Abstract
Human Adenoviruses (HAdV) are known to be potentially associated with strong inflammatory responses and morbidity in pediatric patients. Although most of the primary infections are self-limiting, the severity of clinical presentation, the elevation of the white blood cell count and inflammatory markers often mimic a bacterial infection and lead to an inappropriate use of antibiotics. In infections caused by HAdV, rapid antigen detection kits are advisable but not employed routinely; costs and feasibility of rapid syndromic molecular diagnosis may limit its use in the in-hospital setting; lymphocyte cultures and two-sampled serology are time consuming and impractical when considering the use of antibiotics. In this review, we aim to describe the principal diagnostic tools and the immune response in HAdV infections and evaluate whether markers based on the response of the host may help early recognition of HAdV and avoid inappropriate antimicrobial prescriptions in acute airway infections.
Highlights
Human Adenoviruses (HAdVs) are DNA viruses of the Adenoviridae family, which can produce many different clinical pictures during childhood.Infections are almost always self-limiting in immunocompetent patients, but the severe systemic presentation combined with laboratory alterations such as elevation of white blood cell (WBC) count with neutrophilic prevalence and of C-reactive protein (CRP) may suggest a bacterial infection
WBC count is elevated during the acute phase of HAdV upper respiratory tract infections (URTIs), this does not seem to differ between respiratory infection caused by other pathogens, including bacterial [75,76]
We reviewed the potential feasibility of markers that may unveil early respiratory infections caused by HAdV
Summary
Human Adenoviruses (HAdVs) are DNA viruses of the Adenoviridae family, which can produce many different clinical pictures during childhood. Infections are almost always self-limiting in immunocompetent patients, but the severe systemic presentation combined with laboratory alterations such as elevation of white blood cell (WBC) count with neutrophilic prevalence and of C-reactive protein (CRP) may suggest a bacterial infection. This may result in hospital admission and inappropriate use of antibiotics, with an increased risk of potential side effects, antimicrobial resistance, and ensuing human and economic burden [1,2,3]. The aim of the present paper is to provide an overview of immunological responses of adenoviral infections that may add useful information for diagnosis
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