Epidemiology

XXXXXX

• xxx

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Virology

Adenovirus (Family: Adenoviridae)

• Adenoviruses are Non-Enveloped DNA Viruses
• In Humans, There are Approximately 88 Adenoviruses in 7 Different Species (Species A-G)
  • Respiratory Disease is Predominantly Associated with Adenovirus Species HAdV-B and HAdV-C
  • Conjunctivitis is Predominantly Associated with Adenovirus Species HAdV-B and D
  • Gastroenteritis is Predominantly Associated with Adenovirus Species HAdV-F Types 40, 41, HAdV-G Type 52
  • Obesity/Adipogenesis is Predominantly Associated with Adenovirus Species HAdV-A type 31, HAdV-C Type 5, HAdV-D Types 9/36/37

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Diagnosis

Multiplexed Nucleic Acid Respiratory Pathogen Panel (see xxxx)

General Comments

• xxx

BioFire Panel (Biomérieux)

• Procedure
  • Bronchoalveolar Lavage Fluid (see Bronchoscopy)
  • Nasopharyngeal Swab
• Detected Viruses
  • Adenovirus (see Adenovirus)
  • Coronavirus 229E/HKU1/NL63/OC43 (see Coronavirus)
  • Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2, COVID-19) (see Severe Acute Respiratory Syndrome Coronavirus-2)
  • Human Metapneumovirus (see Metapneumovirus)
  • Human Rhinovirus/Enterovirus (see Rhinovirus and Enteroviruses)
  • Influenza A Virus (Including Subtype) (see Influenza Virus)
  • H1, H3 and H1-2009 Influenza B Virus (see Influenza Virus)
  • Parainfluenza Virus 1/2/3/4 (see Parainfluenza Virus)
  • Respiratory Syncytial Virus (RSV) (see Respiratory Syncytial Virus)
• Detected Bacteria
  • Bordetella Parapertussis
  • Bordetella Pertussis (see Pertussis)
  • Chlamydia Pneumoniae (see Chlamydia Pneumoniae)
  • Mycoplasma Pneumoniae (see Mycoplasma Pneumoniae)

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Clinical Differentiation of Upper Respiratory Tract Infection vs Lower Respiratory Tract Infection

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Clinical Manifestations

Dermatologic Manifestations

Erythema Multiforme (see Erythema Multiforme)

• Epidemiology
  • XXXXX

Morbilliform Rash (see Exanthems)

• Epidemiology
  • XXXXX

Ophthalmologic Manifestations

Conjunctivitis (see Conjunctivitis)

• Epidemiology
  • XXXXX

Otolaryngologic Manifestations

Acute Pharyngitis (see Acute Pharyngitis)

• Epidemiology
  • Adenovirus More Commonly Presents with Pharyngitis and Fever than Common Cold Symptoms

Acute Rhinosinusitis (see Acute Rhinosinusitis)

• Epidemiology
  • XXXXX

Common Cold (see Common Cold)

• Epidemiology
  • Adenoviruses Account for <5% of Common Cold Cases

Pulmonary Manifestations

Acute Bronchitis (see Acute Bronchitis)

• Epidemiology
  • XXXXX

Acute Respiratory Distress Syndrome (ARDS) (see Acute Respiratory Distress Syndrome)

• Epidemiology
  • XXXXX

Bronchiolitis (see Bronchiolitis)

• Epidemiology
  • XXXXX

Influenza-Like Illness

• Clinical
  • General Comments
    • Rapid Onset of Constitutional Symptoms
    • Upper/Lower Respiratory Tract Symptoms Occur Concurrently or After the Constitutional Symptoms
  • Asthenia (see Asthenia)
    • Common in Second Week of Illness
  • Clear Nasal Discharge without Obstruction
    • Common
  • Dry (Often Persistent) Cough (see Cough)
    • Predominates Later in the First Week of Illness
  • Excess Tearing (Lacrimation) (see Lacrimation)
    • Common Early in the Illness
  • Fatigue (see Fatigue)
    • Common in second week of illness
  • Fever/Chills (see Fever)
    • Common Early in the Illness
    • Peaks to 39-40 degrees C
    • Lasts for 1-5 days
  • Headache (see Headache)
    • Common Early in the Illness
  • Mild Conjunctivitis (see Conjunctivitis)
    • Common
  • Mild, Tender Cervical Lymphadenopathy (see Lymphadenopathy)
    • Common
  • Myalgias (see Myalgias)
    • Common Early in the Illness
  • Pain with Eye Movement
    • Common Early in the Illness
  • Pharyngeal Injection/Pharyngitis (see Pharyngitis)
    • Common
  • Photophobia (see Photophobia)
    • Common Early in the Illness

Pneumonia (see Pneumonia)

• Epidemiology
  • Adenovirus May Cause Severe Lower Respiratory Tract Infections in Immunocompromised Patients
  • Adenovirus Has Been Associated with Acute Respiratory Disease in Military Recruits
  • CDC EPIC Study of Children Hospitalized for Community-Acquired Pneumonia (NEJM, 2015) [MEDLINE]
    • Annual Incidence of Community-Acquired Pneumonia Requiring Hospitalization: 15.7 cases per 10k children <18 y/o
    • A Pathogen was Identified in 81% of Cases
    • Adenovirus was Detected in 9.8% of Cases

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Treatment

Supportive Care

• xxx

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References

• Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015 Feb 26;372(9):835-45. doi: 10.1056/NEJMoa1405870 [MEDLINE]