Novel human astroviruses (HAstVs) have recently been implicated as rare causes of fatal encephalitis in immunocompromised patients, for which there is no proven treatment. We report 2 cases from our institution in which HAstV-VA1 was detected in the cerebrospinal fluid by metagenomic next-generation sequencing after the initial evaluation revealed no etiology.

Immunocompromised patients can have life threatening adenoviral infection. Viral load in blood and stool are commonly used to guide antiviral therapy. We developed and evaluated a dPCR assay to quantify HAdV in the respiratory tract and showed that higher peak load correlates with disseminated infection, mechanical ventilation, and death.