2788. Case Report: Severe Community-Acquired Human Adenovirus 7 Infection in a Mother and Son

Abstract

BackgroundWe present the case of a 42-year-old male (Patient 1) with a history of morbid obesity and cirrhosis of unclear etiology who died of acute hypoxic respiratory failure and devastating encephalitis after community-acquired infection with human adenovirus 7 (HAdV7) in spite of antiviral treatment with Cidofovir. Patient 1’s course is outlined in Figure 1. During his stay, the patient’s mother (Patient 2) was also hospitalized in the same unit following a similar presentation with 10 days of flu-like symptoms that progressed to ARDS requiring intubation. Patient 2 recovered from her infection with no specific antiviral treatment.MethodsN/A.ResultsThese cases illustrate particularly fulminant presentations of HAdV7 infection and highlight the high pathogenicity of HAdV7 compared with other adenovirus subtypes. Severe lower respiratory tract HAdV7 infections have been reported most commonly as outbreaks of respiratory illness among military recruits and infants. A notable recent outbreak of HAdV-7d in New Jersey in 2016–2017 resulted in 12 confirmed cases with 4 deaths; however, all deaths occurred in patients with significant medical comorbidities.1 In a case particularly striking for its similarity to the one presented here, a healthy 44-year-old male along with his 68-year-old father were hospitalized with human adenovirus 7 days infection in Chicago in December 2014, with the son requiring ECMO for ARDS and the father briefly requiring ICU-level care.2ConclusionWhile our patient’s case is by no means unprecedented, it does represent an uncommon and potentially serious infection that points to need for continuing nosocomial testing efforts and deserves special attention in outbreak settings. In the future, perhaps use of the extant vaccine for human adenovirus serotypes 4 and 7 (currently licensed for military personnel3) could be expanded for use in civilian populations could be explored and potentially expanded for use in outbreak settings. Disclosures All authors: No reported disclosures.