A case of adenovirus infection complicated by gram-negative polymicrobial sepsis: A clinical and morphological observation


Among respiratory infections, adenovirus infection (ADVI), in the presence of which there may be severe pneumonia that frequently results in a fatal outcome, occupies particular attention. ADVI in patients without immunodeficiency is usually mild and shows a limited extent of injury. At the same time the disease in immunocompromised individuals may be severe, presenting with viremia, evolving sepsis, and high death rates. The paper gives a characteristic example of severe ADVI and its fatal outcome.


  1. Global health estimated summary tables. WHO 2013; Доступно по: http://www.who.int/healthinfo/global_burden_disease/en. Ссылка активна на 19.05.2015.
  2. Russell KL, Hawksworth AW, Ryan МА, Strickler J, Irvine M, Hansen CJ, Gray GC, Gaydos JC. Vaccine-preventable adenoviral respiratory illness in US military recruits, 1999—2004. Vaccine. 2006;24:2835-2842.
  3. Ludwig SL, Brundage JF, Kelley PW, Nang R, Towle C, Schnurr DP, Crawford-Miksza L, Gaydos JC. Prevalence of antibodies to adenovirus serotypes 4 and 7 among unimmunized US Army trainees: results of a retrospective nationwide seroprevalence survey. J Infect Dis. 1998;178:1776-1778.
  4. Chmielewicz В, Benzler J, Pauli G, Krause G, Bergmann F, Schweiger B. Respiratory disease caused by a species B2 Adenovirus in a military camp in Turkey. J Med Virol. 2005;77(2):232-237.
  5. Hakim FA, Tleyjeh IM. Severe adenovirus pneumonia in immunocompetent adults: a case report and review of the literature. Eur J Clin Microbiol Infect Dis. 2008;27(2):153-158.
  6. Яцышина С.Б., Самчук В.В., Васильев В.В., Агеева М.Р., Воробьева Н.С., Савочкина Ю.А., Буланенко В.П., Шипулин Г.А., Малеев В.В. Аденовирусная пневмония с летальным исходом у взрослых. Терапевтический архив. 2014;86(11): 55-59.
  7. Field PR, Patwardhan J, McKenzie JA, Murphy AM. Fatal adenovirus type 7 pneumonia in an adult. Med J Aust. 1978;2(9):445-447.
  8. Viquesnel G, Vabret A, Leroy G, Bricard H, Quesnel J. Severe type 7 Adenovirus pneumoniae in an immunocompetent adult. Ann Fr Anesth Reanim. 1997;16 (1):50-52.
  9. Yamadera S, Yamashita K, Akalsuka M, Kato N, Inouye S. Trend of adenovirus type 7 infection, an emerging disease in Japan. A report of the National Epidemiological Surveillance of Infectious Agents in Japan. Jpn J MedSci Biol. 1998;51(1):43-51.
  10. Tang L, Wang L, Tan X, Xu W. Adenovirus serotype 7 associated with a severe lower respiratory tract disease outbreak in infants in Shaanxi Province, China. Virol J. 2011;18;8 (1):23.
  11. Munoz FM, Piedra PA, Demmler GJ. Disseminated adenovirus disease in immunocompromised and immunocompetent children. Clin Infect Dis. 1998;27:1194-1200.
  12. Dudding BA., Wagner SC., Zeller JA., Gmelich JT., French GR., Top FH JR. Fatal pneumonia associated with adenovirus type 7 in three military trainees. N Engl J Med. 1972;286(24):1289-1292.
  13. Wright J, Couchonnal G, Hodges GR. Adenovirus type 21 infection. Occurrence with pneumonia, rhabdomyolysis, and myoglobinuria in an adult. JAMA. 1979;241(22):2420-2421.
  14. Herbert FA, Wilkinson D, Burchak E, Morgante O. Adenovirus type 3 pneumonia causing lung damage in childhood. Can Med Assoc. 1977;116(3):274-276.
  15. Gu L, Liu Z, Li X, Qu J, Guan W, Liu Y, Song S, Yu X, Cao B. Severe community-acquired pneumonia caused by adenovirus type 11 in immunocompetent adults in Beijing. J ClinVirol. 2012;54(4):295-301.
  16. Pham TT, Burchette JL Jr, Hale LP. Fatal disseminated adenovirus infections in immunocompromised patients. Am J Clin Pathol. 2003;120(4):575-583.
  17. Csata S, Kulcsar G. Virus-host studies in human seminal and mouse testicular cells. Acta Chir Hung. 1991;32(1):83-90.
  18. Figueiredo LT. Viral pneumonia: epidemiological, clinical, pathophysiological, and therapeutic aspects. J Bras Pneumol. 2009; 35(9):899-906.
