Clinical features of adenoviral conjunctivitis at the early stage of infection

Because adenoviral conjunctivitis is a contagious disease, prompt and accurate diagnosis in the early stage of infection is necessary to prevent epidemics. We evaluated and compared the clinical features of adenoviral conjunctivitis at the first medical examination with those of nonadenoviral follicular conjunctivitis. The clinical features of 102 patients with suspected adenoviral conjunctivitis at the first medical examination were retrospectively reviewed. Human adenovirus (HAdV) DNA in samples from the patients was detected by polymerase chain reaction, and HAdV DNA-positive and HAdV DNAnegative patients were respectively assigned to adenoviral and nonadenoviral follicular conjunctivitis groups. The two groups were compared for bilaterality, intrafamilial infection, multiple subepithelial corneal infiltrates (MSI), preauricular lymphadenopathy, and severity of conjunctivitis. Adenoviral conjunctivitis and nonadenoviral conjunctivitis were diagnosed in 68 and 34 patients, respectively. Bilaterality, intrafamilial infection, and MSI showed significant intergroup differences. Remarkably, MSI was observed in 42.6% of the patients in the early stage of infection. There were no significant intergroup differences in preauricular lymphadenopathy or severity of conjunctivitis at any stage. To accurately diagnose adenoviral conjunctivitis in the early stage, bilateral conjunctival conditions, history of intrafamilial infection, and MSI should be checked, even in cases of mild or moderate follicular conjunctivitis.