Immunocompromise: severe disseminated
• Cidofovir for severe

210.2.0.2 必背 — Epidemic Keratoconjunctivitis (EKC)

• Adenovirus 8, 19, 37
• Highly contagious “pink eye”
• Corneal subepithelial infiltrates persist months
• Strict isolation + hand hygiene

210.2.0.3 必背 — BK Virus

• BKVAN — renal transplant nephropathy
• Hemorrhagic cystitis in HSCT
• Diagnosis: urine + plasma PCR; decoy cells; SV40 IHC on biopsy
• Treatment: reduce immunosuppression primary

210.2.0.4 必背 — JC Virus + PML

• Progressive Multifocal Leukoencephalopathy in immunocompromise
• Settings: HIV/AIDS, natalizumab, rituximab, transplant
• MRI: multifocal white matter demyelination, no enhancement
• CSF JC PCR diagnostic
• Treatment: immune reconstitution primary; pembrolizumab emerging

210.2.0.5 必背 — Merkel Cell Carcinoma

• MCV in 80%+ cases
• Aggressive neuroendocrine skin CA
• Elderly + sun + immunocompromise
• Pembrolizumab / Avelumab — significant response

210.2.0.6 必背 — PML-IRIS

• Paradoxical worsening after immune reconstitution
• MRI: enhancement + edema + mass effect
• Continue immune reconstitution + steroid

210.2.0.7 必背 — Natalizumab-PML

• Well-known association
• Risk: JC seropositive + treatment > 2 yr + prior immunosuppression
• Plasmapheresis to remove drug
• 70%+ survival in modern era

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