Use of polymerase chain reaction for diagnosis of disseminated adenovirus infection

Abstract

We report a fatal case of disseminated adenovirus infection with fulminant hepatic failure in an 8-month-old child after peripheral blood stem cell transplantation. The virus was identified in blood, urine, respiratory aspirate and stool samples and was typed as adenovirus type 2 through PCR and sequencing of part of the hexon gene, with the use of degenerated consensus primers.

Monitoring of Adenovirus Infection in Pediatric Transplant Recipients by Quantitative PCR: Report of Six Cases and Review of the Literature

“…Introduction of PCR techniques has improved the chance of AdV detection and early diagnosis of putative AdV‐associated disease (14,15,17,21,22). PCR techniques are reproducible and sensitive diagnostic tools providing reliable results and high detection rates.…”

“…PCR techniques are reproducible and sensitive diagnostic tools providing reliable results and high detection rates. AdV‐PCR appears to be superior to direct ADV isolation from organs or body fluids in early diagnosis of AdV infection after transplantation (2,4,7,12–17,21,22). However, similar to positive cultures for AdV, positive AdV‐PCR might also represent latent infection or sub‐clinical reactivation.…”

“…It has also been shown that AdV‐PCR from blood may be positive prior to the development of symptomatic disease. Intervals of 8–21 days have been described between first positive AdV‐PCR and clinically overt AdV infection in pediatric transplant recipients (7,15,17,22,23). Some authors, presenting data on AdV‐PCR and infection in adult transplant recipients, even suggest that positive qualitative AdV‐PCR from blood alone predicts systemic viral infection and sepsis (15).…”

“…Recent studies have demonstrated that quantitative real‐time PCR assays allow sensitive and quantitative detection of all currently known AdV serotypes and might therefore serve as a useful additional diagnostic tool in the interpretation of positive AdV‐PCR results (14,17,22,23). These assays do not only determine viral load at the time of first detection of AdV, but also allow serial monitoring of changes in viral load in AdV‐positive patients.…”

Emerging Infections: Adenovirus Infections in Transplant Recipients

“…Because the transactivating region of the E1A gene and the N-terminal region of the hexon gene are well conserved between serotypes [60,61], traditional and quantitative real-time PCR techniques have been developed for diagnosis [10,[62][63][64][65][66][67][68]. Although false-negative results have been reported [69], these molecular methods have improved sensitivity over traditional methods [62,[70][71][72][73][74].…”