Invasive adenoviral infection in a recipient of unrelated bone marrow transplantation: Problems with diagnostic PCR.
A hematopoietic stem cell transplantation (SCT) recipient developed severe diarrhea and fever. A rapid test for the presence of adenovirus (AdV)-specific antigen in the patient's stools was positive; however, AdV genome was not detected by conventional or real-time polymerase chain reaction (PCR). AdV was confirmed by specific PCR for AdV serotype 7 and by an AdV hexon/fiber gene DNA sequence homology search of the PCR product. We suspect that conventional/real-time PCR failed to detect AdV due to nine silent single base substitutions in the extracted AdV genome. Treatment with 1 mg/kg cidofovir (CDV) intravenously three times a week was effective.
Ishida
Hiroyuki
H
Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi-Shi, Japan. ishida.hiroyuki002@jp.panasonic.com
Shin-Nakai
Noriko
N
Yoshihara
Takao
T
Teramura
Tomoko
T
Imamura
Toshihiko
T
Mukouyama
Atsushi
A
Morimoto
Akira
A
Imashuku
Shinsaku
S
D000258:Adenovirus Infections, Human / Q000188:drug therapy / Q000821:virology*; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003951:Diagnostic Errors; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D063065:Organophosphonates / Q000627:therapeutic use; D016133:Polymerase Chain Reaction / Q000379:methods*; D011183:Postoperative Complications / Q000188:drug therapy / Q000821:virology*; D014184:Transplantation, Homologous; D014766:Viremia / Q000188:drug therapy / Q000821:virology*
D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir