Adenoviral pharyngitis

Adenoviral pharyngitis in most cases is based on a viral and adenoviral infection that causes so-called adenovirus diseases, which are a group of infectious diseases caused by adenoviruses, characterized by symptoms of mucous membrane damage to the respiratory tract, eyes, intestines, and lymphoid tissue.

In recent years, the adenovirus group has been continuously expanding. At present, several dozen serotypes of adenoviruses are known, and different serotypes can cause the same form of the disease, and vice versa, one serotype - its different forms. In adenovirus infection, antibodies are formed in the blood that are capable of inactivating the corresponding virus.

[1], [2], [3], [4]

Epidemiology of adenovirus pharyngitis

The source of adenoviral diseases is a sick person, as well as ill persons who secrete the virus within 50 days after the disease, and viruses. The transmission path is airborne when talking at close range, sneezing, coughing, and also the fecal-oral route. The most susceptible to adenovirus infection are children aged 6 months to 5 years. The crowding of people contributes to the emergence of epidemic outbreaks, especially in the autumn and spring periods. The emergence of adenoviral epidemics in school and army teams is mainly due to viruses of classes 1-5.

[5], [6], [7], [8], [9], [10], [11]

How does adenoviral pharyngitis develop?

The ability of adenoviruses to multiply in epithelial cells and lymphadenoid tissue of the respiratory tract, eyes, and intestines causes a variety of clinical manifestations that are distinguished in the following forms of adenoviral diseases:

• ORZ or rhinopharyngitis, rhinopharyngonzillitis, rhinopharyngolaringitis, rhinopharyngebronchitis;
• pharyngoconjunctival fever;
• acute follicular and pleural conjunctivitis;
• epidemic keratoconjunctivitis;
• adenovirus pneumonia;
• adenoviral gastroenterocolitis.

Symptoms of adenovirus pharyngitis

The incubation period is 5-7 (3-14) days. The onset of the disease is more often acute: chills, moderate headache, decreased appetite, lomiting pain in the bones, spine, joints, muscles is possible (this clinical picture resembles the debut of influenza infection). On the 2-3rd day of illness, the body temperature can rise to 38-39 ° C. Typical for adenoviral diseases (in contrast to influenza infection) the sequence of the appearance of new symptoms of the disease and the prevalence of local symptoms over the general. From the first day of the illness, there is a common cold with abundant secretions of serous, later - mucopurulent. The mucous membrane of the oral cavity and throat is swollen, the hyperemia is not pronounced; marked perspiration and itching in the throat, hoarseness, cough and mild pains with an "empty" throat. Along with oronasal inflammatory phenomena, acute adenoviral pharyngitis can also occur, in which the adenoviruses play an important role. The mucous membrane of the pharynx is hyperemic, partially covered with mucopurulent deposits; separate large follicles appear on the posterior wall of the pharynx, protruding on the mucous membrane in the form of bright red grains (rhinopharyngitis), swelling and hyperemia of the tongue. Perhaps an increase in palatine tonsils, often with the appearance on their surface of whitish loose raids in the form of dots or islets (rhinopharyngongzillitis). The body temperature can be subfebrile or rise at the height of the disease to 38 ° C. In the blood there is an absence of leukocytosis, some lymphocytosis. Often there is an increase in lymph nodes, mainly submandibular and posterior cervical.

One of the most frequent forms of adenoviral diseases is pharyngoconjunctival fever, which is characterized by a combination of fever, conjunctivitis and pharyngitis with a local reaction of the lymph nodes. The temperature reaction for adenoviral diseases lasts an average of 5-7 days, sometimes up to 14-18 days. Local catarrhal phenomena last up to 10-12 days or more. Many patients develop conjunctivitis in the first 3 days of the disease, initially usually unilateral. It manifests itself as a cut or pain in the eyes, abundant mucous separable, hyperemia of the conjunctiva. In some cases, keratoconjunctivitis occurs. Eyelids swell sharply, there is profuse lacrimation. After the disappearance of clinical signs of adenoviral disease, the asthenic syndrome persists for a long time.

Complications of adenoviral diseases (otitis, sinusitis, vulgar angina, pneumonia, etc.) are associated with the attachment of a bacterial infection or exacerbation of concomitant chronic inflammatory processes, for example, chronic tonsillitis, sinusitis, etc.

How is adenovirus pharyngitis recognized?

The diagnosis is based on the presence of conjunctivitis, erythematous pharyngitis, adenopathy of the cervical lymph nodes and the absence of leukocytosis. Laboratory diagnostics is based on the allocation of adenovirus from nasopharyngeal mucus, separated eyes, with intestinal forms - from the patient's feces. To establish the diagnosis, serological studies are also used, such as immunofluorescence, complement fixation, hemagglutination inhibition, etc.

Differential diagnosis is carried out mainly with influenza, for which such clinical manifestations as prolonged and pronounced catarrhal phenomena in the pharynx, a primary runny nose, moderate temperature reaction, insignificant intoxication, enlarged lymph nodes, conjunctivitis, and often gastrointestinal lesions are not characteristic.

The prognosis is usually favorable, but in young children with the adherence of pneumonia, deaths are possible.

Treatment of adenovirus pharyngitis

Treatment of adenovirus pharyngitis is usually carried out at home. The patient should be isolated in a separate room (the recommendation is more than incorrect, because in Russia, about 20% of families live in communal apartments, and it is there that there are all kinds of "popular" infectious diseases of the upper respiratory tract) or his bed should be fenced off with a screen. In the feverish period, appoint bed rest, complete nutrition, rich in vitamins, alkaline inhalation and gargling; intranasal - oxoline, tebrofen, microbiotenal in the form of ointments. Antibiotics in the usual course of adenoviral diseases are not shown for the same reasons as with other viral infections of the upper respiratory tract. However, they are prescribed for bacterial complications.

Adenoviral pharyngitis is prevented with the help of generally accepted rules: patient isolation, ventilation of premises, wet cleaning, wearing of mask by attendants, disinfection of secretions, etc.