210.4 📌 章末速蚘

  • Adenovirus: dsDNA, > 100 serotypes, diverse tropism
  • Pediatric: URI, EKC pink eye (8/19/37), gastroenteritis (40/41), HC (11/21/35), pneumonia (3/4/7 military)
  • Severe: HSCT + AIDS disseminated; cidofovir / brincidofovir + immune restoration
  • BK polyomavirus: BKVAN (renal transplant nephropathy), HC in HSCT; reduce immunosuppression primary
  • JC polyomavirus: PML (Progressive Multifocal Leukoencephalopathy) in HIV + natalizumab + rituximab + immunocompromise
  • PML diagnosis: MRI multifocal demyelination + CSF JC PCR
  • PML treatment: immune reconstitution primary; pembrolizumab emerging
  • Natalizumab-PML: plasmapheresis to remove drug rapidly
  • PML-IRIS: paradoxical worsening, continue immune restoration + steroid
  • Merkel Cell Polyomavirus (MCV): discovered 2008; 80%+ Merkel cell carcinoma cases
  • Merkel cell CA: aggressive skin cancer; pembrolizumab / avelumab good response
  • Decoy cells in urine = polyomavirus pathognomonic
  • SV40 IHC on biopsy for BKVAN definitive