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Pharyngoconjunctival Fever

Fever Pharyngo Conjunctival

Pharyngoconjunctival fever (PCF) is a clinical syndrome caused by adenoviruses. PCF may occur in unrelated incidents, or as an epidemic. The main features are conjunctivitis, pharyngitis, and fever. It is highly contagious.


Presentation

Most cases of conjunctivitis are caused by viruses, of which the most common microorganism is adenovirus [1] [2]. Viral conjunctivitis is often misdiagnosed as having a bacterial etiology, as viral conjunctivitis presents similarly to other types of conjunctivitis [3].

Pharyngoconjunctival fever (PCF) is a specific syndrome commonly caused by certain serotypes of the human adenovirus [4]. PCF can either occur sporadically or as an outbreak, however, it is more common in warm weather. Populations most susceptible to outbreaks are children in institutions such as schools, and people sharing living quarters. Most outbreaks originate from contaminated water bodies such as public swimming pools [5].

PCF and epidemic keratoconjunctivitis (EKC) are the more frequent syndromic manifestations of adenoviral infection of the eye. PCF is typically less severe than EKC [6]. The incubation period ranges from 5 days to almost 2 weeks, after which patients experience fever that usually resolves over the period of 10 days. There may be a history of exposure to individuals with conjunctivitis or pharyngitis, as infected individuals are highly contagious in the first few days of symptomatic infection. The infection is acute, self-limiting, and is more severe in patients with low immunity. Superimposed bacterial infection is possible.

PCF initially affects one eye, becoming bilateral as the infection progresses. Ocular manifestations include pronounced conjunctivitis. Common complaints are redness, burning, tearing, itching, and photophobia. In addition, there may be a watery discharge, edema, bruising, and tenderness of the eyelids.The appearance of the eye may resemble that of traumatic injury. The virus may occasionally cause the formation of a pseudomembrane (an even rarer occurrence in other types of conjunctivitis) which may be accompanied by a mucopurulent discharge, mostly consisting of mononuclear white blood cells. Subepithelial infiltrates (SEIs), white lesions on the cornea, are a consequence of the disease and may remain for months after the infection has cleared. This leads to possible visual disturbances, including decreased visual acuity.

The respiratory features of PCF are mainly pharyngitis and rhinitis, which vary in severity. Oropharyngeal erythema may be visualized.

Systemic symptoms include high-grade fever and tender or non-tender lymphadenopathy (approximately half of known cases), particularly in the cervical and preauricular regions [3]. Other non-specific features include general malaise and muscle pain.

Preauricular Adenopathy
  • Nontender cervical lymphadenopathy and tender, enlarged preauricular adenopathy may be present.[odlarmed.com]
  • Background Pharyngoconjunctival fever (PCF) is an acute and highly infectious illness characterized by fever, pharyngitis , acute follicular conjunctivitis, and regional lymphoid hyperplasia with tender, enlarged preauricular adenopathy.[emedicine.medscape.com]
  • EKC’s Pediatric Cousin Pharyngoconjunctival fever (PCF) is an acute and highly infectious illness characterized by fever, pharyngitis, acute follicular conjunctivitis and regional lymphoid hyperplasia with tender, enlarged preauricular adenopathy.[reviewofoptometry.com]
  • There is often accompanying eyelid swelling, eye pain on palpation, and preauricular adenopathy. When conjunctivitis is caused by Neisseria gonorrhoeae carries a high risk for corneal involvement and subsequent corneal perforation.[eyewiki.aao.org]
Fever
  • Pharyngoconjunctival fever (PCF) is a clinical syndrome caused by adenoviruses. PCF may occur in unrelated incidents, or as an epidemic. The main features are conjunctivitis, pharyngitis, and fever. It is highly contagious.[symptoma.com]
  • Manifestations of the illness included pharyngitis, cough, fever to 104 F (40 C), headache, myalgia, malaise, and conjunctivitis. On August 2, the DEHNR was notified of a similar outbreak during a second 4-week session at the camp.[ncbi.nlm.nih.gov]
  • Another pharyngoconjunctival fever outbreak was discovered in the Chenjinglun Swimming Center located in the Xihu District between 1 and 15 July 2011.[ncbi.nlm.nih.gov]
  • Symptoms were consistent with a diagnosis of pharyngoconjunctival fever. At the height of the outbreak, about 40 per cent of students were absent.[ncbi.nlm.nih.gov]
  • […] the treatment of pharyngoconjunctival fever. ( 4299710 ) Kitamoto O....Yoshida H. 1968 19 An outbreak of pharyngoconjunctival fever due to adenovirus type 3. ( 4290963 ) Kawana R....Obara K. 1966 20 Pharyngoconjunctival fever due to type 1 adenovirus[malacards.org]
Coarse Rales
  • There was evidence of respiratory infection in 69% of patients, with wheezing and coarse rales frequently present, contrary to the general belief that bronchitis is rare.[medigoo.com]
Excitement
  • Douglas Jones Lippincott Williams & Wilkins , 2006 - 2808 من الصفحات Click here to view a narrated demo to see all the features of this exciting new Solution![books.google.com]

