Adenovirus infection

Adenoviruses cause acute, self-limiting febrile infections, with inflammation of the respiratory or ocular mucous membranes, or both. (See Major adenovirus infections.)

Causes and incidence

Adenovirus has 35 known serotypes; it causes 5 major infections, all of which occur in epidemics. These organisms are common and can remain latent for years; they infect almost everyone early in life, although maternal antibodies offer some protection during the first 6 months of life.

Transmission of adenovirus can occur by direct inoculation into the eye; by the oral-fecal route (adenovirus may persist in the GI tract for years after infection); or by inhalation of an infected droplet.

Signs and symptoms

The incubation period — usually lasting less than 1 week — is followed by acute illness lasting less than 5 days. Clinical features vary, depending on the type of infection. Prolonged asymptomatic reinfection may occur.

Diagnosis

CONFIRMING DIAGNOSIS Definitive diagnosis requires isolation of the virus from respiratory or ocular secretions or fecal smears; during epidemics, however, typical symptoms alone can confirm the diagnosis.

Because adenoviral illnesses resolve rapidly, serum antibody titers aren’t useful for diagnosis. Adenoviral diseases cause lymphocytosis in children. When they cause respiratory disease, chest X-ray may show pneumonitis.

Treatment

Supportive treatment includes bed rest, antipyretics, and analgesics. Ocular infections may require corticosteroids and direct supervision by an ophthalmologist. Hospitalization is required in cases of pneumonia (in infants) to prevent death and in epidemic keratoconjunctivitis (EKC) to prevent blindness.

Special considerations

❑During acute illness, monitor respiratory status and intake and output. Give analgesics and antipyretics, as needed. Stress the need for bed rest.

❑To help minimize the incidence of adenoviral disease, instruct all patients in proper hand hygiene to reduce fecal-oral transmission and eye inoculation.

❑EKC can be prevented by sterilization of ophthalmic instruments, adequate chlorination in swimming pools, and avoidance of swimming pools during epidemics. Killed virus vaccine (not widely available) or a live oral virus vaccine can prevent adenoviral infection and are recommended for high-risk groups.

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Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

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Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.

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More About This Book: Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X

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