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Causes and pathogenesis of adenovirus infection
Last reviewed: 06.07.2025
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The cause of adenovirus infection in children is adenoviruses. The entry point for adenovirus infection is most often the upper respiratory tract, sometimes the conjunctiva or intestine. By pinocytosis, adenoviruses penetrate the cytoplasm and then the nucleus of susceptible epithelial cells and regional lymph nodes. Viral DNA is synthesized in the nuclei of affected cells and mature virus particles appear after 16-20 hours. This process leads to the cessation of division of infected cells and then to their death. Virus reproduction in epithelial cells and regional lymph nodes corresponds to the incubation period.
The released viral particles penetrate into unaffected cells and into the blood. Initially, the mucous membrane of the nose, back wall of the pharynx, tonsils are affected. Regional lymph nodes are involved in the process. Inflammatory changes have a pronounced exudative component, which causes abundant serous discharge and swelling of the mucous membranes. If the conjunctiva is affected, there may be effusion on the mucous membrane with the formation of a delicate film.
Adenoviruses can penetrate the lungs and multiply in the epithelium of the mucous membrane of the bronchi and alveoli and cause pneumonia, necrotic bronchitis. Adenoviruses also enter the intestines through the fecal-oral route of transmission or through blood. Viremia ensures the involvement of not only the respiratory organs and gastrointestinal tract, but also the kidneys, liver and spleen. In fatal cases, cerebral edema may be detected. In the pathogenesis of bronchopulmonary manifestations in adenovirus infection, along with the virus, a bacterial infection is involved.
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