Fatal adenovirus infection associated with new genome type

Abstract

The first fatal case caused by the new genome type 7i is described in an 8-month-old boy requiring long-term respiratory support who developed Reye's syndrome, acute respiratory distress, and bronchiolitis obliterans with fatal evolution. Adenovirus was detected in nasopharyngeal secretions and was persistently positive during hospitalization. IgM and IgG adenovirus antibody titers measured in serum by enzyme-linked immunoassay (EIA) were 1:32 and 1:800, respectively. Serum interleukins (IL) and interferons (IFN) measured by EIA were as follows: IL-2, 110 pg/ml; IL-6, 300 pg/ml; IL-8, 7,000 pg/ml; TNF-alpha, 35 pg/ml, IL-1 and IL-4 undetectable, IFN-alpha 2,200 pg/ml, and IFN-gamma 700 pg/ml. Virologic studies showed that adenovirus isolated belonged to subgenus B, and digestion of viral DNA with Bam HI, Sma I, Bgl II, and Hind III identified the isolate as belonging to genome type 7i. Autopsy showed bronchiolitis obliterans with diffuse alveolar damage and perivenular fatty degeneration with polymorphonuclear infiltrates in the periportal spaces. The difficulty in obtaining adequate oxygenation with minimization of iatrogenic oxygen injury is discussed.

Rapid Typing of Human Adenoviruses by a General PCR Combined with Restriction Endonuclease Analysis

“…Candidate Ad strains of Ad50 and Ad51 (13) were kindly donated by J. C. deJong, Erasmus University, Rotterdam, The Netherlands. The genome variants Ad1D7, Ad1D10, Ad2D5, Ad2D6, Ad2D7, Ad2D25, Ad2D36, Ad2D63, and Ad5D38, classified by the system of Adrian et al (1), together with Ad7b, Ad7c, Ad7h, Ad7i, and Ad7j, were kindly donated by A. Kajon (22,23,30). Ad genome variants 3a, 3a 2 , 3c, and 3d (28), 4a, 4a 1 , 4b, 4p 1 , 4p 2 , and 4p 3 (26), and 11a, 11b, and 11c (27) were kindly donated by Q. G. Li, Umeå, Sweden.…”

“…However, the improved knowledge about the differences in virulence among the several types has increased the medical value of typing. Cases of severe acute respiratory illness and also febrile illness with cardiopulmonary failure in infants and young children have been described (9,30). These syndromes have frequently been associated with subgenus B Ads, preferentially genome variants of Ad type 7, with a high rate of mortality.…”

Molecular Identification of Adenoviruses in Clinical Samples by Analyzing a Partial Hexon Genomic Region

“…In our study, this disease is associated with serotypes 16 and 14 (species B1 and B2), and an indistinguishable member of the cluster 11, 34, and 35 (species B2). Fatal infections due to species B1, serotypes 3 and 7, have been reported (11,12,15). The fact that subgroups B1 and B2 use different cellular receptors for viral entry underscores the importance of typing HAdV for epidemiology and pathobiology (20).…”

Bronchiolitis, an update

“…Some of these adhesion molecules are selectively expressed in certain inflammatory conditions, and others seem to be associated with selective docking of infectious organisms [4,19,21,23,26,31,46]. Respirotropic viruses, for example, preferentially dock to ciliated and Clara cells, whereas bacteria preferentially dock to ciliated and secretary columnar cells [26,31,32,46]. Inorganic toxic substances show an order of susceptibility of ciliated > Clara > secretory cells [43,53].…”