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]

  Preauricular adenopathy may develop. Chemosis, pain, and punctate corneal lesions that are visible with fluorescein staining may be present. Systemic symptoms and signs are mild or absent. [merckmanuals.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]

• 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]

  fever caused by adenovirus type 3. ( 11280197 ) Harley D....DICK A. 2001 8 Outbreak of pharyngoconjunctival fever at a summer camp--North Carolina, 1991. ( 1579128 ) 1992 9 Outbreak of pharyngoconjunctival fever at a summer camp--North Carolina, 1991 [malacards.org]

  […] at Clinical Trials.gov US National Guidelines Clearinghouse NICE Guidance FDA onPharyngoconjunctival fever overview CDC on Pharyngoconjunctival fever overview Pharyngoconjunctival fever overview in the news Blogs on Pharyngoconjunctival fever overview [ec2-184-73-211-184.compute-1.amazonaws.com]

  […] pharyngoconjunctival fever是什么意思及用法 沪江词库精选pharyngoconjunctival fever是什么意思、英语单词推荐 例句 A fevered imagination 奔放的想象力. His medicines had failed; the fever was unabated 他的药剂未起作用。热度未减。 Be Bitten with;catch the fever for .. [hujiang.com]

  Pharyngoconjunctival Fever Pharyngoconjunctival fever is an acute viral illness defined by the presence of fever, conjunctivitis, and pharyngitis. It occurs in epidemic and sporadic fashion. [musculoskeletalkey.com]

• Fatigue

  General Symptoms People who have PCF often complain of fatigue and upset stomach. Some may also have a pharyngitis. A pharyngitis is an inflammation of the throat that appears reddened and is covered with bumps called follicles. [verywell.com]

  Symptoms Prodromal symptoms are typical: fatigue, malaise and low-grade fever for up to one week. Eye pain, redness, watering and photophobia may occur. Facial pain may precede other symptoms and is typically confined to one dermatome. [patient.info]

• Chemosis

  - Chemosis (swelling of conjunctiva). - Subconjunctival (below conjunctiva) haemorrhage. - Swelling of lids. - Ecchymosis (non-raised reddish or bluish discolouration) of lids. - Cervical lymphadenopathy. - Painful pre-auricular lymphadenopathy. [nhp.gov.in]

  Signs of disease include epiphora, conjunctival hyperemia and chemosis, subconjunctival hemorrhage, follicular or mild papillary conjunctival reaction, and eyelid edema. [odlarmed.com]

  Macroscopic noticeable swelling of the conjunctiva, called ‘chemosis’, is sometimes seen. [eyewiki.aao.org]

• Conjunctival Hyperemia

  Signs of disease include epiphora, conjunctival hyperemia and chemosis, subconjunctival hemorrhage, follicular or mild papillary conjunctival reaction, and eyelid edema. [odlarmed.com]

  After an incubation period of five to 12 days, the disease enters the acute phase, causing watery discharge, conjunctival hyperemia and follicle formation. Lymphoid follicles are elevated, with avascular lesions ranging from 0.2 to 2mm in size. [medicalstudy.blogspot.com]

• Visual Impairment

  It is the third most common cause of severe visual impairment worldwide, causing severe conjunctival cicatricial changes and secondary corneal ulceration and scarring [ 5 ]. [patient.info]

• Neck Swelling

  Septic thrombophlebitis of the internal jugular vein causes pain, dysphagia, and neck swelling and stiffness. Sepsis occurs 3-10 days after the sore throat starts. Infection can spread to the lungs and other distant sites. [atsu.edu]

• Headache

  Adenovirus 3 detected F, 12y 17 Itchy, red eyes, fever, headache, nausea - - Left eye swab. [health.gov.au]

  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]

  […] term you might hear if your child has a symptom complex of (you guessed it) high fever that lasts 4-5 days pharyngitis (sore throat) conjunctivitis (inflammed eyes, usually without pus formation) enlargement of the lymph nodes ("glands") of the neck headache [drhull.com]

  The infection has_symptom fever, has_symptom lymphadenopathy of the neck, and has_symptom headache. [ http://www.ebi.ac.uk/ontology/webulous#OPPL_pattern ] A condition characterized by fever, conjunctivitis, and pharyngitis resulting from infection by [ebi.ac.uk]

• Agitation

  The virus containing particles may become resuspended when the water is agitated by swimmers (6,7). Natural bodies of water may have inherent virucidal properties possibly related to certain species of bacteria (6,8). [cdc.gov]

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.

• Chlamydia

  Chlamydia : there is ongoing debate as to which antibiotic is most effective (alone or in combination). [patient.info]

  Topical corticosteroids may be needed (i.e. prednisolone acetate, 0.125%, q.i.d.) to prevent scarring Differential Diagnoses for Follicular Conjunctivitis HSV Chlamydia Bacterial Conjunctivitis (including GC in neonate) Toxic conjunctivitis (molluscum [webeye.ophth.uiowa.edu]

  […] gonorrhoeae Neiseria meningitides Streptococo pneumonia Heamophilus influenza Chronic conjunctivitis: Staphylococus aureus Moraxella lacunata Less common causes includes: Streptococus Moraxella catarrhalis Corynebacterium diphteriae Mycobacterium tuberculosis Chlamydia [eyewiki.aao.org]

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 Traditionally the treatment of viral conjunctivitis simply aimed to relieve symptoms and stop the disease spreading to others. [drmalcolmmckellar.co.nz]

Treatment with topical anti-inflammatory agents is reserved for cases with severe signs and symptoms. [reviewofoptometry.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]

[…] 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]

[…] 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]

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]

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]

[…] of pharyngoconjunctival fever in Northern California, 1955-1956. ( 13411120 ) KIMURA S.J....Jawetz E. 1957 26 An intrafamilial epidemic of pharyngoconjunctival fever. ( 13393836 ) Anderson G.R....VAN HORNE R.G. 1957 27 Studies on the adenovirus as an etiological [malacards.org]

However, if the patient has clinical and epidemiologic features highly suggestive of a bacterial etiology then a rapid antigen detection test can be utilized. [atsu.edu]

Viral conjunctivitis is often misdiagnosed as having a bacterial etiology, as viral conjunctivitis presents similarly to other types of conjunctivitis. [symptoma.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]

Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 53 (‎11)‎, 79. https://apps.who.int/iris/handle/10665/221792 Revue Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 53 (‎11)‎: 79 [apps.who.int]

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]

Respiratory and Enterovirus Br, National Center for Infectious Diseases; Div of Field Epidemiology, Epidemiology Program Office, CDC. [cdc.gov]

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]

How can adenovirus be prevented? Adenovirus infections are difficult to prevent. Some cases can be prevented by good hand washing, and by avoiding contaminated objects. [drgreene.com]

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]

Prevention [ edit ] Safe and effective adenovirus vaccines were developed for adenovirus serotypes 4 and 7, but were available only for preventing ARD among US military recruits, [9] and production stopped in 1996. [10] Strict attention to good infection-control [en.wikipedia.org]

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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.