Adenoviral infection – the sharp virus infectious process which is followed by damage of airways, eyes, lymphoid fabric, a digestive tract. Moderate intoxication, fever, , a voice osiplost, cough, conjunctiva hyperaemia, mucous separated from eyes, dysfunction of intestines are signs of an adenoviral infection. Except clinical manifestations, at diagnosis serological and virologic methods of a research are applied. Therapy of an adenoviral infection is carried out by antiviral medicines (inside and locally), immunomodulators and immunostimulators, symptomatic means.
Adenoviral infection – the disease from the SARS group caused by adenovirus and which is characterized by development of a rinofaringit, laringotrakheobronkhit, conjunctivitis, a limfadenopatiya, dispepsichesky syndrome. In the general structure of acute respiratory diseases the adenoviral infection makes about 20%. The greatest susceptibility to adenoviruses is shown by children from 6 months to 3 years. It is considered that at preschool age practically all children transfer one or several episodes of an adenoviral infection. Sporadic cases of an adenoviral infection are registered all the year round; in cold season incidence has character of epidemic flashes. Close attention to an adenoviral infection is riveted from infectious diseases, pediatrics, otolaryngology, ophthalmology.
Reasons of an adenoviral infection
Now more than 30 serovar of the viruses of the Adenoviridae family causing a disease of the person are known. As the most frequent reason of outbreaks of an adenoviral infection at adults 3, 4, 7, 14 and 21 serotypes act. Serovara of types 1, 2, 5, 6 usually strike children preschool children. As causative agents of faringokonjyunktivalny fever and adenoviral conjunctivitis in most cases serve serotypes 3, 4, 7.
Vireos of the activator contain two-chained DNA, have the diameter of 70-90 nanometers and three anti-genes (group-specific A-antigen; defining toxic properties of adenovirus V-antigen and type-specific S-antigen). Adenoviruses are rather steady in the external environment: under usual conditions remain within 2 weeks, well transfer low temperatures and drying. At the same time, the causative agent of an adenoviral infection is inactivated at influence of ultraviolet rays and chlorine-containing disinfectants.
Adenoviruses extend from sick people who allocate the activator with nasopharyngeal slime and excrements. From there are 2 main ways of infection – in the early period of a disease - airborne; in late - fecal and oral – in this case the disease proceeds as intestinal infections. The waterway of infection therefore the adenoviral infection is often called "a disease of swimming pools" is possible. Virus carriers, patients with the asymptomatic and erased disease forms can also be a source of an adenoviral infection. Immunity after the postponed infection type-specific therefore the repeated diseases caused by other serotype of a virus are possible. Intrahospital infection meets, including when holding parenteral medical procedures.
Adenovirus can get into an organism through mucous the top airways, intestines or a conjunctiva. The reproduction of a virus proceeds in epitelialny cells, regionarny lymph nodes and lymphoid formations of intestines that on time coincides with the incubatory period of an adenoviral infection. After death of the struck cages virus particles are released and get into blood, causing a virusemiya. Changes develop in a cover of a nose, almonds, a back wall of a throat, a conjunctiva; the inflammation is followed by the expressed ekssudativny component that causes emergence of the serous nose separated from a cavity and a conjunctiva. Virusemiya can lead to involvement in pathological process of bronchial tubes, a digestive tract, kidneys, a liver, spleens.
Symptoms of an adenoviral infection
Serve as the main clinical syndromes which form the adenoviral infection can take: faringokonjyunktivalny fever, sharp conjunctivitis and keratokonjyunktivit Qatar of airways (rinofaringit, tonzillofaringit, laringotrakheobronkhit), a diarrheal syndrome. The course of an adenoviral infection can be easy, medium-weight and heavy; uncomplicated and complicated.
