Adenoviral bronchopneumonia in an immunocompetent adult: computed tomography and pathologic correlations

Acute febrile lung disease associated with "patchy ground-glass pattern" on high-resolution computed tomography (HRCT) of the lung in an immunocompromised patient is suggestive of Pneumocystis carinii pneumonia; however, in an immunocompetent young person, it is suggestive of an atypical pneumonia, including viral bronchopneumonia. We studied a 31-year-old man who presented with fever, cough and hypoxemia. HRCT showed bilateral patchy ground-glass opacification. HIV test was negative and lung biopsy specimen grew adenovirus on viral culture. Histopathology of the lung was compatible with bronchopneumonia. In patients without HIV who present with acute lower respiratory infections and patchy ground-glass opacification on HRCT, adenoviral bronchopneumonia should be included in the differential diagnosis.