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Adenovirus Infection Causes Diagnosis and Treatment


Causes Diagnosis and Treatment of Adenovirus Infection

Acute infectious diseases caused by adenoviruses are liable to invade the respiratory and digestive tract mucosa, eye conjunctiva, urinary tract and lymph nodes. Mainly manifested as acute upper respiratory infections (2% to 4% of acute respiratory infections caused by adenoviruses), followed by eye and gastrointestinal infections

The population is generally susceptible and more common in children. About half of the patients are recessive. Infants and young children are susceptible to adenoviral pneumonia, with a severe condition and a high mortality rate. No specific treatment. 

According to the investigation of the human serum specific antibodies and virus isolation, it can be seen that adenovirus infection is very extensive. 
The source of infection is patients and occult infections. 

The virus is excreted from respiratory tract and ocular conjunctival secretions, feces and urine and transmitted through air droplets, close contact and fecal-oral routes.

English name:    Adenovirus infection

Visiting department:    Department of Infectious and Clinical Microbiology

Multiple groups:    Children

Common causes:    Adenovirus

Common symptoms:    Eye irritation and increased secretions, fever, cough, sore throat, runny nose, lung murmur, etc.

Contagious:    Yes

Way for spreading:    Transmission through air droplets, close contact and fecal-oral route

   

    What are the Causes of Adenovirus Infection?

    Adenoviruses were found to have six subtypes (A to F) and 55 different serotypes (according to virus genotype).
    About 20 serotypes are known to infect humans. 
    The virus is an icosahedral capsid with a diameter of 70 to 80 nanometers, and the core contains double-stranded DNA. Unstable to heat and acids.

    Because it does not contain lipids, it has strong resistance to lipid solubilizers such as bile salts, so it can survive in the intestine. Different subtypes can cause different infections.

    What is the Clinical Diagnosis of Adenovirus Infection?

    The incubation period of this disease is 4 to 5 days, and the clinical manifestations of adults and children are different.

    1. What is Adult clinical manifestations?

    (1) Epidemic keratoconjunctivitis In general, adenovirus types 8 and 19 can cause the epidemic, and other types are usually sporadic cases. 
    The incubation period is longer, usually 3 to 24 days, and the early symptoms are not obvious. 
    It involves more eyes, more eye irritation and secretions, which can last for 1 to 4 weeks. 
    Corneal damage can last for several months, and rare blindness.
    It is more commonly transmitted through the family. It can transmit through contaminated public towels, contaminated hands, eye drops, etc.

    (2) Respiratory tract infections generally include fever, cough, sore throat, runny nose, and lung snoring.
    The results of X-ray examination are mostly unilateral interstitial pneumonia or changes in lung consolidation, generally the lower lung field, and may also be accompanied by a small amount of pleural effusion.
    Secondary bacterial infections are relatively rare, and fatal cases have been gradually discovered in the past 10 years. 
    The course of disease is usually short, usually 1 to 2 weeks.

    2. What is Clinical Manifestations of children?

    (1) Hemorrhagic cystitis generally shows no obvious seasonality, and is more common in boys, mostly caused by adenovirus types 11 and 21. For 3 to 7 days, it may be accompanied by frequent urination, hematuria, urgency, dysuria, gross hematuria, and hematuria under microscope can last for about 2 weeks.

    (2) Respiratory infections: The most common symptom of infant adenovirus infection is rhinitis. 
    Fulminant bronchitis and pneumonia may occur in this age group. And some children may develop pertussis syndrome.

    (3) Pharyngeal conjunctivitis is mostly caused by adenovirus types 3 and 7 and a pandemic can occur in summer, which is related to the spread of water in swimming pools. 
    It showed acute onset, fever above 38 ° C, pharyngitis, rhinitis, ocular conjunctivitis, and cervical lymphadenitis.

    Granular conjunctiva and palpebral conjunctiva can see granular protrusions, redness and swelling, often unilateral, bilateral ones are often heavier on one side. 
    Symptoms lasted 1 to 2 weeks without sequelae. 
    Generally without bronchitis and pneumonia.

