The causes, diagnosis and treatment of adenovirus infection

Adenovirus infection is an acute respiratory viral disease, which is characterized by an increase in temperature and damage to the mucous membranes of the respiratory tract, intestines, and lymphoid tissues. Also one of the symptoms is the redness of the conjunctiva of the eyes, which is why pathology is called pharyngoconjunctival fever. The most common disease occurs in young children and can lead to serious complications, so it is important to consult a doctor in a timely manner and begin treatment.

• Symptoms
• Coryza
• pharyngoconjunctival fever
• Keratoconjunctivitis and acute conjunctivitis
• mesenteric limfoadenit( mesenteric adenitis)
• diarrheal syndrome
• Forms
• Complications
• Diagnostics
• Laboratory diagnosis
• Microbiological Examination
• Instrumental methods
• Treatment
• Drugs
• Homeopathy
• Folkfunds
• Additional recommendations
• Vaccination
• In children
• For bPrevention belt

The disease symptoms are genomic DNA viruses genus Mastadenovirus( mammalian adenoviruses) including serotypes 80, 49 of which are pathogenic to humans.

Sources of infection are people who are sick or virus carriers. The release of viruses into the environment occurs by airborne droplets, through tears, with feces and can last up to 40-50 days, which makes the patient potentially dangerous even after recovery. On average, the incubation period is 2-12 days, and the acute period of the disease can last from 5 to 14 days.

The main manifestations of adenovirus can be combined into the following syndromes:

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Qatar of the upper respiratory tract

The most common variant of the disease course is bronchitis, tonsillitis, pharyngitis, which is often associated with a bacterial infection. The disease develops rapidly and has the following symptoms:

• increase in body temperature to 38-40 ° C;
• obstructed nasal breathing, mucosal edema, serous and purulent discharge from the nasal passages;
• inflammation, swelling and congestion( reddening) of the larynx, formation of whitish plaque on the tonsils;
• an increase in the cervical and submandibular lymph nodes;
• fever or loss of voice, dry barking cough, shortness of breath;
• appetite impairment, lethargy, capriciousness, headaches or muscle pains.

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Pharyngoconjunctival fever

Has a lingering or undulating course:

• prolonged( up to 2 weeks) body temperature increase;
• marked mucosal lesions of one or both eyes;
• inflammation of the tonsils and mucous membrane of the throat;
• except for the cervical lymph nodes may increase the liver and spleen.

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Keratoconjunctivitis and acute conjunctivitis

It is an inflammation of the conjunctiva of the eye - first one, and then both:

• tear, stitch, eye pain, foreign body sensation, intolerance to bright light;
• swelling and redness of the eyelids;
• conjunctival hyperemia, sometimes with the appearance of a grayish film on it;
• in the second week of the disease is possible the development of keratitis( inflammation and clouding of the cornea of ​​the eye).

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Mesenteric lymphadenitis( mesadenitis)

Infection can manifest as an acute abdomen, which often leads to surgical intervention. The main symptoms are:

• paroxysmal pain in the navel and right iliac region;
• elevated body temperature;
• nausea, less often - vomiting, diarrhea;
• during the operation, there is a swelling and an increase in the size of the lymph nodes of the mesentery( the membrane supporting the intra-abdominal organs).

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Diarrhea syndrome

Usually observed in children under the age of 1 year. Diarrhea can be either a separate manifestation of adenovirus infection, or a consequence of catarrh of the respiratory tract or mesadenitis. The frequency of bowel movements reaches 5-8 times a day, while mucus without blood is found in the stool.

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Forms

• Light - with a body temperature of up to 38.5 degrees and a mildly expressed remaining symptomatology.
• Average - the temperature rises to 39-40 degrees, the manifestations of intoxication are expressed moderately.
• Severe - occurs rarely, with this form of the disease develops hyperthermia, severe pneumonia, keratoconjunctivitis, respiratory failure and other pathologies.
• Complicated - is associated with the introduction of a bacterial infection. In some cases, a lethal outcome is possible.
• Uncomplicated - with this form of the disease, the predictions for recovery are the most favorable.
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Complications of

Adenovirus infection presents a special danger for children from 6 months to 3 years old - on the third day they may develop complications:

• otitis media;
• bronchitis;
• sinusitis;
• angina;
• false groats;
• pneumonia;
• exacerbation of bronchial asthma and chronic obstructive pulmonary disease( COPD);
• encephalitis;
• bowel dysfunction;
• lesions of the kidneys and bladder;
• muffled heart sounds.

