Adenovirus enteritis

　　1. Etiology

　　Adenovirus 40 and 41 are referred to as enteroviruses, and these two types of adenoviruses mainly invade the small intestine to cause enteritis and thus get their name. Their morphology is similar to that of common adenoviruses, with a diameter of 70-80 nm, a core part of 40-45 nm, containing double-stranded linear DNA, and a capsid in the core; without a lipid envelope. In addition, adenovirus 31 can also cause diarrhea. The World Health Organization has confirmed that enteroviruses are the second most important pathogen causing viral diarrhea in children.

　　2. Pathogenesis

　　Adenovirus primarily infects the jejunum and ileum. The villi of the intestinal mucosal epithelial cells become smaller and shorter, the cells become degenerative and dissolve, and there is infiltration of mononuclear cells in the lamina propria of the intestine. This leads to dysfunction of small intestinal absorption and causes osmotic diarrhea.

　　可并发肺炎，表现出持续性发热、发热伴寒战、发热伴咳嗽、咯痰、胸痛、咳嗽、咳嗽伴胸痛、咳痰、脓痰、黏液脓性痰肺炎是由多种病源菌引起的肺充血，水肿，炎性细胞浸润和渗出性病变.临床上常见，可发生于任何的人群，临床表现主要有发热，咳嗽，咳痰，呼吸困难，肺部X线可见炎性浸润阴影。

　　What are the typical symptoms of adenovirus enteritis

　　How to prevent adenovirus enteritis

　　1. Pay attention to the combination of work and rest, and do not overwork; patients with fulminant, acute onset, and severe chronic types should rest in bed.

　　2. It is important to maintain a cheerful mood, avoid mental stimulation, and relieve various mental stresses. Attention should also be paid to clothing, maintaining appropriate temperatures; and appropriate physical exercise should be performed to enhance physical fitness.

　　3. Generally, soft, easily digestible, nutritious, and sufficiently caloric foods should be consumed. It is advisable to eat small meals frequently and supplement a variety of vitamins. Avoid eating raw, cold, greasy, and high-fiber foods; patients with chronic enteritis should avoid gas-producing foods. Due to the recurrent nature of this disease, ulcers and scarred fibers alternate in the colonic mucosa, resulting in reduced elasticity of the colonic wall. If too much of gas-producing foods such as soybeans, soy products, fried broad beans, sweet potatoes, etc. are consumed, it may lead to excessive intestinal gas and complications such as acute intestinal dilation or ulcer perforation.

　　One, Blood routine

　　The total and classified white blood cell count in peripheral blood is mostly normal, with a few elevated, and the proportion of lymphocytes increases.

　　Two, Fecal routine

　　Cultured feces microscopy mostly shows no special findings, with a few showing a small number of white blood cells, and no pathogenic bacteria grow in the culture.

　　Three, Specific diagnostic tests

　　1. Taking feces for direct or immunoelectron microscopy examination can detect rotavirus particles.

　　2. Detecting viral antigens in the supernatant of feces using enzyme-linked immunosorbent assay or immunoenzyme spot test (Immunoenzymedot test) has high sensitivity and specificity.

　　3. Extracting viral RNA from feces, performing polyacrylamide gel electrophoresis and silver staining, and checking for the presence of rotavirus RNA electrophoresis patterns has diagnostic value and can differentiate between infections by different types of viruses.

　　In general, soft, easy-to-digest, nutritious, and sufficient calorie foods should be eaten. It is recommended to eat small and frequent meals, and supplement a variety of vitamins. Do not eat raw, cold, greasy, and high-fiber foods; patients with chronic colitis should avoid gas-producing foods such as soy products and milk. Pay attention to food hygiene and avoid expired food.
　　Pay attention to avoid catching a cold, avoid staying up late, avoid too much emotional changes, have moderate exercise, and avoid excessive exercise.

　　1. The main treatment method is symptomatic treatment based on the treatment principles of acute diarrhea. For example, oral rehydration salts can be taken to correct dehydration. The formula is 3.5g of sodium chloride, 2.5g of sodium bicarbonate, 1.5g of potassium chloride, 20g of glucose, and 1000ml of boiling water. Take it in divided doses. Oral rehydration is suitable for mild to moderate dehydration, or for severe dehydration after intravenous fluid replacement, to maintain with oral rehydration. According to the condition, 1 to 3 groups can be used.

　　2. Severe dehydration patients need to be rehydrated immediately to maintain water and electrolyte balance and correct acidosis. Adult dosage: initially inject 1000ml of 5% glucose saline, or 500ml of 10% glucose solution and 500ml of 0.9% sodium chloride solution. The subsequent dosage should be determined according to the degree of dehydration, blood pressure, and pulse. After the blood pressure recovers, give a 3:2:1 solution (3 parts of 10% glucose, 2 parts of 0.9% sodium chloride, 1 part of 1.4% sodium bicarbonate solution) to the patient. After the patient has urine, add potassium chloride solution, the concentration should be within 3‰. The amount is between 500-1000ml.

　　3. For children patients, the total fluid intake in the first 24 hours of hospitalization is calculated according to the degree of dehydration per kilogram of body weight. Mild: 100-150ml, moderate: 150-200ml, severe: 200-250ml. If there is still no urine, add potassium, the concentration should be within 3‰. The composition of the fluid should be selected from the above fluids. For those with acidosis, 5% sodium bicarbonate solution is preferred, the dosage should be referred to the carbon dioxide binding power, or 5ml/kg, which can increase the carbon dioxide binding power by 10 volumes, or 4.49mmol/L. For those who cannot measure the carbon dioxide binding power in time, adults can be given 300ml of 5% sodium bicarbonate first, and then adjust the dosage according to the increase or decrease of the carbon dioxide binding power.