title: Severe Adenovirus Pneumonia Followed by Bacterial Septicaemia: Relevance of Co-Infections in Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: Infections are one of the major complications after allogeneic stem cell transplantation (allo-SCT). Disseminated infections with human adenoviruses species A, B or C are associated with a lethality of 24 to 36 %. Fatal outcome is usually observed with high viral loads in blood (median peak HAdV DNAemia 10(8) copies/mL). Here we report two adult patients with disseminated infection with human adenovirus C2 after allo-SCT. Interestingly, both patients developed bacterial septicaemia following the disseminated HAdV infection. Despite lower peak adenoviral loads in blood (<106 copies/mL) than usually reported for fatal cases of HAdV infection and broad spectrum antimicrobial therapy both patients experienced a rapidly fatal outcome. These cases shared the following similarities: disseminated adenovirus infection, adenovirus pneumonia, neurological symptoms and bacterial septicaemia. This suggests that in patients undergoing allo-SCT, viral bacterial co-infections worsen the clinical outcomes.
authors.affiliation: Laboratoire de Virologie EA3610, Université Lille 2, Faculté de Médecine, CHU Lille, Bâtiment Paul Boulanger, F-59000 Lille, France. ilka.engelmann@chru-lille.fr.
authors.forename: Ilka
authors.initials: I
authors.lastname: Engelmann
authors.forename: Valerie
authors.initials: V
authors.lastname: Coiteux
authors.forename: Albert
authors.initials: A
authors.lastname: Heim
authors.forename: Leonardo
authors.initials: L
authors.lastname: Magro
authors.forename: Anny
authors.initials: A
authors.lastname: Dewilde
authors.forename: Remy
authors.initials: R
authors.lastname: Dulery
authors.forename: Didier
authors.initials: D
authors.lastname: Hober
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
mesh_terms: D000258:Adenovirus Infections, Human / Q000150:complications* / Q000821:virology; D000260:Adenoviruses, Human / Q000235:genetics / Q000302:isolation & purification; D000328:Adult; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy; D060085:Coinfection / Q000188:drug therapy; D004279:DNA, Viral / Q000097:blood; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000150:complications* / Q000821:virology; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral