Adenovirus infection in children and adults: signs, treatment

Adenovirus infection
ICD-10B 97.0 97.0
MeshD000257

Adenovirus infection - A group of human infectious diseases, the causative agent of which are adenoviruses. They belong to the group of acute respiratory viral infections (ARVI) and are characterized by lesions of the mucous membranes of the upper respiratory tract, conjunctiva, lymphoid tissue. There is a fever with moderate symptoms of intoxication.

Complications

Adenovirus for the first time (namely a virus of the genus Mastadenovirus families Adenovir> Currently, more than 40 varieties of them are known. Adenovirus is resistant to the environment and to the action of organic solvents.

Epidemiology

The source of infection is a patient with any form of adenoviral infection or a healthy virus carrier. There is a great risk of infection from patients at the beginning of the disease, i.e. during the first two weeks. However, it also happens that the virus continues to be released in the next 3-4 weeks during the recovery period.

The infection is transmitted by airborne droplets and fecal-oral route. The most susceptible to her children aged 6 months to 5 years. Children under 6 months are not susceptible to infection due to the presence of transplacental immunity, i.e. received from the mother. After suffering the disease, type-specific immunity occurs.

Epidemic outbreaks of the disease are recorded throughout the year, especially often in winter, and in the form of sporadic cases in the warm season. Infection contributes to the close communication of children. Often, organized children's groups are sick - in waves, within 10-12 days. For all types of adenoviruses, the presence of a common complement of a binding antigen is characteristic.

Clinical manifestations

The incubation period is from 1 day to 2 weeks. The disease begins acutely, with a rise in temperature. The tetrad of symptoms is characteristic: rhinitis - pharyngitis - conjunctivitis - fever. Also symptoms of general intoxication are noted - weakness, lethargy, headache, lack of appetite, drowsiness. Laboratory diagnosis is ineffective. In general blood tests, non-specific changes (lymphocytosis, leukopenia), nasopharyngeal swabs are not used on a large scale in practical medicine.

Pathogenesis

The infection enters the body through the mucous membranes of the upper respiratory tract, less often - the intestine or conjunctiva. The virus enters the epithelial cells and cells of the lymphoid tissue, infects the cytoplasm and nucleus, where viral DNA replicates. The affected cells stop dividing and die. Viruses invade other cells of the mucous membranes and lymph nodes, as well as into the blood. This is accompanied by massive exudative inflammation of the mucous membranes, i.e. the accumulation of fluid in them. Conjunctivitis appears. Further, the internal organs (lungs, bronchi, intestines, kidneys, liver, spleen), as well as the brain, mesenteric lymph nodes, are involved in the pathological process.

Complications

The most common sinusitis, otitis, rarely pneumonia. Often there is laryngospasm in young children.

Epidemiology of adenovirus infection

The source of infection is a sick person who releases the virus into the environment throughout the course of the illness, as well as the virus carrier. Virus isolation occurs from the upper respiratory tract, with feces, tears. The role of “healthy” virus carriers in the transmission of infection is significant enough. The maximum time of virus release is 40-50 days. Adenoviral conjunctivitis can be a nosocomial infection. The transmission mechanism is airborne, fecal-oral. Ways of transmission - airborne, food, contact-household. Possible intrauterine infection of the fetus. Susceptibility is high. Mostly children and young people are sick. Seasonality is not critical, but in the cold season, the incidence of adenoviral infections increases, with the exception of pharyngoconjunctival fever, which is diagnosed in summer. The nature of the epidemic process is largely determined by the serological types of adenoviruses. Epidemics caused by adenovirus types 1, 2, 5, are rare, types 3, 7 are more common. After the illness, a species-specific immunity is formed.

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What causes adenovirus infection?

Pathogens - adenovirus genus Mastadenovirus (mammalian adenoviruses) family Adenoviridae. The genus includes 80 species (serotypes).

The family combines viruses with a bare capsid, the average diameter of the virion is 60-90 nm. The mature virus consists of 252 capsomers, including 240 hexones that form faces, and 12 pentones. forming verticals. The genome is represented by a linear double stranded DNA. Each virion has at least 7 antigenic determinants. Antigenic properties are the basis for the classification of adenoviruses. Nucleocapsid is a single complement-binding antigen of this family. That is why adenoviruses are detected in the RAC using group-specific serum. Hexons contain reactive determinants of the family and type-specific antigens that act upon the release of hexones from the virion and are responsible for the manifestation of the toxic effect. Hexon antigens also contain genus-and group-specific determinants. Pentones contain small antigens of the virus and reactive soluble antigen of the family, found in infected cells. Purified DNA strands contain the main type-specific antigen. Pentones and filaments cause hemagglutinating properties of viruses. Surface antigens of structural proteins are species- and type-specific. The genome is represented by a linear double-stranded DNA molecule.

Adenoviruses are extremely resistant in the environment. Stored in a frozen state, adapt to a temperature of from 4 to 50 ° C. In water at 4 ° C, they remain viable for 2 years: on glass, clothes survive for 10-45 days. Resistant to ether and other lipid solvents. They die from exposure to ultraviolet radiation, chlorine, at a temperature of 56 ° C, they die after 30 minutes.

For humans, the pathogens are 49 types of adenoviruses, serovars of types 1, 2, 3, 4, 5, 6, 7, 8, 12, 14, 21 are most important, and types 1, 2, 5, 6 are more likely to cause disease in preschool children, types 3, 4, 7, 14, 21 - in adults.

Pathogenesis of adenovirus infection

Various organs and tissues are involved in the pathological process: respiratory tract, lymphoid tissue, intestines, bladder, eyes, brain. Adenoviruses of serotypes 3, 4, 8, 19 cause conjunctivitis, and serotypes 40, 41 cause the development of gastroenteritis. Infections caused by serotypes 3, 7, 11, 14. 21, occur acutely with the rapid elimination of the pathogen. Serotypes 1, 2, 5, 6 cause easily flowing diseases, but can persist for a long time in the lymphoid tissue of the tonsils, adenoids, mesenteric lymph nodes, etc. Adenoviruses can penetrate the placenta, causing abnormal development of the fetus, pneumonia of the newborn. Entrance gates of infection - upper respiratory tract or conjunctival mucosa.

Primary replication of the virus occurs in the epithelial cells of the mucous membrane of the respiratory tract and intestines, in the conjunctiva of the eye and lymphoid tissue (tonsils, mesenteric lymph nodes). Adenoviruses, circulating in the blood, affect the vascular endothelium. In the affected cells, intranuclear inclusions of oval or round shape are formed containing DNA. Cells increase, undergo destruction, serous fluid accumulates under the epithelium. This leads to exudative inflammation of the mucous membranes, the formation of fibrinous films and necrosis. Lymphoid infiltration of the deep layers of the trachea and bronchus walls is observed. In the lumen of the bronchi contains serous exudate mixed with macrophages and single leukocytes.

In young children, viruses can reach the alveoli by bronchogenic means, causing pneumonia. In addition to local changes, adenoviruses have a general toxic effect on the body, which is expressed by symptoms of intoxication.

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Symptoms of adenovirus infection

The incubation period lasts from 5 to 14 days.

Adenovirus infection is distinguished by the polymorphism of clinical symptoms and syndromes. The clinical picture may be dominated by symptoms that indicate lesions of the respiratory tract, eyes, intestines, and bladder. lymphoid tissue. Perhaps the development of meningoencephalitis. In adults, adenovirus infection occurs more often in a latent form, in young people - in a clinically pronounced. The disease develops gradually. The temperature rises from the first day of illness, its duration varies from 5-7 days to 2 weeks. Sometimes subfebrile condition lasts up to 4-6 weeks, there may be two-wave fever, rarely three waves are observed. In most cases, symptoms of intoxication are moderately pronounced even with high fever.

Since the adenoviruses are trophic to the lymphoid tissue, nasopharyngeal tonsils are involved in the process from the first days of the disease and there is difficulty in nasal breathing, facial puffiness, serous rhinitis with abundant discharge (especially in younger age groups). A characteristic symptom of the disease is pharyngitis with a pronounced exudative component. Pharyngitis is characterized by moderate pain or sore throat. On examination, hyperplasia of lymphoid follicles is revealed against the background of edematous and hyperemic mucosa of the posterior pharyngeal wall. Tonsils are enlarged, in some patients white tender patches are visible, which are easily removed with a spatula.

In adults, unlike children, clinical signs of bronchitis are rarely detected. For children characterized by moderate short cough with scanty mucous discharge. In addition, almost every fifth sick child develops acute stenosing laryngotracheitis, which is difficult, with a pronounced exudative component. Some children develop obstructive syndrome, which has a puffy or mixed form. It can last up to 3 weeks. In this case, the cough is wet, obsessive, exhalation is difficult, shortness of breath of the mixed type. Auscultatory is determined by a large number of wet variegated and single dry rales. In young children may develop bronchitis obliterans.

Often, adenoviral infection is accompanied by moderate lymphadenopathy. The cervical, submandibular, mediastinal and mesenteric lymph nodes are enlarged. Mesadenitis is manifested either against the background of other manifestations of adenoviral infection, or as the main syndrome. The main clinical sign is acute paroxysmal pain mainly in the lower abdomen (in the right iliac, paraumbilical areas). Often there is nausea, less vomiting, diarrhea. Changes in the cardiovascular system are practically absent. In some patients, hepatolienal syndrome occurs, sometimes with increased activity of aminotransferases (ALT, ACT).

Conjunctivitis often develops. At first it is one-sided, later the second eye is affected. There are catarrhal, follicular and membranous conjunctivitis. The latter form is most typical. The conjunctiva of the eyelids is hyperemic, granular, somewhat swollen, there may be a slight secretion. After 1-3 days on the conjunctiva appear white or grayish-white film raids. A common symptom is swelling of the eyelids. Rarely, keratoconjunctivitis is observed, in which infiltration is formed in the subepithelial layer of the cornea, clouding of the cornea occurs, and visual acuity decreases. The process lasts up to one month and, as a rule, is reversible.

In adults with adenovirus infection, there may be clinical signs of cystitis. Cases of the acute encephalitis caused more often by a serotype 7 adenovirus are described. Pharyngoconjunctival fever, which has a fairly clear clinical picture, with a high 4-7-day fever, intoxication, rhinopharyngitis, and membranous conjunctivitis has been isolated into an independent form of the disease.

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Causes and risk factors

The causative agents of adenovirus infection are DNA-containing viruses belonging to the genus Mastadenovirus of the Adenoviridae family. Currently, experts have described more than 100 serological types of adenoviruses, about 40 of them have been isolated from people.

All serovars of adenoviruses vary considerably in their epidemiological characteristics. For example, viruses 1, 2 and 5 types can cause in young children affection of the upper respiratory tract, in which the persistence of the virus in the lymphoid tissue is maintained for a long time. Viruses of type 4, 7, 14 or 21 cause the development of inflammation of the upper respiratory tract in adults.

Adenovirus type 3 is the causative agent of pharyngoconjunctival fever (adenoviral conjunctivitis) in adults and children of the older age group.

In the external environment, adenoviruses are fairly stable. At room temperature, they retain their viability for 15 days. Chlorine-containing disinfectants and ultraviolet rays kill them in a few minutes. Adenoviruses tolerate low temperatures well. For example, in water at a temperature of 4 ° C, they retain their viability for more than two years.

The source and reservoir of infection is a sick person or a virus carrier. After the disease, the virus is secreted with the secret of the upper respiratory tract for another 25 days, and with feces over 45 days.

Children of the first years of life and those at risk of infection with adenovirus infection (contact with a sick person) are shown to introduce leukocyte interferon and a specific immunoglobulin.

The mechanism of transmission of adenoviral infection in children and adults is most often aerosol (suspended in the air droplets of mucus, saliva), but alimentary (fecal-oral) can also be observed. Very rarely is the transmission of infection through contaminated objects of the external environment.

The susceptibility of people to adenovirus infection is high. After suffering the disease, persistent immunity remains, but it is type-specific and, therefore, repeated cases of the disease may occur due to a different serovar of the virus.

When the aerosol route of infection adenovirus enters the mucous membrane of the upper respiratory tract, and then migrates through the bronchi to the lower section. The entrance gate can also become the mucous membrane of the eyes or the intestines, into which the virus enters together with sputum particles at the time of their ingestion.

Further reproduction of the infectious pathogen occurs in the epithelial cells of the respiratory tract, small intestine. In the lesion, inflammation begins, accompanied by hyperplasia and infiltration of the submucosal tissue, expansion of its capillaries, hemorrhages. Clinically, it is manifested by pharyngitis, sore throat, diarrhea or conjunctivitis (often of a membranous nature). In severe cases, adenoviral infection can lead to the development of keratoconjunctivitis, accompanied by persistent corneal opacities and visual impairment.

From the primary inflammation site with the current of lymph, the virus enters the regional lymph nodes, causing hyperplasia of the lymphoid tissue. As a result, the patient forms mesadenitis and lymphadenopathy.

Increased tissue permeability and suppression of macrophage activity leads to the development of viremia and the introduction of adenoviruses into various organs, which is accompanied by the development of intoxication syndrome.

Adenoviruses are fixed by macrophages in the cells of the liver and spleen. This process is clinically manifested by the formation of hepatolienal syndrome (an increase in the liver and spleen).

Forms of the disease

According to their ability to cause agglutination (gluing) of red blood cells, adenoviruses are divided into 4 subgroups (I – IV).

Epidemic outbreaks of adenovirus infection are most often caused by viruses of type 14 and 21. Adenoviral hemorrhagic conjunctivitis is caused by type 3, 4, or 7 viruses.

According to the prevalence in the clinical picture of certain symptoms or their combination, the following forms of adenoviral infection in adults and children are distinguished:

  • acute respiratory viral infection (ARVI),
  • rhinopharyngitis,
  • Rhinopharyngitis,
  • rinofaringobronchitis,
  • pharyngoconjunctival fever,
  • conjunctivitis,
  • keratoconjunctivitis,
  • pneumonia.

Diagnostics

Adenovirus infection requires differential diagnosis with a variety of other pathologies:

  • pneumonia,
  • tuberculosis,
  • diphtheria,
  • conjunctivitis and keratitis of a different (non-adenoviral) etiology,
  • acute respiratory infections of a different etiology, including flu.

The main diagnostic criteria for adenovirus infection are:

  • moderate intoxication,
  • signs of airway damage
  • conjunctivitis,
  • lymphadenopathy (regional or common)
  • exanthema,
  • hepatolienal syndrome
  • dysfunction of the digestive system.

Adenovirus type 3 is the causative agent of pharyngoconjunctival fever (adenoviral conjunctivitis) in adults and children of the older age group.

In general, a blood test for adenovirus infection does not show any significant changes, except for a slight increase in ESR.

Virological studies of discharge from the nasopharynx and eyes, allowing to obtain a virus culture in clinical practice is not used due to the high complexity and cost, as well as the duration of the study.

For the retrospective diagnosis of adenovirus infection, type-specific pH and rtga and group-specific CSCs are set up - reactions with paired sera obtained on the first day of the disease and during subsidence of clinical manifestations. The increase in the titer of serum antibodies at least four times confirms the presence of adenoviral infection.

For an indicative diagnosis of adenoviral infection can be used by the method of immune electron microscopy and RIF.

Treatment of adenovirus infection

For uncomplicated diseases caused by adenovirus infection, the patient is prescribed bed rest and is recommended to drink plenty of water. When signs of conjunctivitis appear, instillation of eye drops with antiviral effect is indicated. To normalize body temperature, relieve headache and muscle pain, nonsteroidal anti-inflammatory drugs are prescribed. In some cases, the use of vitamin preparations and antihistamines is justified.

In case of complicated adenovirus and accession to it of a secondary bacterial infection, detoxification therapy (intravenous administration of glucose and saline solutions, ascorbic acid) is carried out, and broad-spectrum antibiotics are prescribed. In case of severe adenoviral infection, the treatment is carried out in a hospital.

For prophylactic purposes, antibiotics for adenovirus infection are used only in elderly patients suffering from chronic bronchopulmonary diseases, as well as in patients with manifestations of immunosuppression.

Possible consequences and complications

The most typical complications of adenovirus infection are:

  • sinusitis,
  • otitis,
  • obstruction of the Eustachian tube, which is formed as a result of a prolonged increase in the pharynx of lymphoid tissue,
  • false croup (laryngospasm),
  • bacterial pneumonia,
  • pyelonephritis.

The forecast is generally favorable. In most cases, the disease ends with full recovery within 7–10 days.

