Significance of viral infections in severe combined immunodeficiency disease

An analysis of a prospective study of viral infections in 12 patients with severe combined immunodeficiency is presented. Infections of viral etiology were common, with pulmonary and gastrointestinal infections being most frequent. Fourteen of 25 infections (56%) were nonsocomially acquired and 10 of 25 (40%) were community-acquired. The period of symptomatology and the duration of viral excretion were usually prolonged beyond those associated with disease in the general pediatric population. Pulmonary infections were associated with considerable morbidity and mortality. Gastrointestinal infections disrupted gastrointestinal function and possibly played a role in enteric Gram-negative bacillary sepsis. The inability of these patients to eradicate these viruses in the absence of immunologic reconstitution resulted in significant morbidity, often with a fatal outcome.