Adenovirus Pneumonia Research Articles

Severe ARDS caused by adenovirus: early initiation of ECMO plus continuous renal replacement therapy.

The reported survival rates of patients with acute respiratory distress syndrome (ARDS) caused by human adenovirus (HAdV) pneumonia are poor. The results do not differ much in immunocompetent patients supported by extracorporeal membrane oxygenation (ECMO). We report two immunocompetent patients with severe ARDS complicating HAdV pneumonia who were treated successfully and survived to discharge. Compared with previous cases, our cases might have benefited from several factors. First, the time interval between mechanical ventilator support and ECMO implantation was shorter. Second, we implemented conservative fluid management as recommended by the ARDS network using continuous renal replacement therapy (CRRT). Third, we administered an antiviral agent as early as possible. A clinical trial of early ECMO with CRRT and the administration of cidofovir in patients with severe ARDS complicating HAdV pneumonia are needed to confirm our results.

A Rare Case of Adenovirus Pneumonia Resulting in Severe ARDS in an Immunocompetent Adult

SESSION TITLE: Student/Resident Case Report Poster - Critical Care IV SESSION TYPE: Student/Resident Case Report Poster PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM INTRODUCTION: Adenovirus is a common cause of respiratory tract infections in pediatric and adult patients and typically manifests as a variant of the common cold. Severe illness secondary to adenovirus infection in immunocompetent adults is rare. We present a case of severe acute respiratory distress syndrome (ARDS) secondary to adenovirus pneumonia in an immunocompetent adult that progressed to shock, multisystem organ failure, and death. CASE PRESENTATION: A 66-year-old male with chronic obstructive pulmonary disease was admitted with several days of dyspnea. On admission, he was febrile to 39.4oC, tachycardic to 140 beats/minute, tachypneic to 44 breaths/minute, and hypoxemic with an oxygen saturation of 86% on ambient air. Chest radiography demonstrated bilateral opacities concerning for multi-focal pneumonia. He was empirically treated with vancomycin, piperacillin-tazobactam, and oseltamivir, and initiated on non-invasive positive pressure ventilation for respiratory support. Because of a rapidly increasing oxygen requirement, he was intubated and mechanically ventilated within 24 hours of admission. A respiratory viral panel was positive for adenovirus type B/E, and culture of a bronchoalveolar lavage specimen was negative for bacteria. Quantitative PCR of the serum showed a viral load greater than 560,000 copies/ml. He experienced progressive ARDS and was managed with lung protective ventilation, deep sedation, paralysis, prone positioning, and inhaled epoprostenol. Based on a rapidly deteriorating clinical course, cidofovir was administered. Despite this, he developed progressive distributive shock requiring vasopressor support and acute kidney injury requiring continuous renal replacement therapy. On hospital day 11, he experienced a cardiac arrest and subsequently expired after withdrawal of aggressive care. DISCUSSION: Severe adenovirus infection is predominantly seen in immunocompromised hosts, such as neonates and transplant recipients. Epidemics of adenovirus in military recruits have been reported and temporarily prompted vaccination. The CDC reported an outbreak of adenovirus serotype 14 in three states in 2007 affecting 140 patients; 24 required ICU care, and 9 died. Although used to treat adenovirus in transplant recipients, the efficacy of cidofovir in immunocompetent adults is unknown. CONCLUSIONS: Adenovirus is a rare cause of pneumonia in immunocompetent adults but can be associated with life-threatening complications, including ARDS, multisystem organ failure, and death. Appreciation of the potential virulence of the pathogen, heightened vigilance in its diagnosis, and better therapeutics are essential to managing patients, particularly those requiring critical care. Reference #1: Dingle JH, Langmuir AD. Epidemiology of acute, respiratory disease in military recruits. Am Rev Respir Dis. 1968;97(6) Reference #2: CDC: MMWR: Acute Respiratory Disease Associated with Adenovirus Serotype 14 --- Four States. November 16, 2007 / 56(45); 1181-1184 DISCLOSURE: The following authors have nothing to disclose: Shaeesta Khan, Steven Keller, Nithya Sritharan, Brad Butcher No Product/Research Disclosure Information

A Fatal Case of ARDS From Adenovirus Pneumonia

A Fatal Case of ARDS From Adenovirus Pneumonia

Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia.