Prevention

In some countries, in order to prevent adenovirus infection in adults, vaccine is administered with live vaccine from attenuated viruses. But in most countries, including Russia, immunization is not carried out, as there is an opinion about the ability of adenoviruses to lead to the malignancy of cells in the human body. For the prevention of adenoviral infections, it is important to observe sanitary and hygienic rules, to control the regularity and correctness of chlorination of water in pools.

Children of the first years of life and those at risk of infection with adenovirus infection (contact with a sick person) are shown to introduce leukocyte interferon and a specific immunoglobulin.

General information

Adenovirus infection is a disease from the group of acute respiratory viral infections caused by adenovirus and characterized by the development of rhinopharyngitis, laryngotracheobronchitis, conjunctivitis, lymphadenopathy, dyspeptic syndrome. In the general structure of acute respiratory diseases, adenoviral infection accounts for about 20%. The greatest susceptibility to adenoviruses is demonstrated by children from 6 months to 3 years. It is believed that in preschool age, almost all children suffer one or more episodes of adenoviral infection. Sporadic cases of adenovirus infection are recorded year-round, in the cold season the incidence is characterized as epidemic outbreaks. Close attention to adenovirus infection is ridden by infectious diseases, pediatrics, otolaryngology, and ophthalmology.

Causes of adenovirus infection

Currently, more than 30 serovars of the Adenoviridae family of viruses that cause human disease are known. The most common cause of outbreaks of adenovirus infection in adults are 3, 4, 7, 14 and 21 serotypes. Serovars of types 1, 2, 5, 6 usually affect preschool children. The causative agents of pharyngoconjunctival fever and adenoviral conjunctivitis in most cases are serotypes 3, 4, 7.

The virions of the pathogen contain double-stranded DNA, have a diameter of 70-90 nm and three antigens (a group-specific A-antigen, which determines the toxic properties of adenovirus B-antigen and type-specific C-antigen). Adenoviruses are relatively stable in the environment: under normal conditions they persist for 2 weeks, tolerate low temperatures and drying well. However, the causative agent of adenovirus infection is inactivated when exposed to ultraviolet rays and chlorine-containing disinfectants.

Adenoviruses are spread from sick people who secrete the pathogen with nasopharyngeal mucus and feces. From here there are 2 main ways of infection - in the early period of the disease - airborne, in the late - fecal-oral - in this case, the disease proceeds according to the type of intestinal infections. A waterway infection is possible, so adenovirus infection is often called the “swimming pool disease”. The source of adenoviral infection can also be virus carriers, patients with asymptomatic and erased forms of the disease. Immunity after infection is type-specific; therefore, repeated diseases caused by another virus serotype are possible. Occurs nosocomial infection, including during parenteral therapeutic procedures.

Adenovirus can enter the body through the mucous membranes of the upper respiratory tract, intestines or conjunctiva. The virus reproduces in epithelial cells, regional lymph nodes and intestinal lymphoid formations, which coincides in time with the incubation period of adenovirus infection. After the death of the affected cells, viral particles are released and enter the bloodstream, causing viremia. Changes develop in the shell of the nose, tonsils, posterior pharyngeal wall, conjunctiva, inflammation is accompanied by a pronounced exudative component, which causes the appearance of a serous discharge from the nasal cavity and conjunctiva. Viremia can lead to involvement in the pathological process of the bronchi, digestive tract, kidneys, liver, spleen.

Symptoms of infection

The main clinical syndromes that can take the form of adenoviral infection are: catarrh of the respiratory tract (rhinopharyngitis, tonsillofaringit, laryngotracheobronchitis), pharyngoconjunctival fever, acute conjunctivitis and keratoconjunctivitis, diarrheal syndrome. The course of adenovirus infection can be mild, moderate and severe, uncomplicated and complicated.

The incubation period for an adenovirus infection lasts 2-12 days (usually 5-7 days), followed by a manifest period with a consistent appearance of symptoms. Early signs are an increase in body temperature to 38-39 ° C and moderately pronounced symptoms of intoxication (lethargy, loss of appetite, muscle and joint pain). Simultaneously with fever, catarrhal changes occur in the upper respiratory tract. Serous nasal secretions appear, which then become mucopurulent, nasal breathing becomes difficult. There is a moderate hyperemia and edema of the mucous membrane of the posterior pharyngeal wall, a point whitish plaque on the tonsils. In adenovirus infection, a reaction occurs from the submandibular and cervical lymph nodes. In the case of the development of laryngotracheobronchitis, hoarseness appears, dry barking cough, shortness of breath, the development of laryngospasm.