  19. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67(1):71-79.
  20. Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Lancet. 2011;377(9773):1264-1275.
  21. Pavia AT. What is the role of respiratory viruses in community-acquired pneumonia? What is the best therapy for influenza and other viral causes of community-acquired pneumonia? Infect Dis Clin North Am. 2013;27(1):157-175.
  22. Qu JX, Gu L, Pu ZH, Yu XM, Liu YM, Li R, Wang YM, Cao B, Wang C. Beijing Network for Adult Community-Acquired Pneumonia (BNACAP). Viral etiology of community-acquired pneumonia among adolescents and adults with mild or moderate severity and its relation to age and severity. BMC Infect Dis. 2015;15:89
  23. Deutschman CS., Tracey KJ. Sepsis: Current dogma and new perspectives. Immunity. 2014;40(4):463-475.
  24. Ramachandran G. Gram-positive and gram-negative bacterial toxins in sepsis: A brief review. Virulence. 2014;5(1):213-218.
  25. Страчунский Л.С., Решедько Г.К., Рядкова Е.Л. Рекомендации по оптимизации антимикробной терапии нозокамиальных инфекций, вызванных грамотрицательными бактериями в отделениях реанимации и интенсивной терапии: пособие для врачей. Клиническая микробиология, антимикробнаяхимиотерапия. 2002;4:379-390.
  26. Kubler A, Adamik B, Durek G, Mayzner-Zawadzka E, Gaszyński W, Karpel E, Duszyńska W. Results of the severe sepsis registry in intensive care units in Poland from 2003—2009. Anaesthesiol Intensive Ther. 2015;47(1):7-13.
  27. Bone RC. Gram-Negative Sepsis: a Dilemma of Modern Medicine. Clin Microbiol Rev. 1993;6(1):57-68.
  28. Park TK, Yang JH, Jeon K, Choi SH, Choi JH, Gwon HC, Chung CR, Park CM, Cho YH, Sung K, Suh GY. Extracorporeal membrane oxygenation for refractory septic shock in adults. Eur J Cardiothorac Surg. 2015;47(2):e68-74.
  29. Esper SA, Levy JH, Waters JH, Welsby IJ. Extracorporeal membrane oxygenation in the adult: a review of anticoagulation monitoring and transfusion. Anesth Analg. 2014;118(4):731-743.
  30. Bartlett RH, Gattinoni L. Current status of extracorporeal life support (ECMO) for cardiopulmonary failure. Minerva Anestesiol. 2010;76(7):534-540.
  31. Ronco C, D’Intini V, Bellomo R, Ricci Z, Bonello M, Ratanarat R, Salvatori G, Bordoni V, Andrikos E, Brendolan A. Обоснование применения экстракорпоральных методов лечения при сепсисе. Анестезиология и реаниматология. 2005;2:87-91.
  32. Wang CJ, Yu S, Ao-Ri-Ge-le, Jia DG, Yao HQ, Zhao HP, Lillehoj HS, Si-Mu-Ji-de, Postnikoff AC, Xu SR. Regulation of T lymphocyte subpopulations in specific pathogen-free chickens following experimental fowl adenovirus-VIII infection. Braz J Microbiol. 2012;43(4):1281-1290.
  33. Schonland M, Strong ML, Wesley A. Fatal Adenovirus Pneumonia: Clinical and Pathological Features. S Afr Med J. 1976;50(43): 1748-1751.
  34. Hayasaka D, Ennis FA., Terajima M. Pathogeneses of respiratory infections with virulent and attenuated vaccinia viruses. Virol J. 2007;4:22.
  35. Thiele AT, Sumpter TL, Walker JA, Xu Q, Chang CH, Bacallao RL, Kher R, Wilkes DS. Pulmonary immunity to viral infection: adenovirus infection of lung dendritic cells renders T cells nonresponsive to interleukin-2. J Virol. 2006;80(4):1826-1836.
  36. Jonda M, Pazirandeh A, Okret S. Different roles for glucocorticoids in thymocyte homeostasis? Trends Immunol. 2004;25(11): 595-600.
  37. Savino W. The thymus is a common target organ in infectious diseases. PLoS Pathog. 2006;2(6):e62.
  38. Russell KL, Hawksworth AW, Ryan MA, Strickler J, Irvine M, Hansen CJ, Gray GC, Gaydos JC. Vaccine-preventable adenoviral respiratory illness in US military recruits, 1999-2004. Vaccine. 2006;24(15):2835-2842.
  39. Kuschner RA, Russell KL, Abuja M, Bauer KM, Faix DJ, Hait H, Henrick J, Jacobs M, Liss A, Lynch JA, Liu Q, Lyons AG, Malik M, Moon JE, Stubbs J, Sun W, Tang D, Towle AC, Walsh DS, Wilkerson D. Adenovirus Vaccine Efficacy Trial Consortium. Vaccine. 2013;31(28):2963-2971.

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