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
It is distinguished from herpes virus, pox virus, influenza,
parainfluenza, and rhinovirus infections.
1. Flu
- The incubation period is several hours to 4 days, usually 1 to 2 days
- High fever, body temperature can reach 39 ℃ - 40 ℃, accompanied by chills, usually lasts 2 to 3 days.
- Symptoms of systemic poisoning are severe, such as fatigue, headache, dizziness and soreness lasting for a long time.
- Symptoms such as fatigue after normal body temperature can last for 1 to 2 weeks.
- 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?
- There is currently no specific treatment.
- Clinically, symptomatic treatment is mainly used to prevent secondary infection.
- Antiviral treatment.
- In severe cases, interferon alpha can be used for treatment.
Author's Bio
 |
| Dr. 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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