title: Adenovirus infection associated with central nervous system dysfunction in children.
abstract: BACKGROUND
  Adenovirus is a common pathogen in the pediatric population. No reports systemically evaluated central nervous system (CNS) dysfunction associated with adenovirus.
  
  
  OBJECTIVE
  To describe the detailed clinical features of adenovirus-associated CNS dysfunction in children.
  
  
  METHODS
  Of 3298 children with a throat virus culture positive for adenovirus treated at a university-affiliated hospital, from January 2000 to June 2008, in northern Taiwan, medical charts were retrospectively reviewed and those with CNS dysfunction were included.
  
  
  RESULTS
  109 (3.3%) children had signs or symptoms of CNS dysfunction on admission. The median age was 3.6 years and 81 (76%) were less than 5 years of age. 64 (59%) were male. The most frequently cited CNS symptoms were seizure (64%), altered state of consciousness (13%), visual hallucination (9.3%) and lethargy (7.5%). The most common diagnoses included febrile seizure (48%), encephalitis (26%), afebrile seizure (11%) and meningitis/meningismus (8.3%). 31 (46%) of 67 patients receiving electroencephalogram examination had abnormal findings and 13 (36%) of 36 with image studies had abnormal findings. Ninety-nine (91%) children returned to normal health, 7 (6.4%) had a sequel of seizure disorder, and 3 (2.7%) had major sequelae and none died. Nine serotypes were identified, with three major serotypes (types 3, 2 and 1).
  
  
  CONCLUSIONS
  CNS dysfunction was identified in 3.3% of children with adenoviral infection and most occurred in those <5 years old. The clinical prognosis seemed well. However, CNS dysfunction is a potentially serious complication of adenovirus infection in children.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. ychuang@cgmh.org.tw
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Sun-Lin
authors.initials: SL
authors.lastname: Huang
authors.forename: Shih-Perng
authors.initials: SP
authors.lastname: Chen
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Huang
authors.forename: Chung-Guei
authors.initials: CG
authors.lastname: Huang
authors.forename: Kuo-Chien
authors.initials: KC
authors.lastname: Tsao
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000257:Adenoviridae Infections / Q000150:complications*; D002490:Central Nervous System / Q000821:virology*; D002493:Central Nervous System Diseases / Q000821:virology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013624:Taiwan