The predictors for fatal adenovirus (AdV) pneumonia among immunocompetent adults are unclear. Laboratory-confirmed, hospitalized AdV pneumonia adults were prospectively enrolled in Beijing Chao-Yang hospital from March to June 2013. Clinical data and serial whole blood and respiratory tract secretions from such patients were collected. Quantitative real-time polymerase chain reaction was performed to quantify the viral load. A total of 14 AdV pneumonia cases were consecutively enrolled, and four of them were fatal. Ten cases were caused by AdV-55, three by AdV-7 and one by AdV-3. There were no differences in age, gender or underlying diseases between the patients in the fatal cases and surviving cases. At admission (on day 5–7 after illness onset), the patients in fatal cases presented higher initial viral loads in respiratory tract secretions (8.578 ± 2.115 vs 6.263 ± 1.225 Log10 copies/ml, p = 0.023). All patients in fatal cases presented with viremia on day 12–14 (100% vs 66.7%, p = 0.017). A higher initial viral load in the respiratory tract and sustained viremia (more than 2 weeks) may be predictors for fatal clinical outcomes.

Clinical characteristics and factors predicting respiratory failure in adenovirus pneumonia.

Background and objectiveLimited data exist regarding factors predicting respiratory failure (RF) in non‐immunocompromised patients with adenovirus (AdV) pneumonia.MethodsWe described characteristics of AdV pneumonia (n = 91) versus non‐AdV pneumonia (n = 55) and compared clinico‐laboratory and radiological characteristics in patient groups categorized by RF.ResultsAll 91 AdV pneumonia patients presented with acute respiratory symptoms and radiological infiltrations and had significantly lower levels of white blood cell counts and platelet counts compared with non‐AdV pneumonia. Of them, 67 patients had mild pneumonia without RF (non‐RF), 14 patients had no RF at admission but progressed to RF during hospitalization (progressed to RF) and 10 patients had RF at admission (initial RF). Initial monocyte percentage and absolute monocyte counts in RF patient groups (progressed to RF and initial RF) were significantly lower than those of non‐RF patients (both P < 0.001), and the differences among progressed to RF and initial RF patients were not significant. Chest computed tomography findings such as dominant pattern or distribution, clinical symptoms, and bacterial or viral co‐infections other than AdV were not discriminable between patients who had RF and those who did not. On univariate analysis, initial monocytopenia, multilobar infiltrations and pleural effusion were associated with RF. However, on multivariable analysis, only initial monocytopenia remained significant (P = 0.004) for predicting RF.ConclusionOur data suggest that initial monocytopenia may help to predict RF during the course of AdV pneumonia in non‐immunocompromised patients.

Severe adenovirus community-acquired pneumonia in immunocompetent adults: chest radiographic and CT findings.

Severe adenovirus pneumonia and its associated imaging features are well-described in immunocompromised patients but are rare and poorly understood in immunocompetent adults. We sought to describe the radiographic and CT findings of severe adenovirus community-acquired pneumonia (CAP) in eight immunocompetent adults. We reviewed systematically chest imaging manifestations of laboratory-confirmed severe adenovirus pneumonia in eight immunocompetent adults from April 2012 to April 2014. All patients showed abnormal results on initial chest radiograph and CT, with the exception of one normal initial chest radiograph. The abnormalities of the initial chest radiographs were unilateral (n=4) or bilateral (n=3), including consolidation (n=4), dense patchy opacity (n=3), ground glass opacity (GGO) (n=1), and pleural effusion (n=1). The initial CT findings consisted of unilateral (n=5) and bilateral (n=3) abnormalities, including consolidation (n=8), GGO (n=2), pleural effusion (n=3) and small nodules (n=1). Focal consolidation was the predominant finding in six patients whose initial CT scans were examined within one week after illness onset. Follow-up radiologic findings showed rapid development of bilateral consolidation within ten days after illness onset, usually accompanied by adjacent ground-glass opacity and pleural effusion. The parenchymal abnormalities began to absorb around two weeks after illness onset, with no appearances of fibrosis. Severe adenovirus CAP in immunocompetent adults mainly appears as focal consolidation followed by rapid progression to bilateral consolidation, usually accompanied by adjacent GGO and pleural effusion, which may resemble bacterial pneumonia. Adenovirus should be considered in severe pneumonia cases with negative cultures and failure to respond to antibiotics.

