Shu-Yan Zhang1, Yan-Ping Luo2, Dou-Dou Huang3, Hang Fan3, Qing-Bin Lu4, Ying Wo3, Gang Chen2, Xiao-Ai Zhang3, Yan Li5, Yi-Gang Tong3, Wu-Chun Cao3, Wei Liu3. 1. a From the Department of Clinical Laboratory , General Hospital of Beijing Military Region , Beijing , PR China. 2. b General Hospital of PLA , Beijing , PR China. 3. c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China. 4. d School of Public Health, Peking University , Beijing , PR China. 5. e PLA 307 Hospital , Beijing , PR China.
Abstract
BACKGROUND: Adenovirus is a frequent cause of mild self-limiting upper respiratory tract infection, gastroenteritis, and conjunctivitis. Severe or fatal infection mostly occurs in newborn, elderly or immunocompromised persons. METHODS: Fatal adenovirus pneumonia in three immunocompetent adults was identified. The clinical data and virological findings were reported from patients. Additional review of recently recorded fatal patients with adenovirus infection was carried out. RESULTS: The patients presented with sudden onset respiratory distress that progressed rapidly to respiratory failure and death. Human adenovirus (HAdV)-55 was detected in both nasopharyngeal aspirates and serum samples in all three cases, and moreover detected in lung, liver, and kidney in one case. In another case, remarkably elevated aspartate aminotransferase, alanine transaminase, and lactate dehydrogenase were identified. Three HAdV-55 strains were isolated and genome sequencing revealed a high similarity with other strains from mild infection. CONCLUSIONS: Fatal infection with HAdv-55 might occur in otherwise healthy adults. Diagnosis of adenovirus infection should be considered in patients with severe pneumonia yielding negative bacterial culture and presenting no response to antibiotic therapy.
BACKGROUND: Adenovirus is a frequent cause of mild self-limiting upper respiratory tract infection, gastroenteritis, and conjunctivitis. Severe or fatal infection mostly occurs in newborn, elderly or immunocompromised persons. METHODS: Fatal adenovirus pneumonia in three immunocompetent adults was identified. The clinical data and virological findings were reported from patients. Additional review of recently recorded fatal patients with adenovirus infection was carried out. RESULTS: The patients presented with sudden onset respiratory distress that progressed rapidly to respiratory failure and death. Human adenovirus (HAdV)-55 was detected in both nasopharyngeal aspirates and serum samples in all three cases, and moreover detected in lung, liver, and kidney in one case. In another case, remarkably elevated aspartate aminotransferase, alanine transaminase, and lactate dehydrogenase were identified. Three HAdV-55 strains were isolated and genome sequencing revealed a high similarity with other strains from mild infection. CONCLUSIONS: Fatal infection with HAdv-55 might occur in otherwise healthy adults. Diagnosis of adenovirus infection should be considered in patients with severe pneumonia yielding negative bacterial culture and presenting no response to antibiotic therapy.
Entities:
Keywords:
Human adenovirus; death; epidemiology; pneumonia; respiratory tract infection
Authors: Karoly Toth; Islam T M Hussein; Ann E Tollefson; Baoling Ying; Jacqueline F Spencer; Jessica Eagar; Scott H James; Mark N Prichard; William S M Wold; Terry L Bowlin Journal: Antimicrob Agents Chemother Date: 2020-10-20 Impact factor: 5.191
Authors: Jun Hang; Adriana E Kajon; Paul C F Graf; Irina Maljkovic Berry; Yu Yang; Mark A Sanborn; Christian K Fung; Anima Adhikari; Melinda S Balansay-Ames; Christopher A Myers; Leonard N Binn; Richard G Jarman; Robert A Kuschner; Natalie D Collins Journal: Emerg Infect Dis Date: 2020-07 Impact factor: 6.883