Adenovirus type F subtype 41 causing disseminated disease following bone marrow transplantation for immunodeficiency

Area of Science:

• Virology
• Immunology
• Hematology

Background:

• Bone marrow transplantation (BMT) is a critical treatment for various hematological conditions.
• Disseminated adenovirus infections pose a significant risk to immunocompromised patients, particularly post-BMT.
• T-cell-depleted BMT is employed to mitigate graft-versus-host disease but may alter immune surveillance.

Observation:

• A pediatric patient undergoing T-cell-depleted BMT developed disseminated disease.
• Adenovirus subgenus F serotype 41 was identified antemortem in cerebrospinal fluid via PCR.
• The same adenovirus serotype was detected in multiple tissues postmortem.

Findings:

• This report documents the first instance of Adenovirus subgenus F serotype 41 causing disseminated disease in a BMT recipient.
• Polymerase chain reaction (PCR) confirmed the presence of the virus in both cerebrospinal fluid and various tissues.
• Adenovirus serotypes 40 and 41 are typically associated with gastroenteritis and have not been previously implicated in systemic infections post-BMT.

Implications:

• The findings expand the spectrum of clinical manifestations associated with Adenovirus subgenus F serotypes 40 and 41.
• This case underscores the importance of considering atypical adenovirus serotypes in the differential diagnosis of disseminated infections in immunocompromised patients.
• Enhanced diagnostic vigilance and potentially novel therapeutic strategies may be warranted for managing disseminated adenovirus infections in BMT survivors.