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Human adenovirus infection in Kawasaki disease: a confounding bystander?

Preeti Jaggi1, Adriana E Kajon, Asuncion Mejias

  • 1Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43205, USA. preeti.jaggi@nationwidechildrens.org

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 27, 2012
PubMed
Abstract

Insights

Human adenovirus (HAdV) detection in Kawasaki disease (KD) patients is common and may indicate persistent HAdV-C. Differentiating HAdV disease from KD with co-detection requires careful interpretation of viral loads and typing.

Area of Science:

  • Pediatric infectious diseases
  • Viral diagnostics
  • Immunology

Background:

  • Human adenovirus (HAdV) infections can mimic Kawasaki disease (KD) and are also found in KD patients.
  • HAdV-C species may persist in pediatric adenoids and tonsils.
  • Distinguishing HAdV disease from KD with concomitant HAdV detection is clinically important.

Purpose of the Study:

  • To determine the frequency of HAdV detection in KD patients using real-time polymerase chain reaction.
  • To compare HAdV viral loads in KD patients with detectable HAdV versus those with HAdV disease.
  • To investigate the occurrence of nasopharyngeal HAdV-C shedding in KD patients.

Main Methods:

  • HAdV detection was performed on KD patients (Groups I and II) and children with KD-like features diagnosed with HAdV disease (Group III).
  • Real-time polymerase chain reaction was used for HAdV detection and viral load quantification.
  • HAdV typing was conducted using viral culture and molecular methods.

Main Results:

  • HAdV was detected in 8.8% of complete/incomplete KD patients (Group I) and 25% of incomplete KD patients not meeting AHA criteria (Group II).
  • Viral loads were significantly lower in Group I KD patients compared to Group III HAdV disease patients (P = .034).
  • HAdV-B was identified in most cultured specimens, while HAdV-C was detected in KD samples via molecular typing.

Conclusions:

  • Molecular-based HAdV detection is frequent in KD and may indicate persistent HAdV-C infection.
  • Quantitative polymerase chain reaction and HAdV typing are valuable tools for differentiating HAdV disease from KD with concurrent HAdV detection.
  • Results should be interpreted cautiously, considering the potential for HAdV persistence in KD.

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