The incubatory period at an adenoviral infection lasts 2-12 days (the thicket is 5-7 days old), after what the manifest period with consecutive emergence of symptoms follows. Are early signs temperature increase of a body to 38-39 °C and moderately expressed intoxication symptoms (slackness, deterioration in appetite, muscular and articulate pains). Along with fever there are catarrhal changes in the top airways. There are serous allocations from a nose which then become mucopurulent; nasal breath is at a loss. Moderate hyperaemia and puffiness of a mucous membrane of a back wall of a throat, a dot whitish raid on almonds is noted. At an adenoviral infection there is a reaction from submaxillary and cervical lymph nodes. In case of development of a laringotrakheobronkhit there is an osiplost of a voice, the dry barking cough, short wind, development of a laryngospasm is possible.
Defeat of a conjunctiva at an adenoviral infection can proceed as catarrhal, follicular or filmy conjunctivitis. Usually are involved in pathological process of an eye serially. Gripes, burning, dacryagogue, feeling of presence of a foreign matter at an eye disturb. At survey moderate reddening and hypostasis of skin a century, hyperaemia and granularity of a conjunctiva, an injetsirovannost a skler, sometimes – existence of a dense grayish-white film on a conjunctiva comes to light. On the second week of a disease signs of a keratit can join conjunctivitis.
If the adenoviral infection proceeds in an intestinal form, there are pristupoobrazny pains in okolopupochny and right podvzdoshny area, fever, diarrhea, vomiting, mezenterialny lymphadenitis. At the expressed pain syndrome the clinic reminds an acute appendicitis.
Fever at an adenoviral infection lasts 1-2 weeks and can have wavy character. Symptoms of rhinitis and conjunctivitis abate in 7-14 days, Qatar of the top airways – in 14-21 days. At a severe form of a disease parenchymatous bodies are surprised; there can be an encephalomeningitis. At children of the first year of life adenoviral pneumonia and the expressed respiratory insufficiency quite often develops. The complicated course of an adenoviral infection is usually connected with stratification of a secondary infection; as the most frequent complications of a disease serve sinusitis, average otitis, bacterial pneumonia.
Diagnostics and treatment of an adenoviral infection
Recognition of an adenoviral infection is usually made on the basis of clinical data: fevers, Qatar of airways, conjunctivitis, poliadenit, consecutive development of symptoms. As methods of express diagnosis of an adenoviral infection serves reaction of an immunofluorescence and immune electronic microscopy. Retrospective confirmation of the etiologichesky diagnosis is carried out by the IFA, RTGA, RSK methods. Virologic diagnostics assumes allocation of adenovirus from nasopharyngeal washouts, scrape from a conjunctiva and the patient's excrements, however in view of complexity and duration is seldom used in clinical practice.
Differential diagnostics of various clinical forms of an adenoviral infection is carried out with flu, other SARS, diphtheria of a throat and an eye, an infectious mononukleoz, a mikoplazmenny infection, iyersiniozy. For this purpose, and also for purpose of local etiotropny treatment patients need consultation of the ophthalmologist and otolaryngologist.
The general etiotropny therapy is carried out by medicines of anti-virus action (, , medicine from antibodies to gamma interferon of the person). Local therapy of an adenoviral infection includes: instillations of eye drops (solution of a deoxyribonuclease or a sulfatsil of sodium), applications of an acyclovir in the form of eye ointment for an eyelid, intranazalny use of oksalinovy ointment, endonasal and endofaringealny instillation of interferon. Symptomatic and posindromny therapy is carried out: inhalations, reception of febrifugal, protivokashlevy and expectorant medicines, vitamins. At the adenoviral infection burdened by bacterial complications antibiotics are appointed.
Forecast and prevention of an adenoviral infection
Uncomplicated forms of an adenoviral infection terminate favorably. Deaths can be noted at children of early age in connection with emergence of heavy bacterial complications. Prevention is similar to the prevention of other SARS. During the periods of epidemic flashes isolation of patients is shown; carrying out the current disinfection, airing and Ural federal district of rooms; purpose of interferon to the persons put risk of infection. Specific vaccination against an adenoviral infection is not developed yet.