Workup

The diagnosis of pharyngoconjunctival fever is clinical [7]. Possible studies carried out entail viral culture, adenovirus-specific antibody titers, polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA), and immunochromatography. Viral cultures may only be beneficial within the first 10 days of infection. Antibodies against the virus are gauged via complement fixation, where blood samples are drawn soon after symptoms appear, and then after 2 to 3 weeks later. An increase in antibodies in the second sample of at least four times the original sample is indicative of recent adenoviral infection. Typically, laboratory tests take about a week to yield results. Electron microscopy may also be utilized.

Treatment

  • As a result, doctors know that people with PCF will eventually feel better so treatment is designed to help manage symptoms. The ultimate goal of treatment is to make the patient feel better.[verywell.com]
  • Treatment: Because pharyngoconjunctival fever is contagious and self-limiting, the primary treatment once again is patient education. Instruct patients to stay home from work or school until there is absolutely no discharge.[medigoo.com]
  • Taper this treatment slowly to avoid recurrence of corneal opacities.[nhp.gov.in]
  • Treatment is of course supportive care while the virus "runs its course."[drhull.com]
  • Treatment Medical Care Because PCF usually is a self-limited disease, treatment is mainly symptomatic, as follows: Cold compresses several times per day for 1-2 weeks Artificial tears 4-8 times per day for 1-3 weeks Drug therapy Drug therapy may be used[emedicine.medscape.com]

Prognosis

  • […] navigation , search Pharyngoconjunctival fever Microchapters Home Patient Information Overview Pathophysiology Causes Differentiating Pharyngoconjunctival Fever from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis[ec2-184-73-211-184.compute-1.amazonaws.com]
  • Prognosis: Most cases of PCF are acute, benign and self-limiting. Infection usually resolves spontaneously within 2-3 weeks. Sub-epithelial infiltrates may last for months together and may decrease vision if visual axis is involved.[nhp.gov.in]
  • […] conditions pharyngitis coryza pneumonia infectious conjunctivitis Prevention vaccinations live, oral, enteric-coated vaccines military recruits 17-50 years of age infection control procedures contact and droplet precaution chlorination of swimming pools Prognosis[medbullets.com]
  • Prognosis [ 11 ] Eyelid and conjunctival lesions tend to resolve over 1-2 weeks. Epithelial keratitis resolves over two weeks and has a good prognosis. Stromal keratitis is more likely to result in corneal scarring.[patient.info]

Etiology

  • Here we explored the epidemiology and etiology of two adenovirus serotype 3 outbreaks in Hangzhou in 2011. One acute respiratory outbreak was found in Chun'an County, where a total of 371 cases were confirmed in 5 of 23 towns from 4 to 31 May 2011.[ncbi.nlm.nih.gov]
  • Viral conjunctivitis is often misdiagnosed as having a bacterial etiology, as viral conjunctivitis presents similarly to other types of conjunctivitis.[symptoma.com]
  • […] of pharyngoconjunctival fever in Northern California, 1955-1956. ( 13411120 ) KIMURA S.J....Jawetz E. 1957 24 An intrafamilial epidemic of pharyngoconjunctival fever. ( 13393836 ) Anderson G.R....VAN HORNE R.G. 1957 25 Studies on the adenovirus as an etiological[malacards.org]
  • Progress logically through consistently formatted chapters that examine etiology, epidemiology, disease presentation, host defenses, identification, diagnosis, prevention, and control for each microbe.[books.google.com]
  • PCF most frequently is caused by adenovirus serotypes 3 and 7, but serotypes 2, 4, and 14 also have been documented as etiologic agents. In addition, sporadic outbreaks caused by serotypes 1, 5, 6, 8, 11, and 19 have been reported.[odlarmed.com]

