title: Adenovirus serotype 3 and 7 infection with acute respiratory failure in children in Taiwan, 2010-2011.
abstract: OBJECTIVE
  Increased incidence of adenovirus infection in children was noticed since September 2010 in Taiwan and severe cases requiring intensive care were noted later. We did this study to find the clinical characteristics and risk factors associated with severe adenovirus infection.
  
  
  METHODS
  We collected cases of severe adenovirus infection between November 2010 and June 2011 to analyze their clinical characteristics in two medical centers in northern Taiwan. Severe adenovirus infection was defined as laboratory-confirmed adenovirus cases with required intensive care. Hexon gene sequencing was performed for molecular genotyping.
  
  
  RESULTS
  45 patients were included, 22 cases (49%) were infected with serotype 7, 19 (42%) with serotype 3, and 4 with serotype 2. The median age (range) was 2.75 years (0.08-15.43 years); 87% were below 5 years. Male to female ratio was 1.65 (28 to 17). Of these patients, 56% had underlying neurological diseases, 50% experienced fever higher than 40°C and 69% suffered fever longer than one week. The clinical diagnosis included pneumonia in 40 (89%) patients, bronchopneumonia in 5 (11%), and encephalitis in 7 (16%). At least 22 patients had pleural effusion. They had complications of respiratory failure (53%), acute respiratory distress syndrome (24%), hypotension (40%), and 6 (13%) patients needed extracorporeal membranous oxygenation. Ten (22%) patients died, all with underlying major systemic diseases and 7 (70%) infected with serotype 7.
  
  
  CONCLUSIONS
  Adenovirus serotype 7 and 3 can cause severe disease-even death-in children, especially those with underlying neurological diseases. Patients infected with adenovirus serotype 7 tended to have a higher case-fatality rate.
authors: Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Chen-Yin
authors: CY
authors: Lai
authors: Chia-Jie
authors: CJ
authors: Lee
authors: Chun-Yi
authors: CY
authors: Lu
authors: Ping-Ing
authors: PI
authors: Lee
authors: Pei-Lan
authors: PL
authors: Shao
authors: En-Ting
authors: ET
authors: Wu
authors: Ching-Chia
authors: CC
authors: Wang
authors: Boon-Fatt
authors: BF
authors: Tan
authors: Hsin-Yu
authors: HY
authors: Chang
authors: Shao-Hsuan
authors: SH
authors: Hsia
authors: Jainn-Jim
authors: JJ
authors: Lin
authors: Luan-Yin
authors: LY
authors: Chang
authors: Yhu-Chering
authors: YC
authors: Huang
authors: Li-Min
authors: LM
authors: Huang
mesh_terms: D000208:Acute Disease; D000258:Adenovirus Infections, Human / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000821:virology*; D000260:Adenoviruses, Human / Q000145:classification* / Q000235:genetics; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D010802:Phylogeny; D013902:Radiography, Thoracic; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000821:virology*; D012703:Serotyping; D013624:Taiwan; D016896:Treatment Outcome