Conjunctival lesions in adenovirus infection can occur by the type of catarrhal, follicular or membranous conjunctivitis. Usually, the eyes are alternately involved in the pathological process. Troublesome pain, burning, tearing, feeling of the presence of a foreign body in the eye. On examination, moderate redness and swelling of the eyelid skin, hyperemia and granularity of the conjunctiva, injection of the sclera, and sometimes the presence of a dense grayish-white film on the conjunctiva are detected. In the second week of the disease, signs of keratitis may join conjunctivitis.

If adenovirus infection occurs in the intestinal form, paroxysmal pain occurs in the paraumbilical and right iliac region, fever, diarrhea, vomiting, mesenterial lymphadenitis. In severe pain, the clinic resembles acute appendicitis.

Fever with adenovirus infection lasts 1-2 weeks and may be undulating. Signs of rhinitis and conjunctivitis subside after 7-14 days, catarrh of the upper respiratory tract - after 14-21 days. In severe disease, parenchymal organs are affected, and meningoencephalitis may occur. Children of the first year of life often develop adenoviral pneumonia and severe respiratory failure. Complicated adenovirus infection is usually associated with the layering of secondary infection, the most common complications of the disease are sinusitis, otitis media, bacterial pneumonia.

Prognosis and prevention

Uncomplicated forms of adenovirus infection end favorably. Deaths can be observed in young children due to the occurrence of severe bacterial complications. Prevention is similar to the prevention of other SARS. During periods of epidemic outbreaks, the isolation of patients, the ongoing disinfection, ventilation and ultraviolet irradiation of premises, the appointment of interferon to persons at risk of infection is shown. Specific vaccination against adenovirus infection has not yet been developed.

Etiology and pathogenesis

The causative agent of the disease is adenovirus, which was isolated for the first time from adenoids and tonsils of sick children. It consists of DNA coated with capsid, due to which the virus retains its pathogenic properties and is resistant to cold, drying, exposure to alkalis, ether.

The reservoir of infection - the patient or the virus carrier.

The mechanisms of transmission of the pathogen are:

  1. Aerosol or droplet, which is implemented by airborne droplets,
  2. Fecal-oral, sold alimentary, water and household contact.

Viruses are parasitic in the epithelial cells of the respiratory tract and small intestine. The capillaries of the mucous membrane expand, the submucosal layer hypertrophies, its leukocytes infiltrate, and pinpoint hemorrhages appear. Clinically, these processes manifest inflammation of the pharynx, tonsils, conjunctiva, intestines.

Viruses with current lymph penetrate into the lymph nodes, accumulate there, which leads to the development of peripheral lymphadenopathy and mesadenitis. The activity of macrophage immunity is suppressed, vascular endothelium is affected, viremia develops.

Pathogens by hematogenous route into various organs. Often viruses are fixed in the liver and spleen with the development of hepatosplenomegaly.

Classification

There are several classifications of the disease into groups:

  • By gravity - light, moderate and heavy,
  • With the flow - smooth, complicated
  • By type - typical and atypical,
  • According to the severity of clinical symptoms - with a predominance of symptoms of intoxication or with a predominance of local changes.

Clinic of the disease in adults

The incubation period lasts 2 weeks and is characterized by the penetration of adenoviruses into cells and their subsequent death.

Prodroma is the stage of precursors of the disease, which is observed from the first manifestations to a detailed clinical picture. It lasts 10-15 days and is manifested by weakness, fatigue, weakness.

A characteristic feature of the disease is the damage of organs and systems in a strict sequence: from the nose and cornea to the intestines.

In adults, adenovirus infection is manifested by the following symptoms:

  1. Symptoms of intoxication - fever, headache, muscle, joint pain.
  2. Violation of nasal breathing and abundant mucous secretions from it,
  3. Inflammation of the tonsils: they are edematous, friable, red with whitish dotted bloom,
  4. Lymphadenitis.

Lymphadenitis and inflammation of the tonsils - signs of adenovirus infection

The infection goes down and affects the throat, trachea and bronchi. Laryngitis, pharyngitis or tracheitis develops with further addition of bronchitis. Symptoms of pathologies are:

  • Hoarseness,
  • Dry, painful cough that gradually becomes wet,
  • Sore throat,
  • Dyspnea.

