Disseminated adenovirus infection: A case report and review of the literature

Adenoviruses cause 5 to 11% of cases of bronchiolitis and 4 to 10% of viral pneumonias of infancy and childhood.1-5 Attack rates are higher in children less than 5 years of age and in closed populations of children such as nurseries or day care facilities.6"8 Clinical syndromes are determined by the viral serotype, socioeconomic conditions, environmental factors and the immunologic status of the host.9"11Illness due to "adenoviruses is usually acute and self-limited, but in early infancy it can be fatal or associated with persistent lung damage and chronic disease.10,12-14 The latter presentation in infants is often accompanied by extrapulmonary manifestations,14"16 and recovery can be prolonged and interrupted by exacerbations.14,17-19 Adenoviruses 3, 7 and 21 are the principal serotypes associated with illness.10,11,14'16,17'20"23 Children with immunodeficiency states, malnutrition or a preceding viral illness and those of specific ethnic groups are more prone to develop overwhelming infection.24"26The purpose of this report is to illustrate the man-ifestations and course of disseminated adenovirus infection in a previously healthy child and to discuss possible reasons for overwhelming disease in an immunologically competent host.