Hematopoietic stem cell transplantation in patients with Fanconi anemia: the experience of the Russian Children's Clinical Hospital and the Dmitry Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology

Background . Fanconi anemia (FA) – rare syndrome characterized by congenital malformations, high risk of bone marrow failure and oncological diseases. Hematopoietic stem cell transplantation (HSCT) – is the only way of correction of hematopoietic insufficiency, but standard very intensive regimens of conditioning are highly toxic for patients with FA. Patients and methods. During the period from November 1994 to April 2014 transplantations were performed for 29 patients with FA (18 females/11 males, age median – 9.5 years, variation – 3.7–15.4). Indication for HSCT was the transfusion-dependent aplastic anemia at 27 patients and transformation to myelodysplastic syndrome/acute myeloid leukemia at 2 patients. At 17 (58.6 %) patients HLA-matched family donor were used, 12 (41.4 %) patients received unrelated graft. Source: bone marrow (BM) – 18 patients, peripheral blood stem cells – 7 patients, BM + umbilical cord blood (UCB) – 3 patients, UCB – 1 patient. One of the related HSCT was performed from 9/10 donor and 2 unrelated HSCT were from 9/10 donor too. Conditioning regimens: busulphan 4–8 mg/kg, cyclophosphamide – 20–40 mg/kg, fludarabine 150 mg/sq.m., anti-thymocyte globulin. “Graft versus host” disease (GvHD) prophylaxis: cyclosporine A/tacrolimus, methotrexate 5 mg/sq.m. (days +1, +3, +6, +11) /+/– mycophenolate mofetil. Three recipients of unrelated HSCT received TCRα/β grafts. Results . All patients engrafted. Secondary graft failure diagnosed at 4 (13.8 %) patients – after 1, 2, 6 and 12 months from HSCT. All these patients received second HSCT with conditioning with alemtuzumab, thoracoabdominal irradiation and fludarabine. Two patients died after the second HSCT, causes: GvHD and adenovirus pneumonia. Eighteen patients were free from GvHD, acute GvHD I–II gr. was revealed at 7 (24.1 %) patients, III–IV gr. – at 4 (13,7 %) patients. Limited chronic GvHD was observed at 4 patients, extensive – at 2 patients. Followup median is 31.9 (3.8–246) months. Overall 5 years survival was 67.4 %. Two patients suffered from oropharyngeal squamous cell cancer. Ten patients died in total – 10 from GvHD and one from the cancer. Conclusion. HSCT with attenuated high immunosuppressive regimens of conditioning can obtain transplant engraftment with minimal visceral toxicity at patients with FA. Frequency of GvHD and infection complications remains high. Non-hematopoietic cancers are the cause of late mortality.

Pneumonia Caused by Adenovirus Genotype 55 in an Army Recruit Training Center

Adenoviral pneumonia is rare in healthy adults. However, several cases were recently reported in a military training center in South Korea. Adenovirus genotype 3, 6, and 7 are predominant in South Korea. More recently, genotype 55, which emerged sporadically in China, has been reported in South Korea. In this study, we present a case of adenoviral pneumonia caused by genotype 55 in a healthy soldier from an army recruit training center in South Korea. Keywords: Adenoviridae; Pneumonia; Military personnel 중심 단어: ì•„ë°ë ¸ë°”ì´ëŸ¬ìŠ¤; íë ´; 군인

Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients.

ObjectiveTo describe radiologic findings of adenovirus pneumonia and to understand clinico-radiological features associated with progression to acute respiratory distress syndrome (ARDS) in patients with adenovirus pneumonia.Materials and MethodsThis study included 19 patients diagnosed with adenovirus pneumonia at a tertiary referral center, in the period between March 2003 and April 2015. Clinical findings were reviewed, and two radiologists assessed imaging findings by consensus. Chi-square, Fisher's exact, and Student's t tests were used for comparing patients with and without subsequent development of ARDS.ResultsOf 19 patients, nine were immunocompromised, and 10 were immunocompetent. Twelve patients (63%) progressed to ARDS, six of whom (32%) eventually died from the disease. The average time for progression to ARDS from symptom onset was 9.6 days. Initial chest radiographic findings were normal (n = 2), focal opacity (n = 9), or multifocal or diffuse opacity (n = 8). Computed tomography (CT) findings included bilateral (n = 17) or unilateral (n = 2) ground-glass opacity with consolidation (n = 14) or pleural effusion (n = 11). Patients having subsequent ARDS had a higher probability of pleural effusion and a higher total CT extent compared with the non-ARDS group (p = 0.010 and 0.007, respectively). However, there were no significant differences in clinical variables such as patient age and premorbid condition.ConclusionAdenovirus pneumonia demonstrates high rates of ARDS and mortality, regardless of patient age and premorbid conditions, in the tertiary care setting. Large disease extent and presence of pleural effusion on CT are factors suggestive of progression to ARDS.

