Adenovirus Infections

At least 57 types, which produce a variety of clinical syndromes

Usually self-limited except in immunosuppressed persons

Common cold

Nonstreptococcal exudative pharyngitis

Lower respiratory tract infections

Epidemic keratoconjunctivitis

Hemorrhagic cystitis

Acute gastroenteritis

Disseminated disease in transplant recipients

Can be cultured from appropriate specimens when definitive diagnosis is desired

Quantitative real-time rapid-cycle PCR useful in distinguishing disease from colonization, especially in hematopoietic stem cell transplant patients

Multiplex nucleic acid amplification assays can test for multiple respiratory viruses simultaneously with increased sensitivity

Appears as a multifocal consolidation or ground-glass opacity without airway inflammatory findings on chest CT imaging

Disease usually self-limited

Immunocompromised patients often treated with ribavirin or cidofovir, with occasional success

• Cidofovir is attendant with significant renal toxicity and reduction in doses of immunosuppressive agents is often required

Brincidofovir, a nucleoside analog

• Appears to be useful in patients infected after stem cell transplantation

• Only available through compassionate use policies

Epidemic adenoviral conjunctivitis is often difficult to control and requires

• Meticulous attention to hand hygiene

• Use of disposable gloves

• Sterilization of equipment (isopropyl alcohol is insufficient, recommendations of manufacturers are preferred)

• Cohorting of cases

• Furloughing of employees

• A combination of povidone-iodine 1.0% eyedrops and dexamethasone 0.1% eyedrops four times a day can reduce symptoms and expedite recovery

Intravenous immunoglobulin (IVIG) is used in immunocompromised persons but data are still limited