Disseminated adenovirus infection after autologous stem cell transplant

Abstract

Adenovirus is an infrequent but challenging viral complication of transplantation that is rarely reported after autologous stem cell transplant. We present a case of disseminated adenovirus infection in a woman who received an autologous stem cell transplant for treatment of multiple sclerosis. After presenting with post‐transplant episodic diarrhea and viremia, endoscopic biopsies and immunohistochemical staining confirmed the diagnosis of disseminated adenovirus infection. Her symptoms and viremia resolved after treatment with cidofovir. This case demonstrates that a high index of suspicion, a systematic clinical approach, and immunohistochemical tissue staining are necessary to diagnose disseminated adenovirus infection in an unexpected host.

Adenovirus infection diagnosed by metagenomic next‐generation sequencing after haploidentical hematopoietic stem cell transplantation: A multicenter study in China

“…However, the anti‐thymocyte globulin (ATG)‐base Beijing protocol may lead to delayed immune reconstitution, which increases the risk of opportunistic infections, especially vulnerable to viral reactivations and/or infections, mainly human herpes viruses (HHVs). In addition, posttransplant patients may be infected with human adenovirus (ADV), which can persist in epithelial cells and lymphoid tissue and reactivate during immunosuppressions 2,3 . The spectrum of ADV‐associated disease in allo‐HSCT patients ranges from mild gastroenteric or respiratory symptoms to severe hemorrhagic enteritis, hepatitis, encephalitis, and fatal multiple organ involvement.…”

“…In addition, posttransplant patients may be infected with human adenovirus (ADV), which can persist in epithelial cells and lymphoid tissue and reactivate during immunosuppressions. 2,3 The spectrum of ADV-associated disease in allo-HSCT patients ranges from mild gastroenteric or respiratory symptoms to severe hemorrhagic enteritis, hepatitis, encephalitis, and fatal multiple organ involvement. Therefore, a retrospective observational analysis was conducted on seven patients with ADV infection after Haplo-HSCT from three transplantation centers in China.…”