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adenovirus

Serotype determines extent of disease: 52 serotypes Epidemiology: - military outbreaks Pathology: 1) fevers 2) gastroenteritis: diarrhea 3) respiratory tract infections - etiology of common cold - cough - serotype 14 associated with pneumonia [2] - pharyngitis 4) bilateral conjunctivitis 5) serotype 41 may be associated with acute hepatitis in children [5] 6) adenovirus has oncogenic potential 7) CXADR interacts with adenovirus subgroup A, C, D, E & F fiber proteins & acts as an adenovirus receptor Laboratory: - adenovirus antigen - direct immunofluorescence assay (DFA) (60% sensitivity) - adenovirus+rotavirus Ag in stool - adenovirus+rotavirus in stool - adenovirus serology - adenovirus nucleic acid - adenovirus DNA - adenovirus rRNA - adenovirus type in specimen - adenovirus identified by culture - see ARUP consult [3] Differential diagnosis: - influenza: conjunctivitis unlikely - respiratory syncytial virus: conjunctivitis unlikely - Coxsackie virus: conjunctivitis & lower respiratory tract infection unlikely - cytomegalovirus is associated with retinitis [7] Management: - cidofovir is most often used in clinical practice - poor bioavailability & associated nephrotoxicity - brincidofovir - not nephrotoxic, but associated with diarrhea - contact precautions & droplet precautions for respiratory adenovirus infection [6]

Related

adenovirus DNA adenovirus vaccine (live virus vaccines, types 4 or 7)

General

adenoviridae

Figures/Diagrams

Diseases Associated with Inhibition of Apoptosis

Properties

KINGDOM: virus GENOME-TYPE: deoxyribonucleic acid (DNA) DOUBLE-STRANDED GENOME-SIZE: 36-38 kB ENVELOPE: NONE CAPSID-SYMMETRY: ICOSAHEDRAL

References

  1. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
  2. Centers for Disease Control and Prevention (CDC). Acute respiratory disease associated with adenovirus serotype 14 - four states, 2006-2007 MMWR Morb Mort Wkly Rep 2007, 56:1181 PMID: 18004235 - Louie JK et al, Severe pneumonia due to adenovirus serotype 14: A new respiratory threat? Clin Infect Dis 2008, 46:421 PMID: 18173356
  3. ARUP Consult: Adenovirus The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/browse-all-topics
  4. Hibbert KA, Shepard JAO, Lane RJ, Azar MM. Case 1-2018 - A 39-Year-Old Woman with Rapidly Progressive Respiratory Failure. N Engl J Med 2018; 378:182-190. January 11, 2018 PMID: 29320657 http://www.nejm.org/doi/full/10.1056/NEJMcpc1712222
  5. Phend C Unexplained Acute Hepatitis in Children: More Evidence for Adenovirus 41. Two studies point to a suspiciously high prevalence. MedPage Today July 13, 2022 https://www.medpagetoday.com/infectiousdisease/hepatitis/99707 - Gutierrez Sanchez LH et al A Case Series of Children with Acute Hepatitis and Human Adenovirus Infection. N Engl J Med. 2022. July 13 PMID: 35830653 https://www.nejm.org/doi/full/10.1056/NEJMoa2206294 - Kelgeri C et al Clinical spectrum of children with acute hepatitis of unknown cause. N Engl J Med. 2022. July 13 PMID: 35830627 https://www.nejm.org/doi/full/10.1056/NEJMoa2206704
  6. Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  7. NEJM Knowledge+ Lynch JP 3rd, Fishbein M, Echavarria M. - Adenovirus. Semin Respir Crit Care Med. 2011 Aug;32(4):494-511. PMID: 21858752 Review.
  8. Lynch JP 3rd, Kajon AE. Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment. Semin Respir Crit Care Med. 2021 Dec;42(6):800-821. PMID: 34918322