title: Pneumonia in military trainees: a comparison study based on adenovirus serotype 14 infection.
abstract: BACKGROUND
  Adenovirus serotype 14 (Ad-14) recently emerged as a respiratory pathogen in the United States, with studies suggesting higher morbidity and mortality. This study was conducted to determine whether Ad-14 is associated with clinical outcomes in otherwise healthy patients with pneumonia.
  
  
  METHODS
  Medical records of military trainees hospitalized with pneumonia during an outbreak of Ad-14 infection were reviewed. Clinical, radiographic, and laboratory parameters were compared on the basis of Ad-14 infection.
  
  
  RESULTS
  Two hundred thirty-four trainees received a diagnosis of pneumonia, and 83(35%) were hospitalized. Sixty-one percent of patients with pneumonia were Ad-14 positive; 43% of patients with Ad-14 pneumonia were hospitalized (83% of female patients and 40% of male patients; P = .04), compared with 40% of patients with Ad-14 negative cases. Ad-14 infection was associated with higher admission temperature (38.3°C [interquartile range, (IQR) 37.7, 39.4] vs 37.3°C [IQR (36.7, 38.5)]; P < .01) and lower white blood cell count (8.3 × 1000 cells/μL [IQR, 5.7, 12.4] vs 13 × 1000 cells/μL [IQR, 7.5, 12.9]; P = .01), neutrophil count (6.7 × 1000 cells/μL [IQR, 2.8, 9.7] vs 9.7 × 1000 cells/μL [IQR, 5.6, 12.1]; P = .02), lymphocyte count (0.9 × 1000 cells/μL [IQR, 0.8, 1.1] vs 1.3 × 1000 cells/μL [IQR, 1, 1.9]; P = .001), and platelet count (210 × 1000 cells/μL [IQR, 145, 285] vs 261 × 1000 cells/μL [IQR, 238, 343]; P < .01). Ad-14 pneumonia was not associated with specific radiographic findings, pneumonia severity score, intensive care unit admission, longer hospitalization, or 30-day mortality.
  
  
  CONCLUSIONS
  During an outbreak of Ad-14 infection, Ad-14 infection was not associated with excess overall morbidity or mortality. Ad-14 infection was associated with specific laboratory and clinical parameters and higher hospitalization rates in female trainees. These data provide new insight to the epidemiology of Ad-14 infection.
authors.affiliation: Infectious Diseases Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA. todd.vento@us.army.mil
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Vento
authors.forename: Vidhya
authors.initials: V
authors.lastname: Prakash
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: Lorie C
authors.initials: LC
authors.lastname: Brosch
authors.forename: Juste B
authors.initials: JB
authors.lastname: Tchandja
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cogburn
authors.forename: Heather C
authors.initials: HC
authors.lastname: Yun
mesh_terms: D000256:Adenoviridae / Q000145:classification*; D000257:Adenoviridae Infections / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D000293:Adolescent; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult