Fatal Adenovirus Pneumonia in an Immunocompetent Adult

Sobia Nizami^1, 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

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

Abstract

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.

Keywords:
adenovirus pneumonia respiratory failure ribavirin cidofovir ECMO

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