Fatal pneumonia cases caused by human adenovirus 55 in immunocompetent adults

Background: Adenovirus is a frequent cause of mild self-limiting upper respiratory tract infection, gastroenteritis, and conjunctivitis. Severe or fatal infection mostly occurs in newborn, elderly or immunocompromised persons. Methods: Fatal adenovirus pneumonia in three immunocompetent adults was identified. The clinical data and virological findings were reported from patients. Additional review of recently recorded fatal patients with adenovirus infection was carried out. Results: The patients presented with sudden onset respiratory distress that progressed rapidly to respiratory failure and death. Human adenovirus (HAdV)-55 was detected in both nasopharyngeal aspirates and serum samples in all three cases, and moreover detected in lung, liver, and kidney in one case. In another case, remarkably elevated aspartate aminotransferase, alanine transaminase, and lactate dehydrogenase were identified. Three HAdV-55 strains were isolated and genome sequencing revealed a high similarity with other strains from mild infection. Conclusions: Fatal infection with HAdv-55 might occur in otherwise healthy adults. Diagnosis of adenovirus infection should be considered in patients with severe pneumonia yielding negative bacterial culture and presenting no response to antibiotic therapy.

Outcomes of early administration of cidofovir in non-immunocompromised patients with severe adenovirus pneumonia.

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.

Viral etiology of community-acquired pneumonia among adolescents and adults with mild or moderate severity and its relation to age and severity.

BackgroundBetter knowledge of distribution of respiratory viruses (RVs) in adolescents and adults with community-acquired pneumonia (CAP) is needed.MethodsTo investigate the RVs etiology among adolescents and adults with CAP, according to age and pneumonia severity index (PSI), a multi-center, prospective study was conducted from November 2010 to April 2012. Fifteen RVs were tested by polymerase chain reaction (PCR). Bacteria were detected by urinary antigen, conventional culture and PCR.ResultsMean (SD) age and median (IQR) PSI score of 954 patients enrolled was 45.2 (19.5) years (range 14–94) and 42 (36). RVs were found in 262 patients (27.5%): influenza virus A (IFV A, 9.9%) comprised of pandemic H1N1 (6.7%) and seasonal H3N2 (3.5%), human rhinovirus (4.3%), adenovirus (4.2%), human metapneumovirus (1.8%), parainfluenza virus 1, 3 and 2 (1.7%, 1.5% and 1.2%). Influenza virus B, enterovirus, respiratory syncytial virus, human coronavirus and parainfluenza virus 4 were rarely detected (<1%). Frequency of IFV A was highest among patients aged between 45–64 years (p < 0.001), while adenovirus among patients aged 14–17 years (p < 0.001), no differences was found in other RVs. The proportion of pandemic H1N1 increased with severity of pneumonia evaluated by PSI (P < 0.05).ConclusionsThe proportion of RVs in CAP is higher than previously reported. IFV A pneumonia are usually found in patients older than 45 years, while, adenovirus pneumonia are common in adolescents and young adults. Pandemic H1N1 virus is still recognized by PSI as a high-severity pathogen. The findings contribute baseline data on viral CAP study in China.

Successful Treatment in Fatal Adenovirus Pneumonia with the Use of Extracorporeal Membrane Oxygenation

Severe adenovirus pneumonia that causes acute respiratory failure can occur in infants, children, and immunocompromised patients. However, severe adenovirus pneumonia is rare in adults with a normal immune system. Adenovirus pneumonia may progress to acute respiratory failure in a few hours or a few days, and its clinical course cannot be predicted. In addition, the mortality rate is very high (range, 50% to 66%). However, the optimal treatment of adenovirus pneumonia has not been established. Herein, we report the successful treatment of acute respiratory failure due to adenovirus pneumonia with extracorporeal membrane oxygenation.

