Presumably, the Varicella zoster virus infects
Correct Answer: Dorsal root ganglion
Description: (A) Dorsal root ganglion[?]Varicella-Zoster Virus (VZV):Herpes Zoster Herpes zoster (shingles) is a sporadic disease that results from reactivation of latent VZV from dorsal root ganglia.Most patients with shingles have no history of recent exposure to other individuals with VZV infection.Herpes zoster is characterized by a unilateral vesicular dermatomal eruption, often associated with severe pain. The dermatomes from T3 to L3 are most frequently involved.If the ophthalmic branch of the trigeminal nerve is involved, zoster ophthalmicus results.The onset of disease is heralded by pain within the dermatome, which may precede lesions by 48-72 h; an erythematous maculopapular rash evolves rapidly into vesicular lesions.In a few patients, characteristic localization of pain to a dermatome with serologic evidence of herpes zoster has been reported in the absence of skin lesions, an entity known as zoster sine herpetica.In Ramsay Hunt syndrome, pain and vesicles appear in the external auditory canal and patients lose their sense of taste in the anterior two-thirds of the tongue while developing ipsilateral facial palsy.The geniculate ganglion of the sensory branch of the facial nerve is involved.CNS involvement may follow localized herpes zoster. Many patients without signs of meningeal irritation have CSF pleocytosis and moderately elevated levels of CSF protein. Symptomatic meningoencephalitis is characterized by headache, fever, photophobia, meningitis and vomiting.Human alpha-herpesvirus Causes varicella (chickenpox) and herpes zoster (shingles) Primary VZV infection leads to chicken pox VZV establishes latency in dorsal root ganglia after primary infection VZV can reactivate at a later time, causing herpes zoster. A. Alpha herpes viruses (E.g. HSV-1, VZV, PRV) infect pseudounipolar sensory neurons of PNS ganglia. CNS spread is rare and requires anterograde axonal transport of progeny virions toward the spinal cord.B. RABV and poliovirus spread via Neuromuscular Junctions (NMJ) from muscles into somatic motor neurons in the spinal cord.C. Several viruses may infect receptor neurons in the nasal olfactory epithelium. Spread to the CNS requires anterograde axonal transport along the olfactory nerve into the brain.D. Infiltration through the blood-brain barrier (BBB). The BBB is composed of brain microvascular endothelium cells (BMVEC) with specialized tight junctions, surrounding basement membrane, pericytes, astrocytes, and neurons. Infected leukocytes can traverse this barrier carrying virus into the brain parenchyma.E Alternatively, virus particles in the bloodstream can infect BMVECs, compromising the BBB.
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