Clinical Background
Adenoviruses are responsible for mild self-limiting respiratory illnesses primarily in children.
Epidemiology
- Prevalence
- 5-7% of respiratory infections in children
- Year-round infection
- Rarely fatal, but 50% of infants and young children have prolonged intermittent disease
- Age - primary infection usually occurs before age 10
- Transmission
- Respiratory droplet transfer
- Neonatal transmission following vaginal delivery (rare)
Organism
- Double-stranded DNA virus
- 41 known serotypes
- Types 4 and 7 are common in military recruit outbreaks
- Classified into 6 groups, A-F
Clinical Presentation
- Most infections - mild respiratory illness
- Bronchiolitis, pneumonia
- Acute diarrhea (types 40, 41)
- Hemorrhagic cystitis (types 11, 21)
- Epidemic keratoconjunctivitis (types 8, 19, 37)
- Fatal adenovirus infections can occur in infants and immunocompromised adults
Treatment
See Also
Diagnosis
Diagnosis
- Laboratory testing
- Most cases are diagnosed on clinical grounds alone
- Viral culture can be used in selected clinical settings
- Serologic testing usually relies on demonstration of antibodies to group-specific antigens
Differential Diagnosis
- Bacterial pneumonia
- Bordetella
- Chlamydia pneumoniae
- Cytomegalovirus
- Enterovirus
- Influenza
- Mycoplasma pneumonia
- Parainfluenza
- Viral gastroenteritis
Tests generally appear in the order most useful for common clinical situations
| Test name: Adenovirus Antibodies, IgG & IgM
|
| ARUP #: 0051077 |
| Methodology: Enzyme-Linked Immunosorbent Assay
|
| Use: Primarily useful in epidemiological studies |
| Follow-up:
For equivocal values, repeat testing in 10-14 days may be helpful
|
| Test name: Adenovirus 40-41 Antigens by EIA
|
| ARUP #: 0065066 |
| Methodology: Enzyme Immunoassay
|
| Use: Use for diagnosing agent of gastroenteritis |
| Test name: Viral Culture
|
| ARUP #: 0065008 |
| Methodology: Cell Culture
|
| Use: Useful for identification of agent in the following diseases:
- pneumonias
- respiratory tract infections
- disseminated disease
- pharyngitis and keratoconjunctivitis
- hemorrhagic cystitis |
| Test name: Respiratory Viruses DFA with Reflex to Viral Culture
|
| ARUP #: 0060281 |
| Methodology: Direct Fluorescent Antibody Stain
|
| Use: Useful for identification of agent in the following diseases:
- pneumonias
- respiratory tract infections
- disseminated disease
- pharyngitis and keratoconjunctivitis
- hemorrhagic cystitis |
| Test name: Immunohistochemistry Stain Offering
|
| ARUP #: arup005 |
| Methodology: Immunohistochemistry
|
| Use: For fixed tissue samples, consultative services as well as immunohistochemical staining for the presence of adenovirus are available |
Additional Tests Available
| Test name: Adenovirus Antibody, IgG
|
| ARUP #: 0051073 |
| Methodology: Enzyme-Linked Immunosorbent Assay
|
| Comments: Primarily useful in epidemiological studies |
| Test name: Adenovirus Antibody, IgM
|
| ARUP #: 0051078 |
| Methodology: Enzyme-Linked Immunosorbent Assay
|
| Comments: Primarily useful in epidemiological studies |
| Test name: Respiratory Viruses DFA
|
| ARUP #: 0060289 |
| Methodology: Direct Fluorescent Antibody Stain
|
| Comments: |
| Test name: Rotavirus & Adenovirus 40-41 Antigens
|
| ARUP #: 0065067 |
| Methodology: Enzyme Immunoassay
|
| Comments: |
References
Guidelines
Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals. American Medical Association - Medical Specialty Society
Center for Food Safety and Applied Nutrition - Federal Government Agency [U.S.]
Centers for Disease Control and Prevention - Federal Government Agency [U.S.]
Food Safety and Inspection Service - Federal Government Agency [U.S.]. 2001 Jan (revised 2004 Apr 16). 33 pages. NGC:003593 General References
Hakim FA, Tleyjeh IM. Severe adenovirus pneumonia in immunocompetent adults: a case report and review of the literature. Eur J Clin Microbiol Infect Dis.
2008;
27(
2):
153-158.
Hammond S, Chenever E, Durbin JE. Respiratory virus infection in infants and children. Pediatr Dev Pathol.
2007;
10(
3):
172-180.
Hayashi S, Hogg JC. Adenovirus infections and lung disease. Curr Opin Pharmacol.
2007;
7(
3):
237-243.
Hurt C, Tammaro D. Diagnostic evaluation of mononucleosis-like illnesses. Am J Med.
2007;
120(
10):
911-918.
Langley JM. Adenoviruses. Pediatr Rev.
2005;
26(
7):
244-249.
Sivan AV, Lee T, Binn LN, Gaydos JC. Adenovirus-associated acute respiratory disease in healthy adolescents and adults: a literature review. Mil Med.
2007;
172(
11):
1198-1203.
Medical Reviewers
Litwin, Christine, M.D. Medical Director, Immunology at ARUP Laboratories; Professor, Clinical Pathology, University of Utah
Petti, Cathy A., M.D. Medical Director, Infectious Diseases at ARUP Laboratories; Assistant Professor, Pathology and Medicine, University of Utah
Comprehensive Review: July 2008
Last Update: July 2008
