Acute respiratory distress syndrome in adenovirus type 4 pneumonia: A case report

Narra, Ramakrishna; Bono, Patrizia; Zoccoli, Antonella; Orlandi, Alessia; Piconi, Stefania; Grasselli, Giacomo; Crotti, Stefania; Girello, Alessia; Piralla, Antonio; Baldanti, Fausto; Lunghi, G.

doi:10.1016/j.jcv.2016.06.005

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…On the basis of the severity of the clinical presentation of some cases in this study, the HAdV-4 vaccine currently licensed for military use should be considered a potentially valuable resource to prevent disease in susceptible populations living in closed communities, such as college settings, summer camps, and long-term care facilities. Our data and reports of cases of severe ARD associated with HAdV-4 infection in Italy and Singapore ( 38 , 39 ) suggest that the role of this HAdV type in the etiology of adult civilian ARD might have been underestimated in the absence of access to molecular (or other) typing resources. Further, in view of the results of this study and previous research documenting the contribution of HAdV infection to influenza-negative ILI ( 29 ), the inclusion of HAdV in differential diagnostic test panels would be invaluable to better assess the role of HAdVs as causative agents of severe respiratory illness and to prevent unnecessary treatment of patients with influenza-negative ILI with anti-influenza agents.…”

Section: Discussionmentioning

confidence: 52%

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–20151

Ae¹,

Lamson²,

Cr³

et al. 2018

Emerg. Infect. Dis.

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Human adenovirus type 4 (HAdV-4) is most commonly isolated in military settings. We conducted detailed molecular characterization on 36 HAdV-4 isolates recovered from civilian adults with acute respiratory disease (ARD) in the northeastern United States during 2011–2015. Specimens came from college students, residents of long-term care facilities or nursing homes, a cancer patient, and young adults without co-morbidities. HAdV-4 genome types 4a1 and 4a2, the variants most frequently detected among US military recruits in basic training before the restoration of vaccination protocols, were isolated in most cases. Two novel a-like variants were recovered from students enrolled at a college in Tompkins County, New York, USA, and a prototype-like variant distinguishable from the vaccine strain was isolated from an 18-year-old woman visiting a physician’s office in Ulster County, New York, USA, with symptoms of influenza-like illness. Our data suggest that HAdV-4 might be an underestimated causative agent of ARD among civilian adults.

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Section: Discussionmentioning

confidence: 52%

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–20151

Ae¹,

Lamson²,

Cr³

et al. 2018

Emerg. Infect. Dis.

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“…Also, when we pooled these two epidemics into analysis, we found that infection with genotype 7 was not statistically associated with pneumonia. HAdV4 caused an epidemic outbreak of acute respiratory disease (ARD) in military recruits in United States and may also result in severe pneumonia [28, 29]. HAdV1 was also reported to cause severe pneumonia in immunocompetent patients in French intensive care unit [30].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of clinical and epidemiological characteristics of major pediatric adenovirus epidemics in southern Taiwan

Shen

Wang

et al. 2019

BMC Infect Dis

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Background Human adenoviruses (HAdV) are important pathogens of pediatric respiratory tract infections in Taiwan. There were two major HAdV epidemics in southern Taiwan in 2011 and 2014, respectively. Methods The demographic, clinical characteristics, and risk factors for hospitalization of pediatric patients with HAdV infection in the two outbreaks were retrospectively compared. The epidemic was defined as > 7% HAdV detection rate for six consecutive weeks. HAdV infection was defined as positive HAdV isolates from respiratory tract specimens. HAdV genotype was determined by PCR-based hexon gene sequencing. Results A total of 1145 pediatric patients were identified (635 cases in 2011; 510 cases in 2014). HAdV genotype 3 and 7 contributed to both epidemics, although the proportion of HAdV3 decreased significantly (64.7% in 2011 to 25.5% in 2014, p < 0.001) and was replaced by other genotypes (type 1, 4, and 6) in the 2014 epidemic. Among the hospitalized patients, there were more patients hospitalized with bronchopneumonia/or pneumonia in the 2011 epidemic (10.6% vs 5.1%, p < 0.001), while more patients hospitalized with acute pharyngitis/pharyngoconjunctival fever (63.9% vs. 38.6%, p < 0.001) in the 2014 epidemic. In both epidemics, hospitalized patients had higher WBC and C-reactive protein (CRP) levels than non-hospitalized patients. Using multivariate regression analysis, underlying disease and elevated CRP levels were independent risk factors for hospitalization in both epidemics. Conclusion There were significant differences in clinical, viral characteristics and risk factors of hospitalization between the 2011 and 2014 epidemics. Understanding changes in the epidemiological and clinical characteristics of HAdV epidemics is important from a public health perspective.

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“…Literature review identified 15 cases of adenovirus pneumonia complicated by ARDS in adults. 8,[11][12][13][14][15][16] Detailed information for 18 cases including this report is presented in Table 1. In these cases, 5 used cidofovir and all showed 28-day survival, even though 2 died on HD 30 and HD 105, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] There are several case series showing the efficacy of cidofovir in adenovirus pneumonia but only 2 reports of patients treated with cidofovir for adenovirus pneumonia complicated by ARDS. 8,13 From January 2015 to August 2016, we experienced 3 cases of adenovirus pneumonia (2 immunocompetent and 1 immunocompromised) complicated by ARDS. All 3 patients were treated with cidofovir and respiratory support (ECMO in 2 patients).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation

Lee

Kim

Kwon

et al. 2016

J Intensive Care Med

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Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir. However, few reports discussed the efficacy of cidofovir in acute respiratory distress syndrome (ARDS). We experienced 3 cases of adenoviral pneumonia associated with ARDS and treated with cidofovir and respiratory support, including extracorporeal membrane oxygenation (ECMO). All 3 patients showed a positive clinical response to cidofovir and survival at 28 days. Cidofovir with early ECMO therapy may be a therapeutic option in adenoviral ARDS. A literature review identified 15 cases of adenovirus pneumonia associated with ARDS.

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Acute respiratory distress syndrome in adenovirus type 4 pneumonia: A case report

Cited by 16 publications

References 24 publications

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–20151

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–20151

Comparative study of clinical and epidemiological characteristics of major pediatric adenovirus epidemics in southern Taiwan

Treatment of Adenoviral Acute Respiratory Distress Syndrome Using Cidofovir With Extracorporeal Membrane Oxygenation

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