Related Experiment Videos
Fatal adenovirus type 7b infection in a child with Smith-Lemli-Opitz syndrome
A Beby-Defaux1, L Maille, S Chabot
1Laboratory of Virology, University Hospital Center La Milétrie, Poitiers, France.
Insights
A fatal disseminated adenovirus type 7 infection occurred in a child with Smith-Lemli-Opitz syndrome. This case highlights the need for effective therapies against virulent adenovirus strains, particularly in vulnerable populations.
Area of Science:
- Virology
- Genetics
- Immunology
Background:
- Adenovirus type 7 is a common cause of respiratory infections globally, particularly in children.
- Severe systemic infections can arise, especially in immunocompromised individuals or those with chronic conditions.
Observation:
- This report details the first fatal case of disseminated adenovirus type 7 infection in a child diagnosed with Smith-Lemli-Opitz syndrome.
- Adenovirus type 7 (genome type 7b, a virulent strain) was isolated from multiple sites in the patient, excluding the liver.
Findings:
- The child's Smith-Lemli-Opitz syndrome, a disorder of cholesterol metabolism, may have contributed to the fatal outcome due to an associated immunodeficiency.
- Recurrent infections in Smith-Lemli-Opitz syndrome might be preventable with cholesterol supplementation.
Implications:
- This case underscores the critical need for advanced therapeutic strategies targeting disseminated adenovirus infections, especially those caused by virulent strains.
- Early intervention and management of underlying conditions like Smith-Lemli-Opitz syndrome are crucial for improving patient outcomes.
Abstract:
Adenovirus type 7 causes worldwide respiratory tract infections, mainly in children. Severe systemic infections can occur, especially in immunocompromised patients and in patients with underlying chronic diseases. This report describes the first case of a fatal disseminated adenovirus type 7 infection in a child with Smith-Lemli-Opitz syndrome, a rare autosomal recessive disorder due to a primary enzymatic defect in cholesterol metabolism. Nasopharyngeal secretions and autopsy specimens including liver, lung, pleural fluid, and rectum were collected for viral culture. Adenovirus serotype 7 strains were obtained from all anatomic sites, except the liver. All these clinical isolates were analyzed using restriction endonuclease digestion of the genome, identifying them as genome type 7b, a virulent type. In this case, the fatal evolution could have been accelerated by the presence of an immunodeficiency although immunodeficiency is not included in the definition of Smith-Lemli-Opitz syndrome. The frequent recurrent banal infections in Smith-Lemli-Opitz syndrome could be prevented by a cholesterol supplementation regimen. Finally, this report emphasizes the need for efficient therapy for disseminated adenovirus infections, especially for virulent genome types.