Keratoconjunctivitis - inflammation of the conjunctiva and cornea, manifested by the feeling of sand in the eyes, their redness, sclera injections, pain, the formation of scabs on the eyelashes and films on the conjunctival membrane. Whitish spots appear on the cornea, which merge, which leads to corneal opacification.

With the simultaneous development of conjunctivitis and pharyngitis, pharyngoconjunctival fever occurs.

Intestinal lesions accompanied by mesadenitis - inflammation of the lymph nodes of the mesentery, which is accompanied by paroxysmal abdominal pain, intoxication and intestinal dysfunction. Clinic is characteristic of mesenteric lymphadenitis «acute abdomen.

Complications of the disease in adults are the following pathologies: frontal sinusitis, sinusitis, eustachitis, otitis media purulent, secondary bacterial pneumonia, bronchial obstruction, kidney disease.

Clinic of the disease in children

Adenovirus infection in children is manifested by the following symptoms:

  1. Intoxication syndrome. The child is often naughty, becomes restless, does not sleep well, often spits, his appetite worsens, intestinal colic and diarrhea occur.
  2. Nose breathing is difficult, pharyngitis, tracheitis, tonsillitis develops. At the beginning of the disease, the discharge of the nose is serous, and then thickens and becomes mucopurulent.
  3. Symptoms of pharyngitis - pain and sore throat, coughing.Tonsils are hypertrophied and go beyond the palatine arches, which turn red and swell. On the hyperemic back wall of the pharynx, foci of bright red color appear, covered with mucus or whitish overlays.
  4. Bronchitis develops when a bacterial infection joins. It is manifested by a dry, obsessive cough that worries the baby a lot. After a while, the cough is moistened and sputum appears.
  5. Conjunctivitis - a frequent symptom of a disease that appears by the 5th day of indisposition. Children are worried about pain and burning in the eyes, pain, tearing, feeling of interference, itching. The mucous membrane of the eye becomes red and swollen, the eyelashes stick together, crusts appear on them, representing a dried-off discharge of an inflamed conjunctiva.
  6. Perhaps the development of gastroenteritis, as well as the spread of infection to the urinary tract, which is manifested by burning during urination and the appearance of blood in the urine.

A sick child has a typical appearance: pasty face, swollen and hyperemic eyelids, narrowed eye slit. On palpation, mobile and enlarged lymph nodes are found. For young children, a violation of the chair is characteristic - diarrhea.

In infants the disease develops extremely rarely, due to the presence of passive immunity. If the infection still occurred, the disease is severe, especially in children with perinatal pathology. In patients after the addition of a bacterial infection, signs of respiratory failure appear. This can be fatal.

By severity, there are three forms of adenovirus infection:

  • Easy - with a temperature of less than 38.5 ° C and intoxication.
  • Moderate - with a temperature of up to 40 ° C without intoxication.
  • Severe - with the development of complications: inflammation of the bronchi or lungs, keratoconjunctivitis.

Complications of pathology in children - inflammation of the middle ear, croup, bronchitis, pneumonia, encephalitis, dysfunction of the cardiovascular system, maculopapular rash on the skin.

Features of the treatment of adenoviral infection in children

  • Sick children are shown bed rest, plentiful warm drink and gentle nutrition.
  • If the temperature of a child is above 38.5 ° C, one should use antipyretic drugs in accordance with age - “Nurofen”, “Panadol”. Well reduce the temperature in children vinegar wiping the body.
  • Etiotropic treatment is the use of "Interferon", "Viferon".
  • Warm milk with soda helps to cope with a dry cough. The same effect has heated alkaline mineral water. The fight against wet cough is carried out by using expectorants - Ambroxol, Bromhexin.

  • Treatment of conjunctivitis child is at washing the eyes with a weak solution of potassium permanganate or weak tea, and then putting eyes into the eyes with a solution of Sulfacyl Sodium or Levimicitin.
  • When symptoms of rhinitis appear, patients are buried in the nose with Pinosol, Nazivin, Tizin after cleansing the mucous with saline or Aquamaris.
  • Restorative therapy - multivitamins.

Watch the video: Emergency Medicine Physician Explains Adenovirus Symptoms and Treatments (December 2019).

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