Annals of “Dunarea de Jos” University of Galati Fascicle I. Economics and Applied Informatics Years XXVIII – n o 2/2022 ISSN-L 1584-0409 ISSN-Online 2344-441X www.eia.feaa.ugal.ro DOI https://doi.org/10.35219/eai15840409280 The Management of Adenovirus Infection in the Children’s Hospital from Galati Elena-Roxana MATACHE  , Daniela ONISOR  , Lucian PEPTINE  , Larisa GOROFTEI  , Diana-Andreea CIORTEA  ARTICLE INFO ABSTRACT Article history: Accepted September 2022 Available online September 2022 Adenoviruses represents one of the primary pathogens responsible for children hospitalization. The aim of this study was to analize the incidence, clinical and laboratory characteristics in pediatric patients infected with adenovirus. It was conducted a retrospective study on a number of 117 patients, ages between 0-16 years, having clinical signs of gastroenteritis, admitted to the Emergency Clinical Hospital for Children “Sf. Ioan” from Galati, between January and November 2022. The clinical history, socio-demographic characteristics, physical examination findings and laboratory investigations were recorded. Stool samples were collected from children on presentation to the hospital before starting therapy. From the total of 1602 patients investigated for adenovirus infection, 117 were positive (7%). The season with the most cases recorded was autumn (11.13%). The most affected age group was 1-3 years (45,29%). Admission symptoms were diverse, vomiting (34%) and diarrheal stools (26%) being the most commonly seen in positive patients. Laboratory tests revealed an elevated CRP (46,15%), leukocytosis (17,09 %) and hydroelectrolytic imbalances: low sodium (36,75%) and an elevated potassium (6,83%). In 35% of cases, coinfections were found. Adenoviruses detection rate is correlated to season and age, in our study being risen mostly in autumn and in pediatric patients between 1 to 3 years. The predominant symptoms at admission were digestive. Our study reveales that adenoviruses can be one of the main causes for viral gastrointestinal infections in children. The management of adenovirus infection focuses on the treatment of dehydration, diet, probiotics and symptomatic drugs, although the use of anti-emetics can be indicated in some cases. © 2022 EAI. All rights reserved. JEL Classification A39, I19 Keywords: adenovirus, children, health management, immunochromatographic method, gastroenteritis 1. Introduction Lower respiratory tract infections (LRTIs) are one of the leading causes of hospitalization and mortality among young children worldwide (1). In the pediatric patient, most LRTIs are the result of viruses such as: adenovirus, respiratory syncytial virus (RSV), severe acute respiratory syndrome (SARS), coronavirus, (RSV), human metapneumovirus, influenza A and B and bocavirus (2). Human adenoviruses (HAdVs) are doubled-stranded DNA viruses that spread by close personal contact, respiratory droplets, direct conjunctival inoculation, fecal oral route, or contact with infected tissues or surfaces and are responsible for a wide range of clinical syndromes including upper respiratory tract infection, pneumonia, nephritis, hemorrhagic cystitis, hepatitis, and enteritis. (3). Also, in Europe and the United States, have been associated with adenovirus infection recent cases of hepatitis outbreaks, including severe liver failure in children. In most of these cases, adenovirus infection causes mild disease, but in some cases, infection is severe enough to cause death. Because adenovirus infection does not fully explain the more severe cases, investigations are still ongoing given (4). HAdV were first isolated in 1953 as respiratory pathogens [5] and to date, over 60 types of HAdV have been identified and classified into seven species (A to G) [6]. Cases of severe infection, outbreaks in closed populations, and even epidemic outbreaks have been associated with the newly emerging or re- emergent types or variants [7]. Very interestingly, different types of HAdV display various tissue tropisms that correlate with different clinical manifestations of infection and HAdV infections of the respiratory tract are predominantly caused by HAdV-B (including subspecies B1 and B2), HAdV-C, or HAdV-E. Also, the predominant types vary among different countries and regions, and they change over time because transmission of novel strains between countries or across continents may occur [8].  ,  ,  Dunarea de Jos University of Galati, Romania, Emergency Clinical Hospital for Children, "St. Ioan", Galati, Romania,  Dunarea de Jos University of Galati, Romania,  Emergency Clinical Hospital for Children, "St. Ioan", Galati, Romania. E-mail address: danielaghimpu76@yahoo.com (D. Onisor – Corresponding author).