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[Fatal adenovirus pneumonia]
Insights
Adenoviruses caused fatal acute lower respiratory infections in 25 infants, often linked to malnutrition and hospital-acquired infections. Necrotizing bronchiolitis was a common finding in these severe pediatric adenovirus cases.
Area of Science:
- Pediatric Pathology
- Virology
- Respiratory Medicine
Context:
- Adenoviruses are common causes of respiratory illness in children.
- Severe outcomes, including fatalities, can occur in young children with adenoviral respiratory infections.
Purpose:
- To report on the clinical and histopathological features of 25 infants who died from acute lower respiratory tract infections attributed to adenoviruses.
- To document the diagnostic findings and associated factors in fatal pediatric adenovirus cases.
Summary:
- The study examined 25 infants with fatal acute lower respiratory tract infections, diagnosed via intranuclear inclusions in pulmonary lesions.
- Necrotizing bronchiolitis was present in 96% of cases. Most infants were under one year old and had malnutrition.
- A significant proportion (68%) of infections were nosocomial, and antimicrobial treatments were unsuccessful in 96% of patients.
Impact:
- Highlights the severe potential of adenovirus infections in vulnerable infants.
- Underscores the importance of considering nosocomial infections and underlying conditions like malnutrition in severe pediatric respiratory cases.
- Suggests limitations of antimicrobial therapy for severe adenoviral respiratory disease in infants.
Abstract:
Adenoviruses are well known and ubiquitous causes of respiratory illness in children. Serious long-term sequelae and even fatalities have been described in young children affected by adenoviral infections of the respiratory tract. This is a report on clinical and histopathological features of 25 infants dying from acute lower respiratory tract infections apparently caused by adenoviruses, from January 1st 1983 through December 31st 1986. The diagnosis was based on the finding of distinctive intranuclear inclusions in the pulmonary lesions that were present in all 25 cases at necropsy. Necrotizing bronchiolitis was found in 24 patients (96%). Nineteen patients (76%) were younger than 1 year of age and 15 (60%) had underlying malnutrition. In 17 instances (68%) the respiratory illness was nosocomial in origin. A specific etiologic diagnosis was not made in any of the 25 patients during the course of the illness, twenty four of them (96%) received various antimicrobial drugs without success.