Adenoviral disease

Adenoviral disease (syn.: adenovirus infection) - a group of infectious diseases caused by adenovirus, characterized by symptoms of the mucous membrane of respiratory tract, eyes, intestines and lymphoid tissues. Included in the group of acute respiratory viral infections (ARI). Found everywhere, ranging from 3 to 7% of all SARS in children and 0.6 - 3% in adults.

The ability of adenoviruses to replicate in the epithelial cells lining the airways, the conjunctiva, intestine and associated lymphoid tissue accounts for a variety of clinical manifestations of disease. In accordance with the predominance of certain symptoms identify the following clinical forms of adenovirus diseases: acute respiratory infections (nasopharyngitis, rinofaringotonzillit, rinofaringobronhit) faringokonyunktivalnaya fever, acute follicular conjunctivitis and filmy, epidemic keratoconjunctivitis, adenovirus pneumonia gastroenterocolitis.

From a man identified 37 serotypes of adenovirus, with different serotypes can cause the same form of the disease and, conversely, one serotype - different forms. Adenoviruses are highly resistant to low temperatures and readily inactivated by heating and exposure to disinfectants.

Source of infectious agents are a sick man, and recover from those that produce virus for 50 days or more, and healthy virus carrier. The main route of transmission of infectious agents airborne (by speaking, coughing, sneezing). It is also possible fecal-oral route of transmission (through food, dishes, toys, clothing, and feces containing the virus). Most susceptible to infection in children aged 6 months to 5 years. The disease is detected throughout the year, especially during the cold season, in the form of epidemic outbreaks and sporadic disease. Most often infected by adenoviruses are in close communication between children.

Clinical picture. The incubation period lasts on average 5 - 7 days with a range from 3 to 14 days. More acute onset: fever, mild headache, loss of appetite, possible lomyaschie pain in bones, joints and muscles. On 2 - 3rd day of illness may increase the temperature to 38 - 39 ° C. Characteristic of adenovirus infection is the sequence of appearance of new symptoms and the prevalence of local symptoms of the common. From the first notes for the disease rhinitis with profuse serous, mucous, and later mucopurulent secretions, mucous membrane of the mouth and throat swollen, expressed mild hyperemia, have been frequently reported sore throat, cough and hoarseness. There is often a sore throat. Posterior pharyngeal wall at the same time is usually swollen and slightly hyperemic, with large, protruding above the surface of the mucous membrane enlarged follicles (nasopharyngitis). May increase the tonsils, often with the appearance of whitish friable plaque in the form of dots or islands (rinofaringotonzillit).

Many patients in the first 3 days of illness developed conjunctivitis, usually unilateral initially. It appears rezyu or pain in the eyes, copious mucous discharge, conjunctival hyperemia. Sometimes after 1-3 days in the conjunctiva of the film appear grayish-white color. Conjunctivitis is often accompanied by edema of the eyelids, sometimes pronounced. In some cases, the affected cornea (keratoconjunctivitis).

Often there is swelling of the lymph nodes, mainly the submandibular and zadnesheynyh. Sometimes it affects the mesenteric lymph nodes (mesenteric adenitis), while there are paroxysmal abdominal pain, marked tenderness on palpation of the lower abdomen.

For faringokonyunktivalnoy fever characterized by a combination of fever, conjunctivitis and pharyngitis to the local lymph node reaction. Sometimes the first days of illness marked clinical and radiological signs of small focal or focal pneumonia, prone to protracted course (adenovirus pneumonia).

Some patients from the early days of the disease becomes more frequent stools, defecation, liquid, sometimes with an admixture of mucus observed in the epigastric pain, nausea and vomiting (gastroenterocolitis). Especially frequent dyspepsia in infants. These phenomena are often combined with lesions of the upper respiratory tract.

Temperature reaction with adenoviral disease lasts on average 5 - 7 days, sometimes up to 14 - 18 days. Local catarrhal phenomena keep up to 10-12 days or more. Duration of catarrhal symptoms and temperature of reaction, signs of mild intoxication, conjunctivitis, swollen lymph nodes, often defeat the gastrointestinal tract differentiate adenovirus infection from the flu and most other respiratory viral diseases.

Complications of adenovirus disease (otitis media, sinusitis, tonsillitis, pneumonia) associated with the addition of a bacterial infection or exacerbation of concomitant chronic inflammatory processes.

Diagnosis is established on the basis of clinical presentation and laboratory results. Laboratory diagnostic methods are applied in practice is rare. Possible detection of virus antigen in nasopharyngeal mucus discharge of the eye by enzyme immunoassay, rarely secrete the virus in cell culture. The differential diagnosis is carried out with the flu and other respiratory viral infections, infectious mononucleosis, tifoparatifoznymi diseases, HIV infection.

Treatment is usually performed at home. The patient should be isolated in a separate room or bed should be separated fronts. In the febrile period required bed rest, good nutrition, vitamin-rich food. Prescribe vitamins, alkaline inhalation. Topically (intranasal) may be used oksolin, tebrofen, florenal in the form of ointments. Antibiotics are shown only for bacterial complications.

Prognosis is generally favorable. However, in young children with pneumonia accession possible deaths.

Prevention comes down to the early detection, isolation and treatment of patients, frequent airing of the room where the patient, disinfection discharge the patient, utensils, linens, clothing, bedding, rooms, furniture. Person, caregivers should wear a mask from 4 - 6 layers of stretch and ironed muslin, wash your hands after contact with patients.