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Adenovirus pneumonia
1Department of Microbiology and Immunology, Baylor College of Medicine, Houston, Texas 77030.
Insights
Adenovirus infections cause significant pneumonia in children, particularly those under five. Prevention involves specific adenovirus vaccines, while treatment focuses on symptom management.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Pulmonology
Background:
- Adenoviruses are common DNA viruses causing diverse illnesses, including pneumonia.
- Six serotypes are responsible for most adenovirus-induced pneumonia cases.
- Adenovirus accounts for up to 20% of childhood pneumonias in children under five.
Purpose of the Study:
- To summarize the clinical features, diagnosis, and treatment of adenovirus pneumonia.
- To highlight the impact of specific adenovirus serotypes on disease severity and mortality.
Main Methods:
- Review of roentgenologic and histopathologic findings in adenovirus pneumonia.
- Analysis of diagnostic criteria, including virus isolation and serologic antibody rise.
- Evaluation of treatment strategies and preventive vaccine efficacy.
Main Results:
- Roentgenologic findings include infiltrates, consolidation, and pleural effusion.
- Histopathology often shows necrotizing bronchitis and bronchiolitis, leading to abnormal pulmonary function in up to 60% of patients.
- Mortality rates range from 15-20% in children with adenovirus type 7 pneumonia to 60% in immunocompromised patients.
Conclusions:
- Adenovirus pneumonia presents with characteristic radiographic and histopathologic findings.
- Accurate diagnosis relies on viral detection or significant antibody titer increase.
- Symptomatic care is the primary treatment, with serotype-specific vaccines offering prevention.
Abstract:
Adenoviruses are ubiquitous DNA viruses that cause a wide variety of illnesses, including pneumonia, in children and adults. Forty-one distinct human sero-types have been identified, yet only about six of these serotypes are associated with the majority of the cases of adenovirus-induced pneumonia. Adeno-virus infection accounts for up to 20% of childhood pneumonias, primarily in those children younger than 5 years of age, but such pneumonias occur infrequently in the nonmilitary adult population. Roentgenologic findings include patchy or diffuse infiltrates, consolidation, and occasionally, pleural effusion. Histopathologic examination of lung tissue frequently reveals a necrotizing bronchitis and bronchiolitis. Such pulmonary destruction results in abnormal pulmonary function in up to 60% of these patients. Mortality rates vary with the population studied and the etiologic serotype, reaching as high as 60% in immunocompromised patients and 15% to 20% of the children with adenovirus type 7 pneumonia. Diagnosis requires either virus isolation or detection of a four-fold or greater rise in serum antibody over a 2- to 3-week period of time. Treatment consists primarily of symptomatic care, while prevention of infection relies upon the selected use of serotype-specific, enteric-coated, live adenovirus vaccines.