Adenovirus pneumonia in an immunocompetent adult

Hijikata, Naoya; Takayanagi, Noboru; Sato, Shintaro; Harasawa, Keiji; Miyaoka, Keisuke; Asanuma, Kozo; Kawabata, Yoshinori

doi:10.1007/s10156-012-0367-x

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…Firstly, the study was not controlled with respect to the treatment administered because of its retrospective design. Although we obtained favorable outcomes, other factors may have influenced the outcomes in the study patients, such as the supportive treatment strategies, including ventilator settings and the prone position, or host factors, including young age and previous good health status, and moreover, self-limiting cases of severe AdV infection have been reported previously [9][10][11]16]. To date, no controlled study has been reported on the benefits of antiviral therapy in severe AdV pneumonia.…”

Section: Discussionmentioning

confidence: 76%

“…In contrast, in immunocompromised patients, AdV infection can be disseminated and result in a considerable mortality rate [2][3][4]. Despite the low incidence of serious illness in non-immunocompromised patients, Levin et al reported fatal AdV pneumonia in a previously healthy adult in 1967 [5], and sporadic cases of severe respiratory disease in non-immunocompromised adults have been reported [6][7][8][9][10][11] since. These reports include several outbreaks of AdV respiratory infections in previously healthy adults in vulnerable populations, such as residents of mental health care centers and military recruits [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Early Administration of Cidofovir in Non-Immunocompromised Patients with Severe Adenovirus Pneumonia

Kim

Park

et al. 2015

PLoS ONE

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The benefits of treatment with antiviral therapy for severe adenovirus (AdV) pneumonia are not well established. We described the clinical characteristics and treatment outcomes of early cidofovir treatment of severe AdV pneumonia in non-immunocompromised patients. We retrospectively reviewed the medical records of all patients diagnosed with severe AdV pneumonia between 2012 and 2014. A total of seven non-immunocompromised patients with severe AdV pneumonia were identified, and all isolates typed (n = 6) were human AdV-B55. All patients had progressive respiratory failure with lobar consolidation with or without patchy ground glass opacity. Three patients required vasopressors and mechanical ventilation. All patients had abnormal laboratory findings including: leukopenia, thrombocytopenia, or elevated liver enzymes. After admission, all patients received antiviral therapy with cidofovir, and the median time from admission to cidofovir administration was 48 h and median the time from onset of symptoms to cidofovir administration was 7.1 days. After cidofovir administration, complete symptomatic improvement occurred after a median of 12 days and radiographic resolution occurred after a median of 21 days. Consequently, all patients completely improved without complications. Our data suggest that early administration of cidofovir in the course of treatment for respiratory failure as a result of AdV pneumonia in non-immunocompromised patients could be a treatment strategy worth considering, especially in cases of HAdV-55 infection.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Outcomes of Early Administration of Cidofovir in Non-Immunocompromised Patients with Severe Adenovirus Pneumonia

Kim

Park

et al. 2015

PLoS ONE

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“…2 Furthermore, viruses in species B, C, and E are more commonly associated with symptomatic respiratory infections. 1,[3][4][5][6][7] Human adenovirus type 55 (HAdV55), a member of HAdV-B family, was first identified from a military outbreak in Spain in 1969. 8 This virus used to be recognized as HAdV-B11a by partial characterization of its hexon and fiber epitopes.…”

Section: Introductionmentioning

confidence: 99%

“…As of now, at least 68 HAdV genotypes have been identified and are classified into seven species (A‐G) . Furthermore, viruses in species B, C, and E are more commonly associated with symptomatic respiratory infections …”

Section: Introductionmentioning

confidence: 99%

A cluster of adenovirus type B55 infection in a neurosurgical inpatient department of a general hospital in Guangdong, China

Liu

Zou

et al. 2017

Influenza Resp Viruses

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BackgroundHuman adenovirus type 55 is a re‐emerging human respiratory pathogen that is associated with several respiratory infections outbreaks in military and school populations. In this study, we describe the first HAdV55‐associated hospital outbreak documented in Guangdong, China.MethodsActive surveillance was conducted in the involved neurosurgical inpatient department. All staff and patients in the involved neurosurgical department were surveyed for any symptoms of fever (≥38°C) and enlarged tonsils during the outbreak period. Throat swabs and demographic information were collected for all cases. For each specimen, assays for common respiratory viruses were performed using one‐step reverse transcription‐polymerase chain reaction. HAdV‐positive samples were inoculated onto Hep‐2 cells for isolation. Hexon genes, fiber genes, penton genes, and whole genomes were sequenced. A phylogenetic tree was constructed.Results and ConclusionsForty‐three cases, including 24 laboratory‐confirmed cases and 19 possible cases, were identified. Nurses had the highest attack rate of infection, with a rate of 36.4%. The attack rate for doctors and inpatients was 20.0% and 16.7%, respectively. HAdV55 was the sole pathogen identified during this outbreak. The hexon, fiber, and penton genes from seven isolated HAdV55 stains were sequenced. All these genes showed 100% homology and fell into the HAdV55 [P14H11F14] cluster, indicating that HAdV55 was the single viral strain for the outbreak. While not conclusive, the epidemic investigation revealed that the outbreak was introduced by nurses from sources outside the hospital. It was likely that a transmission from staff to inpatients had occurred.

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“…Although antiviral drugs were empirically used, whether antiviral drugs improve clinical outcomes in the context of RAI remains controversial. Most experts believed that no medicines have been proven effective to treat adenovirus infection [ 2 , 7 , 35 ]. However, few studies indicated that earlier initiation of treatment might be associated with favourable clinical outcomes in immunocompromised RAI patients [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Immune status affects the clinical features and outcomes of adult patients with respiratory adenovirus infection

et al. 2021

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The differences in the clinical features and outcomes of respiratory adenovirus infection (RAI) between immunocompetent and immunocompromised adult patients remain unclear. Thirty-nine adult RAI patients, including 28 (71.8%) immunocompetent patients and 11 (28.2%) immunocompromised patients were enrolled in this retrospective study. Demographic characteristics, symptoms, laboratory tests, radiographic findings, therapies and clinical outcomes were compared between the two groups. We found fever (94.9%), cough (66.7%) and sputum production (56.4%) were the most frequent symptoms. Compared with immunocompetent RAI patients, the immunocompromised RAI patients were more likely to experience anemia (g/L; 90.8 ± 24.0 vs 134.3 ± 14.6, P ＜ 0.001), thrombocytopenia (×10 9 /L; 116.9 ± 92.7 vs 178.4 ± 74.6, P = 0.037), hypoalbuminemia (g/L; 29.6 ± 5.5 vs 36.9 ± 5.2, P ＜ 0.001), hyponatremia (mmol/L; 134.8 ± 5.6 vs 138.5 ± 3.9, P = 0.026) and low levels of cholinesterase (U/L; 2650.5 ± 1467.4 vs 5892.8 ± 1875.1, P ＜ 0.001). Chest computed tomography (CT) scans indicated that lung infiltrate was the most common finding (64.1%).Immunocompromised patients had a higher likelihood of bilateral lung involvement (72.7%) and lower lobe involvement (81.8%) of both lungs. The hospitalized mortality rate was 27.3% in immunocompromised RAI patients, but no deaths

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Adenovirus pneumonia in an immunocompetent adult

Cited by 13 publications

References 17 publications

Outcomes of Early Administration of Cidofovir in Non-Immunocompromised Patients with Severe Adenovirus Pneumonia

Outcomes of Early Administration of Cidofovir in Non-Immunocompromised Patients with Severe Adenovirus Pneumonia

A cluster of adenovirus type B55 infection in a neurosurgical inpatient department of a general hospital in Guangdong, China

Immune status affects the clinical features and outcomes of adult patients with respiratory adenovirus infection

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