Internal Medicine

P1: SBT

0521779407-02 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:18

64 Adenovirus

Signs & Symptoms

■Spectrum of disease very broad—mostly associated with respiratory

illness and gastroenteritis but cardiac neurologic, cutaneous, uri-

nary and lymphatic manifestations also occur. Disease more severe

in immunodeficient patients

Respiratory:

■Common cold – only rarely associated with cold.

■Acute febrile pharyngitis (types 1, 2, 3, 5, 6, 7) – mostly infants/young

children

■with fever, exudative tonsillitis cervical adenopathy and sometimes

dry hacking cough

■Laryngotracheitis – occasionally

■Acute respiratory disease – syndrome well described in military recruits

■With fever, pharyngitis, non-productive cough, malaise, chills and

headache

■Pneumonia – most common in young children and military recruits

■Atypical pneumonia – fever, sore throat, rhinorrhea and chest pain

■Pertussis-like syndrome – most common in infants <36 months

■Pharyngoconjunctival fever – fever, pharyngitis, conjunctivitis,

malaise and cervical lymphadenopathy

■Bronchiolitis obliterans

Eye:

■Acute follicular conjunctivitis

➣usually unilateral

➣follicular lesions on conjunctival surface

➣subconjunctival hemorrhages

■Epidemic keratoconjunctivitis:

➣highly contagious, more severe than follicular conjunctivitis

➣corneal epithelial inflammation

➣photophobia, lacrimation, discharge, hyperemia

➣often pharyngitis, rhinitis and fever

➣preauricular adenopathy

➣outbreaks often due to types 8, 19, or 37

■Gastrointestinal

➣Acute gastroenteritis

➣Types 40/41 most frequently involved

➣Children and infants most frequently affected

➣Complications; intussusception, acute mesenteric lymphadeni-

tis, appendicitis