Herpes 101

Three Nonfatal Cases of Neonatal Adenovirus Infection

Choristomas are common congenital lesions that possess little growth potential. There is a low grade fever and a runny right eye. Lysozyme is a protein found in our tears that possesses potent antiviral and antibacterial properties. Fortunately in most cases, laboratory studies can identify the causative organism and unlike other form of conjunctivitis, this perinatal ocular infection has to be treated with systemic antibiotics to prevent systemic colonization of the organism. A screen for bacterial sepsis, which included examination of the cerebrospinal fluid (CSF), was initiated. RESULTS From 23 patients, HSV type 1 was isolated but Ad or C trachomatis was not isolated. The red eye is a common chief complaint in both primary care and emergency department settings.

Differential diagnosis is facilitated by laboratory tests (e.g. Most of all other forms of bacterial conjunctivitis can be treated with topical antibiotics, with the exception of Pseudomonas infection. This led to the development of the non-infectious chemical Conjunctivitis that lasts less than a week. Goldbloom RB. Extracted samples were tested by PCRs for detection of adenovirus, herpes simplex virus, and C. trachomatis (6, 8). In addition, an antigen detection method (immune dot blot test) was used for detection of C.

Most microorganisms have sufficient destructive activity to kill the fetus once it is infected, leading to spontaneous abortion or stillbirth. Some women shed herpes simplex virus type 2 (HSV-2) during pregnancy even in the absence of typical genital lesions. Seeing the doctor if you have these symptoms is important because there is a chance that a more serious condition is causing them. Although chlamydial conjunctivitis was suspected clinically, all three neonates were C. trachomatis negative by both PCR and immune dot blot. 55-5 ). 1993; 22(6):379-383.

Neonatal conjunctivitis is a condition wherein the tissue which lines the eyelids of newly born babies gets inflamed. Specific treatment modalities are available for different types of neonatal conjunctivitis and treatment should be based on clinical picture and laboratory diagnosis (Gram stain & Giemsa stain). trachomatis investigation were placed in sucrose phosphate transport medium and extracted using a simple lysis buffer procedure as described previously (6). Enzyme immunoassay (EIA) (Adenoclone, Cambridge BioScience, Worcester, MA, USA) to detect Ad antigen was carried out on the conjunctival specimens according to the manufacturer’s instructions. Ocular motility should be assessed and documented if trauma or anatomic abnormality is suspected. Neonatal adenovirus infection has rarely been reported, but in most cases the outcome of the infection was fatal (1-3, 12, 14, 16, 21), although cases with and without complications have been reported (19). A fatal disseminated adenovirus infection was described for a neonate born after spontaneous vaginal delivery who suffered from severe keratoconjunctivitis, pneumonitis, pharyngitis, skin lesions, hepatosplenomegaly, and hemorrhagic diathesis (14).

Another study (2) described adenovirus infection of four neonates and reviewed nine further neonatal adenovirus cases reported in the literature. In all cases, adenovirus infection followed vaginal delivery, and symptoms began within 10 days of birth. One half of the mothers were ill with upper respiratory symptoms, fever, and/or constitutional symptoms in the perinatal period. All infants had pneumonia, lethargy, fever, and hepatomegaly, but none developed any form of ocular abnormality. In 11 of the 13 neonates (85%), infection was fatal, with death occurring 4 to 19 days after onset of symptoms. They are often small, fail to thrive or show detectable abnormalities later in childhood. Septicemia and meningitis are possible systemic involvements.

Respiratory insufficiency was detected just after birth or in the immediate postnatal period and was associated with lethargy and chest X-ray findings of pneumonic infiltration. Postmortem findings of these neonates were consistent with predominant lung involvement. More recently, nonfatal adenovirus infection has been described for seven neonates (19). Systemic antibiotics should be used if such findings are present. 2010 Azar MJ, Dhaliwal DK, Bower KS, Kowalski RP, and Gordon YJ, “Possible consequences of shaking hands wit hyour patients with epidemic keratoconjunctivitis,” Am J Ophthalmol 1996; 121(6): 711. The corneal region of the eye can be affected in advanced stage of viral conjunctivitis, persisting for close to a month and causing blurry eyesight. Renal patients should be advised to avoid star fruits.

Another study (2) described adenovirus infection of four neonates and reviewed nine further neonatal adenovirus cases reported in the literature. No case was identified as HSV-2. Finally, in order to view the posterior portions of the eye and retina, funduscopic examination may be indicated. The factors that control the severity of adenovirus infection in neonates remain to be elucidated, although the presence of marked abnormalities in blood lymphocytes and cytokine profile has been noted in cases of fatal adenovirus infection in children aged between 30 and 730 days (17). The variation in severity may be serotype dependent, as fatal infection appears to have been mainly associated with serotypes of subgroup B, possibly due to their predilection for respiratory tissues. It is possible that infection with subgroup D strains results in only transient conjunctivitis. Conjunctivitis in neonates is usually investigated for possible C.

trachomatis infection, but our results indicate that adenovirus infection should also be considered.