From the Guidelines
Fever associated with adenovirus infection should be managed with over-the-counter medications like acetaminophen (Tylenol) at a dose of 325-650 mg every 4-6 hours for adults (not exceeding 3,000 mg daily) or ibuprofen (Advil, Motrin) at 200-400 mg every 4-6 hours (not exceeding 1,200 mg daily), as there is no proven effective treatment for eradication of adenovirus infection 1.
Management of Fever
To manage fever, the following steps can be taken:
- Use over-the-counter medications like acetaminophen or ibuprofen as directed above
- Ensure rest and adequate hydration
- Apply lightweight clothing and maintain a comfortable room temperature
Monitoring and Follow-up
It is essential to monitor the patient's condition and seek medical attention if:
- Fever exceeds 103°F (39.4°C)
- Fever persists beyond 5 days
- Severe symptoms like difficulty breathing, chest pain, or severe headache occur
Additional Considerations
As adenovirus infections are highly contagious, patients should be educated on measures to reduce the spread of the infection, such as minimizing contact with others for 10 to 14 days from the onset of symptoms in the last eye affected 1. In addition to managing fever, artificial tears, topical antihistamines, topical steroids, oral analgesics, or cold compresses may be used to mitigate symptoms associated with adenoviral conjunctivitis 1. However, the use of antibiotics should be avoided due to potential adverse treatment effects 1. Topical corticosteroids may be helpful in reducing symptoms and scarring in severe cases, but close follow-up is warranted due to the potential for prolonged viral shedding 1.
From the Research
Adenovirus Infection and Fever
- Adenovirus infections can cause a range of symptoms, including fever, and can be severe in immunocompromised patients 2, 3.
- In immunocompetent adults, adenovirus infection can cause severe pneumonia, but the benefits of cidofovir treatment are limited 4.
- Cidofovir is considered the drug of choice for severe adenovirus infections, but its effectiveness is still a topic of debate 2, 3, 5.
Treatment of Adenovirus Infections
- The use of cidofovir in pediatric patients with adenovirus infection has shown promise, with viral clearance and clinical response observed in the majority of patients 5.
- However, reversible renal dysfunction is a potential side effect of cidofovir treatment 5.
- Further studies are needed to evaluate the efficacy of cidofovir and other antiviral agents for the treatment of adenovirus infections 2, 4, 6, 5.
Clinical Outcomes
- The treatment of adenovirus infections with cidofovir did not improve clinical outcomes in immunocompetent patients with severe adenovirus pneumonia 4.
- In pediatric patients, cidofovir treatment was associated with viral response and clinical improvement, but further studies are needed to confirm these findings 5.