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Diagnosis

The characteristic clinical picture and the sequence of the appearance of symptoms allow to diagnose on the basis of the patient's examination and complaints. To confirm and exclude other diseases with similar manifestations( influenza, SARS of another etiology, infectious mononucleosis, yersineosis, typhoid fever, mycoplasmal infection, eye and pharyngeal diphtheria), the following studies are carried out:

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Laboratory diagnostics

• Clinical blood test. With uncomplicated disease, no changes in blood are detected. The presence of pneumonia causes leukocytosis and an increase in ESR.
• Biochemical blood test .Does not reveal changes in uncomplicated infection. Pneumonia causes an increase in the level of sialic acid, fibrinogen, positive samples for C-reactive protein.

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Microbiological tests

• Express diagnostics. Used for early confirmation of the disease. Immunofluorescent method involves the detection of a specific viral antigen in the epithelial cells of the nasopharyngeal mucosa.
• Serological diagnosis. For the detection of antibodies to adenoviruses, ELISA( enzyme-linked immunosorbent assay), RSK( complement fixation test), RTGA( haemagglutination inhibition) are used. In this case, the blood test from the vein is carried out twice - during the acute period of the disease and during the recovery period. Significant is an increase in antibody titres of 4 or more times.
• PCR diagnostics. The polymerase chain reaction method allows detecting the DNA of a virus in the blood or in a throat swab.
• Sputum examination. Carried out with pneumonia to identify the pathogen and determine its susceptibility to antibiotics.
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Instrumental methods

• X-ray examination of chest organs. It is used for suspected adenovirus pneumonia for signs of small focal or drainage pneumonia.
• X-ray of the paranasal sinuses. Effective for suspected inflammation of the frontal or maxillary sinuses. Detects shading or the presence of pus.

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Treatment

In most cases, therapy is performed on an outpatient basis, that is, at home. Hospitalization in an infectious hospital is indicated only in cases of severe and complicated course of the disease. Specific treatment of adenovirus infection is not developed, and the effect of antiviral drugs is negligible. Therapeutic measures are limited to the use of funds for the relief of symptoms.

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Medications

• Antipyretic and analgesic agents - are used when the temperature rises above 38.5 degrees( if the temperature is poorly tolerated - before).The safest are paracetamol-based drugs( Panadol, Efferalgan) and ibuprofen( Nurofen, Bofen).
• Antitussive and expectorants - serve to facilitate coughing and sputum discharge: Ambroxol, ATSTS, Bromgeksin, Kodelak, Lazolvan, Mukaltin, Erespal. With these drugs you can do inhalations.
• Antiviral drugs - are prescribed in severe infectious process: Arbidol, interferon preparations( Wiferon, Kipferon) and its inducers( Amiksin, Kagocel, Tiloron).Some antiviral agents are effective only for RNA viruses, and do not improve the condition with an adenovirus that has DNA( Isoprinosine, Remantadine).
• Antibiotics - are indicated upon attachment of a secondary bacterial infection: Amoxiclav, Augmentin, Klacid, Pansef, Sumamed, Flemoxin Solutab.
• Eye drops - eliminate the symptoms of conjunctivitis and keratoconjunctivitis: a weak solution of potassium permanganate or furacilin, Albucid, Levomycetin, Okomistin, Poludan, Tobrex, Ciprolet. Less commonly, Derinat, Ophthalmoferon. You can also make applications with ointments - Acyclovir, Oxolin Ointment.
• Nasal drops - used with nasal congestion, the use of children requires compliance with the concentration: saline, Vibrocil, Nazivin, Galazolin. You can use a decoction of chamomile.
• Throat - relieves sore throat, eliminates plaque. These can be sprays( Geksoral, Tantum Verde) or tablets for absorption( Strepsils, Pharyngosept, Sage).You can gargle with a decoction of chamomile, a solution of soda with salt or lubricate Lugol, Chlorophyllipt, sea buckthorn oil.
• Antihistamines - prevent the occurrence of allergic reactions: Zirtek, Lordestin, Suprastin, Erius.

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Homeopathy

Together with medications recognized by official medicine( and in some cases - instead of them), you can take homeopathic remedies.

• Ophthalmic pharmacy is a herbal preparation that eliminates eye diseases, including conjunctivitis.
• Agraphis nutans is a herbal preparation, its action is directed to the nasopharynx( nasal congestion due to adenoid outgrowths, deafness due to inflammation of the Eustachian tubes, enlarged tonsils, frequent nasopharyngeal lesions, speech delay).
• Sulfur - a preparation of sulfur, has anti-inflammatory, resorptive, antibacterial action, increases the sensitivity of the body to the effects of other drugs.

