title: Fatal pneumonia cases caused by human adenovirus 55 in immunocompetent adults.
abstract: BACKGROUND
  Adenovirus is a frequent cause of mild self-limiting upper respiratory tract infection, gastroenteritis, and conjunctivitis. Severe or fatal infection mostly occurs in newborn, elderly or immunocompromised persons.
  
  
  METHODS
  Fatal adenovirus pneumonia in three immunocompetent adults was identified. The clinical data and virological findings were reported from patients. Additional review of recently recorded fatal patients with adenovirus infection was carried out.
  
  
  RESULTS
  The patients presented with sudden onset respiratory distress that progressed rapidly to respiratory failure and death. Human adenovirus (HAdV)-55 was detected in both nasopharyngeal aspirates and serum samples in all three cases, and moreover detected in lung, liver, and kidney in one case. In another case, remarkably elevated aspartate aminotransferase, alanine transaminase, and lactate dehydrogenase were identified. Three HAdV-55 strains were isolated and genome sequencing revealed a high similarity with other strains from mild infection.
  
  
  CONCLUSIONS
  Fatal infection with HAdv-55 might occur in otherwise healthy adults. Diagnosis of adenovirus infection should be considered in patients with severe pneumonia yielding negative bacterial culture and presenting no response to antibiotic therapy.
authors.affiliation: a From the Department of Clinical Laboratory , General Hospital of Beijing Military Region , Beijing , PR China.
authors.forename: Shu-Yan
authors.initials: SY
authors.lastname: Zhang
authors.affiliation: b General Hospital of PLA , Beijing , PR China.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Luo
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Dou-Dou
authors.initials: DD
authors.lastname: Huang
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Hang
authors.initials: H
authors.lastname: Fan
authors.affiliation: d School of Public Health, Peking University , Beijing , PR China.
authors.forename: Qing-Bin
authors.initials: QB
authors.lastname: Lu
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wo
authors.affiliation: b General Hospital of PLA , Beijing , PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Xiao-Ai
authors.initials: XA
authors.lastname: Zhang
authors.affiliation: e PLA 307 Hospital , Beijing , PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Yi-Gang
authors.initials: YG
authors.lastname: Tong
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Wu-Chun
authors.initials: WC
authors.lastname: Cao
authors.affiliation: c State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology , Beijing , PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
mesh_terms: D000258:Adenovirus Infections, Human / Q000175:diagnosis / Q000821:virology*; D000260:Adenoviruses, Human / Q000235:genetics / Q000472:pathogenicity*; D000328:Adult; D002681:China / Q000453:epidemiology; D017809:Fatal Outcome; D006801:Humans; D007121:Immunocompetence; D008297:Male; D010802:Phylogeny; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000821:virology*; D012131:Respiratory Insufficiency; D017422:Sequence Analysis, DNA
keywords: Human adenovirus; death; epidemiology; pneumonia; respiratory tract infection