Adenovirus enteritis
Introduction
Introduction to adenoviral enteritis Adenovirus enteritis is caused by an adenovirus infection. The clinical features are acute onset, nausea, vomiting, abdominal pain, diarrhea, drainage or loose stools, fever and general malaise, short duration and low mortality. The clinical manifestations of gastroenteritis caused by various viruses are basically similar. There are many types of viruses associated with acute gastroenteritis. basic knowledge The proportion of illness: 0.016% Susceptible people: young children Mode of infection: fecal mouth spread Complications: pneumonia
Cause
Cause of adenoviral enteritis
(1) Causes of the disease
Intestinal adenovirus refers to adenovirus type 40 and 41. These two types of adenovirus mainly invade the small intestine and cause gastroenteritis. The morphology is the same as that of common adenovirus. The diameter is 70-80 nm, and the core part is 40-45 nm. Straight linear DNA, the core has a capsid; lipid-free capsule, and adenovirus type 31 can also cause diarrhea, WHO has confirmed that intestinal adenovirus is the second most important pathogen causing viral diarrhea in children.
(two) pathogenesis
Intestinal adenovirus mainly infects jejunum and ileum, intestinal mucosal epithelial cells become smaller, shorter, cell degeneration, dissolution, mononuclear cell infiltration in intestinal lamina propria, leading to intestinal dysfunction, causing osmotic diarrhea.
Prevention
Adenovirus enteritis prevention
Cutting off the route of transmission is the focus of prevention.
1. Manage the source of infection
Patients should be found early and isolated. Close observations were made on close contacts and suspected patients.
2. Cut off the route of transmission
Strengthen diet, drinking water and personal hygiene, and do a good job of disinfecting patients' feces: prevent drinking water sources and food from being contaminated. The hospital must strictly carry out the disinfection work in the baby area and the newborn room. If the child can not control the stool, it should be restricted to enter the day care or school.
3. Vaccination
Rotavirus vaccines are already available for clinical use. During the epidemic, passive immunization methods for high-risk groups and susceptible populations also have a certain preventive effect. Human milk can have a protective effect to a certain extent. Promote breastfeeding to reduce the severity of illness in young children. The calf of the calf immunized with bovine rotavirus contains IgA and IgG antibodies, and feeding the baby with this milk also has a protective effect.
Complication
Adenoviral enteritis complications Complications pneumonia
Can be complicated by pneumonia, showing persistent fever, fever with chills, fever with cough, sputum, chest pain, cough, cough with chest pain, cough, purulent sputum, mucopurulent pneumonia is a pulmonary congestion caused by a variety of pathogenic bacteria , edema, inflammatory cell infiltration and exudative lesions. Clinically common, can occur in any population, clinical manifestations are mainly fever, cough, cough, difficulty breathing, inflammatory infiltrates in the lungs X-ray.
Symptom
Adenoviral enteritis symptoms common symptoms watery stool diarrhea high fever infectious rhinitis defecation
The incubation period is 3 to 10 days, mostly for 7 days. The children are mainly diarrhea, several times to ten times a day, and the watery stools last for 1 to 2 weeks, with an average of 8 to 9 days. The minority can last for 3 to 4 weeks. 70% of children with vomiting, 40% of children with fever onset, accompanied by diarrhea, body temperature above 38 ° C, 2 to 3 days after retreat, some children can have rhinitis, pharyngitis, bronchitis and other upper respiratory tract infections Symptoms, 3% to 6% have pneumonia.
Examine
Examination of adenoviral enteritis
1. The total number and classification of white blood cells in blood routine are mostly normal, a few are high, and the number of lymphocytes is increased.
2. Most of the stool routine and culture stool microscopy have no special findings, a small number of white blood cells can be seen, and no pathogenic bacteria grow.
3. Specific diagnostic experiments:
(1) Rotary granules can be found by taking feces for direct or immunoelectron microscopy.
(2) The detection of viral antigen in fecal supernatant by enzyme-linked immunosorbent assay or immunoenzymatic plaque assay (Immnnoenzymedottest) has high sensitivity and specificity.
(3) Extracting viral RNA from feces, performing polyacrylamide gel electrophoresis and silver staining, and examining the presence or absence of rotavirus RNA electropherogram, which has both diagnostic value and different types of virus infection.
Diagnosis
Diagnosis and diagnosis of adenovirus enteritis
diagnosis
Clinical diagnosis is difficult and cannot be distinguished from other viral gastroenteritis, relying on laboratory tests to confirm the diagnosis.
The stool of the child was collected, the virus particles were examined by electron microscopy or immunoelectron microscopy, and the viral antigen was examined by ELISA or indirect immunofluorescence.
Differential diagnosis
It needs to be differentiated from acute enteritis caused by Nobel virus, intestinal adenovirus, calicivirus, and astrovirus.
