Adenovirus

Snapshot

A 4-year-old boy presents to the pediatrician with fever and bilateral conjunctivitis. This was preceded by a 5-day history of a non-productive cough, rhinorrhea, and sore throat. There is no history of sick contacts, but the child attends daycare 3 times a week. Physical exam revealed an ill-looking child with bilateral conjunctival injection, scanty greenish discharge, and cervical lymphadenopathy. The mucosa of the oropharynx is hyperemic. Complete blood count shows a leukocyte count of 8500/mm³. Throat swab and blood cultures proved negative for bacteria and a swab of the posterior pharynx was sent for viral PCR.

Introduction

Classification
- linear, non-enveloped, double-stranded DNA virus
Epidemiology
- worldwide distribution
  - most individuals have serologic evidence by 10 years of age
- demographics
  - young children
- risk factors
  - daycare centers and households with young children
  - closed or crowded settings
    - e.g., public swimming pools, military barracks, medical facilities
Pathogenesis
- transmission
  - aerosol droplets
  - fecal-oral
  - contact via contaminated fomites
- reservoir
  - ubiquitous and can survive for long periods on environmental surfaces
Associated conditions
- pharyngitis coryza
- pneumonia
- infectious conjunctivitis
Prevention
- vaccinations
  - live, oral, enteric-coated vaccines
  - military recruits 17-50 years of age
- infection control procedures
  - contact and droplet precaution
  - chlorination of swimming pools
Prognosis
depends on clinical presentation

Presentation

Studies

Differential

Rhinovirus
- distinguishing factor
  - does not usually present with conjunctivitis
GAS pharyngitis
- distinguishing factor
  - Centor criteria – no cough
Influenza
- distinguishing factor
presents with minimal coryza and acute onset

Treatment

Complications