Pharyngoconjunctival Fever 

  • Author: Ingrid U Scott, MD, MPH; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 17, 2010
 

Background

Adenoviruses are the most common cause of acute viral infections of the conjunctiva, occurring epidemically or sporadically throughout all seasons. Clinically, 4 syndromes of adenoviral ocular infection have been recognized, as follows: epidemic keratoconjunctivitis, pharyngoconjunctival fever (PCF), nonspecific sporadic follicular conjunctivitis, and chronic papillary conjunctivitis.

This article focuses on PCF, an acute and highly infectious illness characterized by fever, pharyngitis, acute follicular conjunctivitis, and regional lymphoid hyperplasia with tender, enlarged preauricular adenopathy.

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Pathophysiology

The adenoviruses consist of a group of 35 morphologically similar but antigenically distinct DNA viruses that share a common complement-fixing antigen. Ubiquitous throughout the world, these extremely stable, ether-resistant organisms cause infections of the upper respiratory tract and the eye. 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.[1, 2, 3, 4]

Transmission occurs through contact with infected upper respiratory droplets or fomites, or through swimming pools, in which fecal excretion of the virus is believed to be responsible. Communicability ranges from 100% during the first few days to 0% by 10-15 days after the onset of symptoms. The incubation period after exposure is 5-12 days (average, 8 d).

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Epidemiology

Frequency

United States

Because PCF occurs epidemically and sporadically, the frequency is not known.

Mortality/Morbidity

Many cases are self-limited and mild, although chronic infections have been reported. Long-term ocular sequelae are rare.

Sex

PCF occurs equally in men and in women.

Age

Disease is seen predominantly in children and institutionalized individuals, with epidemics occurring within families, schools, prisons, ships, and military organizations.

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Contributor Information and Disclosures
Author

Ingrid U Scott, MD, MPH  Professor, Department of Ophthalmology and Public Health Sciences, Penn State College of Medicine

Ingrid U Scott, MD, MPH is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Macula Society, Phi Beta Kappa, and Retina Society

Disclosure: Nothing to disclose.

Specialty Editor Board

John D Sheppard Jr, MD, MMSc  Professor of Ophthalmology, Microbiology and Molecular Biology, Clinical Director, Thomas R Lee Center for Ocular Pharmacology, Ophthalmology Residency Research Program Director, Eastern Virginia Medical School; President, Virginia Eye Consultants

John D Sheppard Jr, MD, MMSc is a member of the following medical societies: American Academy of Ophthalmology, American Society for Microbiology, American Society of Cataract and Refractive Surgery, American Uveitis Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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