Adenoviridae Notes

NOTES NOTES ADENOVIRIDAE ADENOVIRUS osms.it/adenovirus PATHOLOGY & CAUSES ▪ Seven subgroups, 52 serotypes ▪ Directly invades human epithelial cells (several organs) → multiple cytopathic effects, usually within 2–7 days postinfection ▪ Responsible for variety of upper, lower respiratory tract; gastrointestinal; genitourinary infections ▪ Common clinical syndromes ▫ Upper respiratory disease, pharyngoconjunctival fever, coryza, pneumonia, gastroenteritis, hepatitis, hemorrhagic cystitis, interstitial nephritis, epidemic keratoconjunctivitis Genetic material ▪ Double-stranded DNA virus Taxonomy ▪ Adenoviridae family Morphology ▪ Non-enveloped icosahedral nucleocapsid ▪ Unique ▫ Fiber-like projections (hemagglutinins) protrude from capsid’s 12 vertices Transmission ▪ Aerosol droplets ▪ Fecal-oral route ▪ Neonates ▫ Infected cervical secretion exposure ▪ Solid organ transplant 308 OSMOSIS.ORG ▪ Fomite contact ▫ Survives on environmental surfaces for long periods; inactivated by heat, formaldehyde, bleach RISK FACTORS ▪ Close living space (e.g. military barracks, daycare centers) ▪ Summer camps (especially with swimming pools/lakes) ▪ Healthcare facilities ▪ Immunocompromised status (especially cell-mediated immunity deficiency) COMPLICATIONS ▪ Secondary bacterial infection; meningoencephalitis; myocarditis; disseminated intravascular coagulation; myositis, rhabdomyolysis; hypogammaglobulinemia ▪ Disseminated adenovirus infection ▫ Affects multiple organs, immunocompromised individuals especially; high mortality rate SIGNS & SYMPTOMS ▪ Varies with clinical syndrome ▪ Upper respiratory ▫ Sore throat, nasal congestion, rhinorrhea, dry cough, hoarseness, inflamed tonsils, cervical lymphadenopathy; wheezes/rhonchi on auscultation

Chapter 54 Adenoviridae ▪ Ocular ▫ Conjunctivitis, preauricular, lymphadenopathy ▪ Gastrointestinal ▫ Nausea, vomiting, diarrhea ▪ Systemic ▫ Fever, malaise, headache, myalgia DIAGNOSIS ▪ History, physical examination ▫ Characteristic findings ▫ Diagnostic test choice based on clinical presentation DIAGNOSTIC IMAGING Chest X-ray ▪ May show diffuse bilateral pulmonary mononuclear cell infiltration, hyaline membranes, necrosis LAB RESULTS Microbe identification ▪ Viral culture (e.g. nasopharyngeal swabs, blood, urine, sputum) ▪ Viral assay (e.g. adenovirus-specific enzyme immunoassay (EIA)/ immunofluorescence assay) ▪ Nucleotide amplification test (NAT) ▪ Polymerase chain reaction (PCR) Serology ▪ Antigen/complement fixation assays ▪ Hemagglutination inhibition/neutralizing antibodies ▪ Restriction endonuclease (RE) analysis Tissue biopsy ▪ Eosinophilic inclusions (early stage) ▪ Basophilic inclusion surrounded by clear intranuclear inclusion Electron microscopy ▪ Icosahedral virions forming intranuclear paracrystalline aggregates TREATMENT ▪ Usually self-limiting disease MEDICATIONS Pharmacotherapy ▪ Immunocompromised/severe infection individuals ▫ Antivirals, immunoglobulin (IVIG) Prevention ▪ Infection control measures ▪ Live oral enteric-coated vaccine used for military recruits only OSMOSIS.ORG 309