Emergence of Community-Acquired Adenovirus Type 55 as a Cause of Community-Onset Pneumonia

BackgroundSince 2008, severe cases of emerging human adenovirus (HAdV) type 55 (HAdV-55) were reported sporadically in China. But no comparative studies had been conducted to discern the differences in epidemiologic and clinical abnormalities between HAdV-55 and other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C).MethodsA multicenter surveillance study for adult and adolescent community-acquired pneumonia (CAP) was conducted prospectively in Beijing and Yan Tai between November 2010 and April 2012. A standardized data form was used to record clinical information. The viral DNA extracted from the clinical samples or adenovirus viral isolates was sequenced.ResultsAmong 969 cases, 48 (5%) were identified as adenovirus pneumonia. Six branches were clustered: HAdV-55 in 21, HAdV-7 in 11, HAdV-3 in nine, HAdV-14 in four, HAdV-50 in two, and HAdV-C in one. Most HAdV-55 cases were identified during February and March. All the hypervariable regions of the hexon genes of the 21 HAdV-55 strains were completely identical. Patients who had HAdV-55 were about 10 years older (P = .027) and had higher pneumonia severity index scores (P = .030) compared with those with other types (HAdV-7, HAdV-3, HAdV-14, HAdV-50, and HAdV-C). Systemic BP was also higher among patients in the HAdV-55 group (P = .006). Unilateral or bilateral consolidations were the most common radiologic findings in both patients with HAdV-55 and those with other types (57.9% vs 36%). More than one-half of the patients were admitted to hospital; oxygen therapy was given to 29.2% of the 48 patients, and two needed mechanical ventilation.ConclusionsHAdV-55 has established itself as a major pneumonia pathogen in the Chinese population, and further surveillance and monitoring of this agent as a cause of CAP is warranted.

Adenovirus Pneumonia Presenting with Nodular Shadows on Chest X-ray in Two Unrelated Allogeneic Bone Marrow Transplant Recipients

Adenoviruses are increasingly recognized as important pathogens following allogeneic stem cell transplantation. We herein report two cases of disseminated adenovirus infection that presented with nodular shadows on chest X-ray after allogeneic bone marrow transplantation from unrelated donors. Both patients died of respiratory failure. Autopsies revealed adenovirus infection of multiple organs. Adenovirus infection should be suspected when nodular lung lesions of unknown origin appear in allogeneic stem cell transplant recipients.

Favorable Outcome Of Hematopoietic Stem Cell Transplantation Using a Targeted Once-Daily IV Busulfan Fludarabine Etoposide Regimen In Pediatric and Infant ALL Patients

Conditioning regimens for pediatric acute lymphoblastic leukemia (ALL) usually include total body irradiation (TBI), but TBI may result in serious sequelae such as growth impairment, endocrinologic and metabolic problem, and secondary malignancies. Busulfan based conditioning regimen with cyclophosphamide has been used as an alternative to TBI based regimen in many diseases including pediatric ALL. Etoposide has been widely used in hematopoietic stem cell transplantation (HSCT) for lymphoid and myeloid malignancy because of its anti-leukemic effect, and a conditioning regimen containing busulfan, cyclophosphamide and etoposide (BuCyVP) was used in many studies including pediatric patients. But, toxicities have been reported in some studies using BuCyVP regimen. Recently, a reduced toxicity myeloablative regimen using busulfan and fludarabine showed promising results. Also, therapeutic drug monitoring (TDM) and administration of targeted dose of busulfan has been recommended to improve the outcome of HSCT. In this study, we evaluated the outcome of HSCT using a targeted once-daily intravenous (IV) busulfan fludarabine etoposide (BuFluVP) regimen in pediatric and infant ALL. The conditioning regimen was composed of busulfan, fludarabine (40 mg/m2 once daily i.v. on days -8 ∼ -3) and etoposide (20 mg/kg once daily i.v. on days -4 ∼ -2). Busulfan (≥ 1 year-120 mg/m2 and &lt; 1 year-80 mg/m2) was administered once daily as the first dose on day -8, and targeted dose of busulfan was used according to the TDM results on day -7 ∼ -5. A total of 33 patients were evaluated. Donor-type neutrophil engraftment was achieved in all patients. Veno-occlusive disease occurred in 5 (15.2%) patients, but all of them were successfully treated. Grade II-IV acute GVHD developed in 11 patients (grade 2 in 9 patients, grade 3 in 1 and grade 4 in 1 patient) and the cumulative incidence was 33.6%. Chronic GVHD developed in 3 patients (2 extensive and 1 limited). Three patients died of treatment-related mortality (TRM) and the cumulative incidence was 9.1%. The causes of TRM were adenoviral pneumonia in 1, respiratory syncytial viral (RSV) pneumonia in 1 and interstitial lung disease in 1 patient. Relapse occurred in 3 patients and cumulative incidence was 9.1%. Overall survival (OS) and event free survival (EFS) of all patients were 84.9% and 81.8%, respectively. EFS showed no difference according to the type of HSCT (77.8% in related BMT/PBSCT, 82.4% in unrelated BMT/PBSCT, and 85.7% in CBT, P=0.95). Eleven patients (33.3%) were infants at diagnosis, and OS of these patients was 81.8%. Our study demonstrated that HSCT using a targeted once-daily IV BuFluVP regimen showed favorable outcome and could be one option for HSCT in pediatric and infant ALL. Disclosures: No relevant conflicts of interest to declare.

