[Pneumonia due to adenovirus type 7: a case report in a healthy infant]

Area of Science:

• Pediatric Infectious Diseases
• Critical Care Medicine
• Virology

Background:

• Severe pneumonia in infants can present with complex clinical courses.
• Hemophagocytic syndrome (HFS) is a rare but life-threatening condition.
• Adenovirus infections, particularly types 3 and 7, are known causes of severe respiratory illness in children.

Observation:

• A 15-month-old boy developed severe pneumonia and persistent fever despite broad-spectrum antibiotic therapy.
• Clinical deterioration and laboratory findings prompted suspicion of hemophagocytic syndrome.
• Adenovirus type 7 was identified as the causative agent through polymerase chain reaction and bronchoalveolar lavage culture.

Findings:

• The patient was diagnosed with severe adenovirus pneumonia complicated by hemophagocytic syndrome.
• Despite intensive care, the child recovered within 3 weeks with normal immunologic evaluations.
• No primary immunodeficiency was identified, suggesting adenovirus as a trigger in an otherwise healthy child.

Implications:

• This case underscores the importance of considering hemophagocytic syndrome in pediatric patients with severe, refractory pneumonia and systemic inflammation.
• Early identification and management of adenovirus infections are crucial for preventing severe outcomes.
• The findings emphasize the potential for adenovirus to induce severe illness and secondary hemophagocytic syndrome in immunocompetent children.