Epidemiology

  • The epidemiologic investigation, initiated by the DEHNR on August 7, identified the cause as pharyngoconjunctival fever (PCF) associated with infection with adenovirus type 3. This report summarizes findings from the investigation.[ncbi.nlm.nih.gov]
  • In an epidemiologic study carried out in Rio de Janeiro and Belem between 1977 and 1986, 148 Ads were isolated from children with respiratory disease. All five Ad4 strains encountered during this study were also Ad4a.[ncbi.nlm.nih.gov]
  • Weekly Epidemiological Record Relevé épidémiologique hebdomadaire, 53 (‎11)‎, 79.[who.int]
  • Focus on clinical relevance with new interactive case presentations to introduce each of the microbial pathogens that illustrate the epidemiology, diagnosis, and treatment of infectious diseases.[books.google.com]
  • Here we explored the epidemiology and etiology of two adenovirus serotype 3 outbreaks in Hangzhou in 2011. One acute respiratory outbreak was found in Chun'an County, where a total of 371 cases were confirmed in 5 of 23 towns from 4 to 31 May 2011.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • PATHOPHYSIOLOGY The route of inoculation of adenoviruses causing pharyngoconjunctival fever determines the pathophysiologic sequence.[musculoskeletalkey.com]
  • Jump to: navigation , search Pharyngoconjunctival fever Microchapters Home Patient Information Overview Pathophysiology Causes Differentiating Pharyngoconjunctival Fever from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications[ec2-184-73-211-184.compute-1.amazonaws.com]
  • Pathophysiology The adenoviruses consist of a group of 35 morphologically similar but antigenically distinct DNA viruses that share a common complement-fixing antigen.[odlarmed.com]
  • PATHOPHYSIOLOGY Viral conjunctival infections are thought to be caused by airborne respiratory droplets or direct transfer from one’s fingers to the conjunctival surface of the eyelids.[medicalstudy.blogspot.com]

Prevention

  • Author information 1 Department of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, Jianqiao Town, Hangzhou, Zhejiang Province, China.[ncbi.nlm.nih.gov]
  • Goals of pharmacotherapy (treatment with medicines) are to reduce morbidity and to prevent any complications. Antiviral eye drops were tried in some patients, but there was no definite benefit of these.[nhp.gov.in]
  • Elsevier Health Sciences , ٠٨‏/٠٩‏/٢٠١٤ - 161 من الصفحات As the authors describe in this volume dedicated to vision in children, great strides have been made in recent years in preventing and identifying any loss of visual acuity, and, when identified[books.google.com]
  • Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse[books.google.com]
  • Progress logically through consistently formatted chapters that examine etiology, epidemiology, disease presentation, host defenses, identification, diagnosis, prevention, and control for each microbe.[books.google.com]

References

Article

  1. Uchio E, Takeuchi S, Itoh N, Matsuura N, Ohno S, Aoki K. Clinical and epidemiological features of acute follicular conjunctivitis with special reference to that caused by herpes simplex virus type 1. Br J Ophthalmol. 2000;84(9):968–972.
  2. Epling J. Bacterial conjunctivitis. BMJ Clin Evid. 2010;2010:0704.
  3. O’Brien TP, Jeng BH, McDonald M, Raizman MB. Acute conjunctivitis: truth and misconceptions. Curr Med Res Opin. 2009;25(8):1953–1961.
  4. Kuo SC, Shen SC, Chang SW, Huang SC, Hsiao CH. Corneal superinfection in acute viral conjunctivitis in young children. J Pediatr Ophthalmol Strabismus. 2008;45(6):374–376.
  5. González-López JJ, Morcillo-Laiz R, Muñoz-Negrete FJ. Adenoviral keratoconjunctivitis: an update. Arch Soc Esp Oftalmol. 2013;88(3):108–115.
  6. Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin North Am. 2008;26(1):35–55.
  7. Ghebremedhin B. Human adenovirus: Viral pathogen with increasing importance. Eur J Microbiol Immunol (Bp). 2014;4(1):26–33.

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Last updated: 2018-06-21 20:45