Severe adenovirus bronchiolitis in children

Pichler, M.

doi:10.1080/080352500300002633

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…In situ hybridization showed that alveolar and bronchiolar epithelial cells are infected by adenovirus in pneumonias [15] (Figure 2). Other less common respiratory consequences of adenovirus infection reported in this age group include bronchiolitis [14,16,17], post-infectious bronchiolitis obliterans [18 ] and, when combined with or preceded by measles infection, bronchiectasis [19,20].…”

Section: Pediatric Populationmentioning

confidence: 99%

Adenovirus infections and lung disease

Hayashi¹,

Hogg²

2007

Current Opinion in Pharmacology

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Adenovirus, particularly its E1A protein, has been investigated in the pathogenesis of chronic obstructive pulmonary disease (COPD). High levels of E1A DNA were found in the lungs of COPD patients, where its expression increased with disease severity. In lung epithelial cells, E1A increased intercellular adhesion molecule-1 and interleukin-8 expression, as well as nuclear factor-kappaB activation, in response to inflammatory stimuli. In addition to regulating the mediators that promote emphysema, E1A upregulates transforming growth factor-beta1 expression in bronchiolar epithelial cells and transforms lung epithelial cells to express mesenchymal markers. These results support its additional role in the airway remodeling process reported in COPD.

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Section: Pediatric Populationmentioning

confidence: 99%

Adenovirus infections and lung disease

Hayashi¹,

Hogg²

2007

Current Opinion in Pharmacology

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“…Adenoviruses cause a broad spectrum of clinical disease, including respiratory tract infection, pharyngoconjunctival fever, conjunctivitis, hemorrhagic cystitis, and gastroenteritis. Although most infections are self-limited, adenoviruses have been associated with severe and even fatal infections in both immunocompromised and healthy individuals (6,22,27). In the immunocompromised host, adenovirus can cause severe localized disease or disseminated disease with multiorgan failure (2,11).…”

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confidence: 99%

Adenovirus Infections in Hospitalized Patients in Israel: Epidemiology and Molecular Characterization

et al. 2011

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Adenoviruses can cause a broad spectrum of clinical diseases, most of which are self-limited. However, adenovirus infection can occasionally result in severe or lethal infection. Fifty-five adenovirus serotypes are known today, and they are classified into 7 subgroups (subgroups A to G). Here we examined 282 samples derived from hospitalized patients in Israel (September 2006 to August 2008) who were diagnosed as suffering from adenovirus infections. We used a recently described PCR amplification method and subsequent sequencing to identify the adenovirus. In addition, we studied the medical charts of 106 hospitalized patients from Sheba Medical Center in Israel. The most prevalent adenovirus serotypes found were serotypes 1 (22.8%), 2 (19.2%), 7 (18%), and 3 (14%). In addition, we identified several serotypes that have not been identified previously in Israel. Overall, serotypes of subgroup B were found to be approximately 4 times more prevalent among immunocompromised children than among generally healthy children (52.6%; P < 0.007). The realization that the virus subtypes are different among healthy and immunocompromised patients may lead to more efficient treatment of adenovirus infections among immunocompromised children in the future.

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“…6 Although most infections are self-limited, ADV can be associated with severe or lethal infection in both immunocompromised and healthy individuals. [7][8][9][10] In clinical practice, ADV may be underdiagnosed. Isolation of ADV from cell culture is quite sensitive, but results take several days, limiting clinical utility.…”

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confidence: 99%

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

et al. 2004

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ABSTRACT. Background. Adenovirus (ADV) infections were difficult to diagnose in the past, and many infections were unrecognized. Direct fluorescent assay (DFA) for the rapid diagnosis of ADV infection, as part of a viral respiratory panel, became available at Primary Children's Medical Center (Salt Lake City, UT) in December 2000.Objective. To describe children with ADV infection diagnosed by DFA and viral culture and document the impact of rapid ADV testing on patient care.Methods. DFA testing for respiratory viruses including ADV was performed on nasal wash specimens with parallel viral culture. Chart review was performed for all ADV-positive patients identified from microbiology records between December 2000 and May 2002.Results. Of 1901 patients positive for respiratory viruses, 143 (7.5%) were ADV-positive by DFA or culture. The mean age of ADV-positive children was 23 months; 90% were <60 months old. Eighty percent were previously healthy, and 56% required admission with a mean length of stay of 3.4 days. The most common diagnoses included fever (31%), bronchiolitis (24%), and pneumonia (14%). Other conditions included suspected Kawasaki disease (KD) and hepatitis. Forty-six percent of ADV-positive children were given antibiotics at presentation, but only 2 (1.4%) had documented bacterial infection (one had Escherichia coli urinary tract infection and one had Moraxella catarrhalis bacteremia). Thirty-six percent of children had a change in management based on positive ADV DFA. In children with suspected KD (n ‫؍‬ 5), 100% had positive ADV DFA, and immune globulin was withheld in 4. One immunocompetent patient with fulminant liver failure received cidofovir treatment after a positive ADV DFA and recovered before liver transplant.Conclusions. ADV is a common infection in young children and often results in admission and unnecessary antibiotic therapy. Identifying ADV as the cause of illness can favorably impact care and in some instances may be life-saving. DFA testing for ADV should be considered for infants and children requiring admission for fever, respiratory illness, suspected KD, and hepatitis. Pediatrics 2004;113:e51-e56. URL: http://www.pediatrics. org/cgi/content/full/113/1/e51; adenovirus, rapid diagnosis, Kawasaki disease.ABBREVIATIONS. ADV, adenovirus; PCMC, Primary Children's Medical Center; DFA, direct fluorescent assay; ED, emergency department; RSV, respiratory syncytial virus; KD, Kawasaki disease; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; IVIG, intravenous immune globulin.A denovirus (ADV) is a well-known cause of respiratory illness in children. [1][2][3][4] It may produce upper or lower respiratory infection including bronchiolitis and pneumonia. 5 In addition, ADV infection is frequently associated with entities such as pharyngoconjunctival fever and epidemic conjunctivitis that are often diagnosed based on clinical examination alone. 6 Although most infections are self-limited, ADV can be associated with severe or lethal infection in both immunocompromised and healt...

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Severe adenovirus bronchiolitis in children

Abstract: Adenovirus can cause severe bronchiolitis in previously healthy children. Diagnosis may be difficult to achieve. The role of antiviral therapy in the treatment of adenoviral infections remains to be cleared.

Cited by 8 publications

References 15 publications

Adenovirus infections and lung disease

Adenovirus infections and lung disease

Adenovirus Infections in Hospitalized Patients in Israel: Epidemiology and Molecular Characterization

Adenoviral Infections in Children: The Impact of Rapid Diagnosis

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