American Journal of Epidemiology and Infectious Disease
ISSN (Print): 2333-116X ISSN (Online): 2333-1275 Website: Editor-in-chief: John Opuda-Asibo
Open Access
Journal Browser
American Journal of Epidemiology and Infectious Disease. 2016, 4(1), 14-17
DOI: 10.12691/ajeid-4-1-3
Open AccessCase Report

Fatal Adenovirus Pneumonia in an Immunocompetent Adult

Sobia Nizami1, and Lisa L. Dever2

1Department of Medicine, Rutgers New Jersey Medical School, University Hospital, 150 Bergen St, Level I-248, Newark, NJ 07103

2Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, 185 S. Orange Avenue MSB I-689, Newark, NJ 07101

Pub. Date: April 13, 2016

Cite this paper:
Sobia Nizami and Lisa L. Dever. Fatal Adenovirus Pneumonia in an Immunocompetent Adult. American Journal of Epidemiology and Infectious Disease. 2016; 4(1):14-17. doi: 10.12691/ajeid-4-1-3


Adenovirus is a rare cause of severe respiratory disease in immunocompetent adults. Life-threatening infections are usually encountered in children and immunocompromised hosts, such as HIV/AIDS patients and transplant recipients. We present a case of adenovirus infection in a 64-year old woman who presented with unilateral rhinorrhea for two months and a one-week history of cough and malaise. She was intubated for urgent neurosurgical repair of a cerebrospinal fluid (CSF) leak. She rapidly developed severe pneumonia with acute respiratory distress syndrome. Broncheoalveolar lavage and stool were positive for adenovirus by polymerase chain reaction assay. No other clinically significant microbial pathogens were identified. Despite cardiopulmonary support with invasive mechanical ventilation, inhaled nitrous oxide and extracorporeal membrane oxygenation (ECMO), the patient did not survive. Our report highlights the need to consider adenoviral pneumonia as an etiology of acute respiratory distress syndrome with severe sepsis and multi-organ failure in immunocompetent adults. Current evidence for treatment of adenovirus pneumonia with antiviral agents and the role of ECMO is discussed.

adenovirus pneumonia respiratory failure ribavirin cidofovir ECMO

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Gu, L., et al., Severe community-acquired pneumonia caused by adenovirus type 11 in immunocompetent adults in Beijing. J Clin Virol, 2012. 54(4): p. 295-301.
[2]  Giberson, A.N., A.R. Davidson, and R.J. Parks, Chromatin structure of adenovirus DNA throughout infection. Nucleic Acids Research, 2012. 40(6): p. 2369-2376.
[3]  Kim, S.J., et al., Outcomes of early administration of cidofovir in non-immunocompromised patients with severe adenovirus pneumonia. PLoS One, 2015. 10(4): p. e0122642.
[4]  Sandrock, C. and N. Stollenwerk, Acute febrile respiratory illness in the ICU: reducing disease transmission. Chest, 2008. 133(5): p. 1221-31.
[5]  Nguyen, C., et al., Viral Respiratory Infections of Adults in the Intensive Care Unit. J Intensive Care Med, 2015. first published on May 19, 2015.
[6]  Potter, R.N., et al., Adenovirus-associated deaths in US military during postvaccination period, 1999-2010. Emerg Infect Dis, 2012. 18(3): p. 507-9.
[7]  Klinger, J.R., et al., Multiple cases of life-threatening adenovirus pneumonia in a mental health care center. Am J Respir Crit Care Med, 1998. 157(2): p. 645-9.
[8]  Ahmad, N.M., M.P. Weinstein, and S.E. Boruchoff, Life-Threatening Adenovirus Pneumonia in an Immunocompetent Civilian Adult. Infectious Diseases in Clinical Practice, 2005. 13(1): p. 39-41.
[9]  Levine, S.A. and M.S. Niederman, The impact of tracheal intubation on host defenses and risks for nosocomial pneumonia. Clin Chest Med, 1991. 12(3): p. 523-543.
[10]  Borg, A., M.A. Kirkman, and D. Choi, Endoscopic endonasal anterior skull base surgery: a systematic review of complications over the past 65 years. World Neurosurg, 2016.
[11]  Clark, T., D. Fleet, and M. Wiselka, Severe community-acquired adenovirus pneumonia in an immunocompetent 44-year-old woman: a case report and review of the literature. J Med Case Rep, 2011. 5(1): p. 1-6.
[12]  Hakim, F.A. and I.M. Tleyjeh, Severe adenovirus pneumonia in immunocompetent adults: a case report and review of the literature. Eur J Clin Microbiol Infect Dis, 2008. 27(2): p. 153-8.
[13]  Hung, K.-H. and L.-H. Lin, Adenovirus Pneumonia Complicated With Acute Respiratory Distress Syndrome: A Case Report. Medicine (Baltimore), 2015. 94(20): p. e776.
[14]  Kim, S.J., et al., Successful Treatment in Fatal Adenovirus Pneumonia with the Use of Extracorporeal Membrane Oxygenation. Soonchunhyang Med Sci, 2014. 20(1): p. 52-55.
[15]  Gattinoni, L., E. Carlesso, and T. Langer, Clinical review: Extracorporeal membrane oxygenation. Crit Care, 2011. 15(6): p. 243.
[16]  Ng, G.W., et al., Three-year experience of using venovenous extracorporeal membrane oxygenation for patients with severe respiratory failure. Hong Kong Med J, 2014. 20(5): p. 407-12.