title: Disseminated adenovirus disease in immunocompromised patient successfully treated with oral ribavirin: a case report.
abstract: In patients with immunological disorders, adenovirus infections are associated with significant rates of morbidity and mortality. Only few hematological units use molecular virological methods, such as polymerase chain reaction, for surveillance of adenovirus infection, and treatment strategies have never been evaluated in multicenter clinical trials. This report describes the detection and treatment of human adenovirus (HAdVs) disseminated disease in the case of a 46-year-old immunocompromised female having myelodysplastic syndrome with refractory cytopenia with multilineage dysplasia: International Prognostic Scoring System 1. Serum and urine samples were tested for the presence of adenoviral DNA using the quantitative real-time polymerase chain reaction (PCR) assay. For additional confirmation, sequencing of PCR products was also performed. With real-time PCR, we detected HAdV DNA in both serum and urine samples. The viral level constantly decreased with applied oral ribavirin therapy. As the result of sequencing, HAdVs type 11 was determined. Surveillance of adenovirus by real-time PCR is useful in detecting and monitoring disseminated HAdV infection; it is a potential standard diagnostic approach that could assist clinicians to decide whether antiviral therapy ought to be administered.
authors.affiliation: Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ewa Elżbieta
authors.initials: EE
authors.lastname: Ulrych
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dzieciątkowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Przybylski
authors.forename: Dorota
authors.initials: D
authors.lastname: Zduńczyk
authors.forename: Piotr
authors.initials: P
authors.lastname: Boguradzki
authors.forename: Tigran
authors.initials: T
authors.lastname: Torosian
authors.forename: Anna
authors.initials: A
authors.lastname: Waszczuk-Gajda
authors.forename: Sylwia
authors.initials: S
authors.lastname: Rynans
authors.forename: Marta
authors.initials: M
authors.lastname: Wróblewska
authors.forename: Wiesław Wiktor
authors.initials: WW
authors.lastname: Jędrzejczak
authors.forename: Grażyna
authors.initials: G
authors.lastname: Młynarczyk
mesh_terms: D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D000260:Adenoviruses, Human / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D012254:Ribavirin