What is Adenovirus Conjunctivitis?
Adenovirus conjunctivitis is an acute infectious disease of the mucous membrane of the eyes.
What provokes / Causes of Adenovirus Conjunctivitis
The main most common causative agents of adenoviral conjunctivitis are adenoviruses 3, 4, 6, 7, 7a, 10, 11. As shown by numerous studies, serotypes 3,7a,11 are usually detected during epidemic outbreaks, serotypes 4, 6, 7, 10 – in cases sporadic diseases.
Outbreaks of adenoviral conjunctivitis are observed in the spring-autumn period, most often in children’s groups. First, a runny nose, headache, cough, sore throat, weakness, chills, abdominal pain appear in a sick child, and the temperature rises. Then the mucous membrane of the eyes becomes inflamed, conjunctivitis develops, but it proceeds more easily than in adults. The cornea is rarely involved in the process. Visual acuity is not reduced.
Pathogenesis (what happens?) during Adenovirus Conjunctivitis
Infection with adenoviral conjunctivitis occurs by airborne droplets when coughing and sneezing, less often by direct contact with the pathogen on the mucous membrane of the eyes.
Symptoms of Adenovirus Conjunctivitis
The incubation period is 7-8 days. The disease begins with severe nasopharyngitis and fever. On the second wave of temperature increase, symptoms of conjunctivitis appear first on one eye, and after 2-3 days on the other. The eyelids swell. The mucous membrane of the eye turns red. A scanty clear mucous discharge appears. Regional lymph nodes are enlarged. The sensitivity of the cornea is reduced.
There are three forms of adenoviral conjunctivitis:
- In the catarrhal form of adenoviral conjunctivitis, the phenomena of inflammation are slightly expressed. Redness is small, the amount of discharge too. The flow is easy. The duration of the illness is up to one week.
- In 25% of cases, a membranous form of adenoviral conjunctivitis occurs. With this form, thin films of a grayish-white color form on the mucous membrane of the eye, which can be easily removed with a cotton swab. Sometimes the films can be tightly soldered to the conjunctiva, a bleeding surface is exposed under them. In this case, it may be necessary to conduct an examination for diphtheria. After the disappearance of the films, there are usually no traces left, but sometimes mild scars may appear. In the conjunctiva, petechial hemorrhages and infiltrates (seals) may also occur, which completely resolve after recovery.
- With the follicular form of adenoviral conjunctivitis, small bubbles appear on the mucous membrane of the eye, sometimes they are large.
As shown by numerous studies in recent years, a serious consequence of adenovirus damage to the organ of vision is the development of dry eye syndrome due to impaired production of lacrimal fluid.
Diagnosis of Adenovirus Conjunctivitis
The diagnosis of adenoviral conjunctivitis is established by the characteristic clinical picture and by smear and culture by exclusion. It must be remembered that very often there are mixed forms, that is, a combination of different pathogens.
Treatment of Adenovirus Conjunctivitis
Treatment of adenoviral conjunctivitis is associated with some difficulties, since there are no selective agents for adenoviruses. Broad antiviral drugs are used: interferons (interferon, laferon) or interferon inducers, instillations are carried out 6-8 times a day in the first week of treatment and the number of instillations is reduced to 2-3 times a day in the second week. It is also advisable to add antibacterial drops to prevent the development of a secondary infection. Antihistamine (antiallergic) drugs are taken throughout the entire duration of the disease. To prevent complications associated with the development of dry eye syndrome, artificial tear substitutes (oftagel, systain, vidisik) are used.
Interferon solution 6-8 times a day (prepared from powder before use every day), 0.1% deoxyribonuclease 4-5 times a day. Poludan solution 4-5 times a day. Pyrogenal 6 times a day in the first days of the disease, then 2-3 times a day. Ointments 0.25-0.5% tebrofen, florenal, bonafton 2-4 times a day. For the prevention of secondary microbial infection, solutions of antibiotics, sulfonamides are added.
Prevention of Adenovirus Conjunctivitis
Prevention of adenovirus infection, as well as other acute respiratory infections and influenza, is hand hygiene, frequent airing of the room, wet cleaning and bed rest.
To prevent the addition of a secondary infection, 2-3 r / day for 10-14 days are used:
- picloxidine 0.05% solution;
- miramistin 0.01% solution;
- levomycetin 0.25% solution.