Severe Adenovirus Pneumonia Followed by Bacterial Septicaemia: Relevance of Co-Infections in Allogeneic Hematopoietic Stem Cell Transplantation

Infect Disord Drug Targets. 2016;16(1):69-76. doi: 10.2174/1871526516666160407114623.

Abstract

Infections are one of the major complications after allogeneic stem cell transplantation (allo-SCT). Disseminated infections with human adenoviruses species A, B or C are associated with a lethality of 24 to 36 %. Fatal outcome is usually observed with high viral loads in blood (median peak HAdV DNAemia 10(8) copies/mL). Here we report two adult patients with disseminated infection with human adenovirus C2 after allo-SCT. Interestingly, both patients developed bacterial septicaemia following the disseminated HAdV infection. Despite lower peak adenoviral loads in blood (<106 copies/mL) than usually reported for fatal cases of HAdV infection and broad spectrum antimicrobial therapy both patients experienced a rapidly fatal outcome. These cases shared the following similarities: disseminated adenovirus infection, adenovirus pneumonia, neurological symptoms and bacterial septicaemia. This suggests that in patients undergoing allo-SCT, viral bacterial co-infections worsen the clinical outcomes.

Publication types

  • Case Reports

MeSH terms

  • Adenovirus Infections, Human / complications*
  • Adenovirus Infections, Human / virology
  • Adenoviruses, Human* / genetics
  • Adenoviruses, Human* / isolation & purification
  • Adult
  • Bacteremia / complications*
  • Bacteremia / drug therapy
  • Coinfection* / drug therapy
  • DNA, Viral / blood
  • Fatal Outcome
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant, Newborn
  • Male
  • Middle Aged
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / virology
  • Polymerase Chain Reaction
  • Severity of Illness Index
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • DNA, Viral