Fatal adenovirus infection in a neonate and transmission to health-care workers.
BACKGROUND
Human adenovirus (HAdV) infections, while common in infancy and childhood, occur rarely in the neonatal period but may be fatal.


OBJECTIVE
To describe a transmission of HAdV from a patient with fatal pneumonia to heath-care workers that could be considered as a model of respiratory virus transmission in a care unit.


METHODS
Case report with virologic studies.


RESULTS
A 10-day-old neonate developed pneumonia with acute respiratory distress, external pulmonary bleeding and coagulopathy and died 36h after admission of multivisceral failure. An adenovirus was isolated from pulmonary biopsy and detected by PCR in blood and respiratory secretions. Ten days later, three members of medical staff in charge of this infant, who used neither masks nor glasses for close patient contact, developed keratoconjunctivitis. Molecular analysis of the infant's and one of the pediatrician's isolates identified a species D HAdv and showed 100% identity, thereby demonstrating viral transmission.


CONCLUSIONS
In view of the serious outcome, HAdV infections should be considered in the differential diagnosis of pneumonia in neonates. This case illustrates the epidemic potential of viruses with respiratory transmission and underlines the importance of complying with standard precautions to prevent viral spread in routine practice.
Henquell
Cécile
C
CHU Clermont-Ferrand, Laboratoire de Virologie, Hôpital Gabriel Montpied, F-63003 Clermont-Ferrand, France. chenquell@chu-clermontferrand.fr
Boeuf
Benoît
B
Mirand
Audrey
A
Bacher
Catherine
C
Traore
Ousmane
O
Déchelotte
Pierre
P
Labbé
André
A
Bailly
Jean-Luc
JL
Peigue-Lafeuille
Hélène
H
D000258:Adenovirus Infections, Human / Q000175:diagnosis* / Q000635:transmission*; D017809:Fatal Outcome; D005260:Female; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000821:virology*; D017758:Infectious Disease Transmission, Patient-to-Professional; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000821:virology