From Upper Respiratory Symptoms to Hemophagocytic Lymphohistiocytosis: Case Report of a Human Adenovirus Infection in Haploidentical Hematopoietic Stem Cell Transplant Recipient

Baptiste Demey,Clément Brault,Catherine Francois,Julien Maizel

doi:10.3390/pathogens10030340

Abstract

Human adenovirus infection is rare in adult population, except for in immunocompromised individuals. Recipients of allogenic haploidentical hematopoietic stem cell transplantation are reported at high risk for human adenovirus, which is often lethal when it evolves into the disseminated form. Despite existent guidelines, prevention, early diagnosis, and therapeutics remain challenging. Here, we report the case of a fatal evolution of human adenovirus respiratory infection and discuss the actual recommendations to prevent recurrence of this major issue.

Highlights

Human adenovirus (HAdV) is a rare infection in adult population but can be fatal for immunocompromised patients
HAdV disease leads to a 20–80% rate of death [2], and Taniguchi et al showed that up to 5.8% of haplo-hematopoietic stem cell transplantation (HSCT) recipients develop this lethal form of infection [3]
European Conference on Infections in Leukaemia (ECIL)-4 recommendations indicate that HAdV screening should be considered in high-risk allogenic HSCT patients, such as those receiving haploidentical and umbilical cord blood transplantation

Summary

Introduction

Human adenovirus (HAdV) is a rare infection in adult population but can be fatal for immunocompromised patients. Recipients of allogenic hematopoietic stem cell transplantation (HSCT), especially haploidentical (haplo-) HSCT, present higher risk of HAdV reactivation or primary infection, due to immunosuppressive regimens. HAdV disease leads to a 20–80% rate of death [2], and Taniguchi et al showed that up to 5.8% of haplo-HSCT recipients develop this lethal form of infection [3]. Recommendations concerning HAdV monitoring for high-risk patients were issued in 2012 by the European Conference on Infections in Leukaemia (ECIL)-4 group [4], with an update by the ECIL-8 group for community-acquired respiratory virus [5]. Syndromic approaches and the expansion of molecular analyses offer us new screening tools to prevent disseminated HAdV infections and define new recommendations

Case Presentation

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Discussion

Conclusions