Successful Treatment of Severe Adenovirus Pneumonia With Cidofovir in a Lung Transplant Recipient

Successful Treatment of Severe Adenovirus Pneumonia With Cidofovir in a Lung Transplant Recipient

Severe adenovirus pneumonia requiring extracorporeal membrane oxygenation support – Serotype 7 revisited

Adenovirus causing severe fatal pneumonia has been well described in infants, children, and patients with immunocompromised function, but reports in previously healthy adults are rare. We report 3 cases of severe adenovirus pneumonia in whom conventional mechanical ventilation failed and required extracorporeal membrane oxygenation support. Retrospective case records review of 3 patients admitted to the medical intensive care unit, Singapore General Hospital, a tertiary care university-affiliated hospital, with severe adenovirus pneumonia requiring extracorporeal membrane oxygenation support from February to March 2013. All 3 patients were previously healthy immunocompetent adults from the community with negative HIV serology. Duration prior to development of respiratory failure requiring intubation and invasive mechanical ventilation was 2, 8 and 3 days. Veno-venous extracorporeal membrane oxygenation (ECMO) support as rescue ventilation was instituted in all 3 patients after 2, 16, and 5 days of conventional mechanical ventilator support. Duration on ECMO support was 16, 22, and 9 days and mechanical ventilation was 18, 62, and 19 days respectively. Length of stay in intensive care unit was 18, 68, and 21 days, and length of stay in hospital was 20, 70, and 31 days respectively. Two of the 3 patients died. The mainstay of treatment for patients with severe adenovirus pneumonia is still supportive, with the use of antivirals not apparently effective. Whilst ECMO support for rescue ventilation may be considered, the outcomes do not appear as promising as other viral pneumonias, mirroring that previously described in the paediatric population.

Fatal Adenovirus Pneumonia in an Adult Lung Transplantation Recipient: a Case Report and Review of Literature

Adenovirus pneumonia has been reported in pediatric lung transplantation recipients, but is rare in adults. Adenovirus infection in adult lung transplant cases are often associated with disseminated disease, significant graft dysfunction, and high mortality. Here, we report a rare autopsy-proven case of bilateral adenovirus necrotizing pneumonia in an adult after bilateral lung transplantation. This …

Adenovirus pneumonia during induction therapy for childhood acute lymphoblastic leukemia

Pediatric Blood & CancerVolume 60, Issue 8 p. 1390-1391 Letter to the Editor Adenovirus pneumonia during induction therapy for childhood acute lymphoblastic leukemia Désirée Caselli MD, Corresponding Author Désirée Caselli MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, Italy Correspondence to: Désirée Caselli, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, Itlay. E-mail: [email protected]Search for more papers by this authorAnnalisa Tondo MD, Annalisa Tondo MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorFabio Tucci MD, Fabio Tucci MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorTommaso Casini MD, Tommaso Casini MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorOlivia Paolicchi MD, Olivia Paolicchi MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorSara Savelli MD, Sara Savelli MD Department of Radiology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorMaurizio Aricò MD, Maurizio Aricò MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this author Désirée Caselli MD, Corresponding Author Désirée Caselli MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, Italy Correspondence to: Désirée Caselli, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, Itlay. E-mail: [email protected]Search for more papers by this authorAnnalisa Tondo MD, Annalisa Tondo MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorFabio Tucci MD, Fabio Tucci MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorTommaso Casini MD, Tommaso Casini MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorOlivia Paolicchi MD, Olivia Paolicchi MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorSara Savelli MD, Sara Savelli MD Department of Radiology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this authorMaurizio Aricò MD, Maurizio Aricò MD Department of Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Meyer Children Hospital, Firenze, ItalySearch for more papers by this author First published: 29 April 2013 https://doi.org/10.1002/pbc.24550Citations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume60, Issue8August 2013Pages 1390-1391 RelatedInformation