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Folk remedies

Some natural ingredientsnot inferior in effectiveness to synthetic and widely used in folk medicine for the treatment of adenovirus infection:

• Oats broth - reduces the level of intoxication of the body. Wash 300 grams of oats, pour 1 liter of boiled milk, cook for 45 minutes over low heat. Slightly cool, strain and add 0.5 tablespoon of honey. Drink 1/3 cup 5-6 times a day.
• Decoction of turnips. Chopped raw material pour boiling water at the rate of 1 tablespoon turnip per 1 glass of water, boil for 20 minutes, stirring. After 40 minutes strain and drink 0.5 glasses 2-3 times a day.
• A mixture of egg yolks - envelops the irritated pharyngeal mucosa and relieves inflammation. Carefully mix 3 yolks, 3 tablespoons of butter, 1 teaspoon of honey and flour. Eat 1 tablespoon of the mixture 3 times a day.
• Infusion of aloe. Grind 300 grams of washed leaves, put in a glass or ceramic container, add 1 glass of honey and red wine. Leave the mixture in a dark place for 10 days, take 1 tablespoon 3 times a day.
• Collection of flowers of linden and berries of the viburnum - stimulates immunity, helping to fight the virus. Mix 1 tablespoon of ingredients, pour 0.5 liters of boiling water, insist about 1 hour. Drink infusion in a warm form for 1 glass before going to bed.

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Additional recommendations of

In addition to medicines, the following rules help to improve the health:

• Bed rest. It is necessary before the temperature decreases and the disappearance of headaches and muscle pains, weakness. Then for 3 days set a semi-postal regime. The duration of the restrictions depends on the course of the disease and the nature of the complications.
• Diet. Includes foods rich in vitamins A, C, E, with a sufficient protein content. In the first days, preference should be given to milk and vegetable food, gradually increasing the caloric content of foods. Drinks and meals should be warm, from the diet should be excluded from sharp, salty, pickled foods, seasonings and sauces.
• Drinking regime. You should consume at least 1.5-2 liters of fluid per day, in small portions. Recommended: compote of dried fruits, broths of wild rose, black currant or sea-buckthorn, fruit and vegetable juices, cranberry juice.
• Wet cleaning and ventilation. Cleaning is desirable to be done daily, with the help of disinfectants. Ventilate the room in which the patient is, should be 5-6 times a day.

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Vaccination of

In some countries, a living vaccine from adenoviruses is used to prevent disease. In Russia, such vaccination is not currently carried out. Nevertheless, it is noted that in people vaccinated against the influenza virus, other types of SARS occur in mild form and do not cause serious complications.

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In children

Adenovirus infection rarely infects children under 6 months - the children have passive immunity. However, if the mother has no antibodies, the newborn can be prone to the disease from the first days of life. Susceptibility to infection is greatest in children from 6 months to 3 years. After the first disease, the child develops active immunity, and after 5 years the possibility of infection decreases.

Symptomatology in newborns differs from older children - the temperature does not rise above 37-37.5 ° C( in premature babies it can even be decreased), intoxication manifests itself poorly, a slight cough and capriciousness of the child due to congestion of the nose is possible. In children under 1 year, the disease is usually accompanied by a loose stool, rarely there is an increase in lymph nodes and conjunctivitis, but complications are frequent - obstructive bronchitis, pneumonia.

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During pregnancy

Because during the gestation of a child the protective functions of the body of a woman are weakened, the risk of infection with adenovirus increases. Especially dangerous is the illness in the first trimester of pregnancy.

Consequences of infection can be:

• spontaneous abortion( miscarriage);
• complicated pregnancy;
• fetal development delay;
• severe or premature delivery;
• congenital pathology.

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Prevention of

To reduce the likelihood of infection with adenovirus, the following measures will help:

• hardening - strengthens the protective functions of the body;
• reception of vitamin C or multivitamin complexes, interferon;
• lubrication of the nasal passages with oxolin ointment before leaving the house;
• hygiene procedures - thorough hand washing after visiting public places;
• refusal to visit places of congestion during the epidemic;
• for a family member's illness - his isolation, the provision of separate utensils and hygiene items, while communicating - using a cotton-gauze dressing;
• regular wet cleaning, airing the room.