    (4) Other pericarditis, chronic interstitial fibrosis, infant diarrhea, rubella-like disease and congenital malformations have been found to be associated with adenovirus infection.
    It is worth noting that after organ transplantation and adenovirus infection in immunodeficiency patients, in addition to causing respiratory and urinary tract infections. 
    It can also cause central nervous system infections such as encephalitis.

    What are the Diagnostic Tests for Adenovirus Infection?

    1. Rapid Diagnostic method

    The smear of exfoliated cells removed from the pharynx was stained with a fluorescent immunosera of polyvalent adenovirus. 
    Bright fluorescence was found in the nucleus of the exfoliated cells under a fluorescence microscope, indicating that the virus was positive.

    2. Virus isolation

    Passaged monolayer human epithelial cells were inoculated with pharyngeal secretions, sputum, conjunctival scrape, and fresh urine of different clinical types, and typical cytopathic changes could be detected after 2-7 days. 
    Groups were determined by the hemagglutination test and typed by the neutralization test.

    3. Serology

    To confirm the diagnosis of this disease, you can take two sera in the acute phase and the recovery phase, test complement-binding antibodies, neutralizing antibodies, and hemagglutination-inhibiting antibodies, if you find a 4-fold increase. 

    Different antibodies have different titers after infection:
    (1) The titer of complement-binding antibody decreases or disappears one year after infection;
    (2) Hemagglutination inhibiting antibody is a specific antibody, and the antibody titer increases after one week of infection;
    (3) The neutralizing antibody lasts for at least 10 years, and the titer does not decrease. 
    In patients with hemorrhagic cystitis, a single serum adenovirus type 11 or 21 neutralizing antibody titer exceeding 1:32 can be diagnosed.

    4. Molecular diagnosis

    Respiratory tract specimens were taken, and adenovirus-specific gene fragments were amplified by PCR to diagnose.

    Differential Diagnosis Adenovirus Infection

    Differential diagnosis

    It is distinguished from herpes virus, pox virus, influenza, parainfluenza, and rhinovirus infections.

    1. Flu


    1.  The incubation period is several hours to 4 days, usually 1 to 2 days
    2.  High fever, body temperature can reach 39 - 40 , accompanied by chills, usually lasts 2 to 3 days.
    3.  Symptoms of systemic poisoning are severe, such as fatigue, headache, dizziness and soreness lasting for a long time.
    4. Symptoms such as fatigue after normal body temperature can last for 1 to 2 weeks.
    5.  Symptoms of catarrh in the respiratory tract are slight, often with sore throat, and a few have nasal congestion, runny nose, etc.


    2. Pox virus

    Viruses that cause local or systemic purulent skin damage if infected in humans and animals.

    What is the Complication with Adenovirus Infection?

    Complicated with bronchitis and pneumonia, if it is immune-deficient, it may be accompanied by encephalitis and other central nervous system infections.

    The main symptoms of bronchitis

    Sputum, wheezing and chronic cough. If there is no smoking, exposure to harmful gases, overwork, climate change or cold, the general symptoms are mild. 
    Otherwise, it may cause an acute attack or worsen. Chronic bronchitis continues unabated from upper respiratory tract infections and gradually evolves.

    What is the Treatment of Adenovirus Infection?


    1.  There is currently no specific treatment.
    2.  Clinically, symptomatic treatment is mainly used to prevent secondary infection.
    3.  Antiviral treatment.
    4.  In severe cases, interferon alpha can be used for treatment.


    Author's Bio

    Doctor Shawna Reason, Virologist
    Dr. Shawna Reason
    Name: Shawna Reason

    Education: MBBS, MD

    Occupation: Medical Doctor / Virologist 

    Specialization: Medical Science, Micro Biology / Virology, Natural Treatment

    Experience: 15 Years as a Medical Practitioner

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