Clinical Features and Radiological Findings of Adenovirus Pneumonia Associated with Progression to Acute Respiratory Distress Syndrome: A Single Center Study in 19 Adult Patients.
To describe radiologic findings of adenovirus pneumonia and to understand clinico-radiological features associated with progression to acute respiratory distress syndrome (ARDS) in patients with adenovirus pneumonia.



This study included 19 patients diagnosed with adenovirus pneumonia at a tertiary referral center, in the period between March 2003 and April 2015. Clinical findings were reviewed, and two radiologists assessed imaging findings by consensus. Chi-square, Fisher's exact, and Student'sttests were used for comparing patients with and without subsequent development of ARDS.



Of 19 patients, nine were immunocompromised, and 10 were immunocompetent. Twelve patients (63%) progressed to ARDS, six of whom (32%) eventually died from the disease. The average time for progression to ARDS from symptom onset was 9.6 days. Initial chest radiographic findings were normal (n = 2), focal opacity (n = 9), or multifocal or diffuse opacity (n = 8). Computed tomography (CT) findings included bilateral (n = 17) or unilateral (n = 2) ground-glass opacity with consolidation (n = 14) or pleural effusion (n = 11). Patients having subsequent ARDS had a higher probability of pleural effusion and a higher total CT extent compared with the non-ARDS group (p= 0.010 and 0.007, respectively). However, there were no significant differences in clinical variables such as patient age and premorbid condition.



Adenovirus pneumonia demonstrates high rates of ARDS and mortality, regardless of patient age and premorbid conditions, in the tertiary care setting. Large disease extent and presence of pleural effusion on CT are factors suggestive of progression to ARDS.
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
Min Jae
MJ
Cha
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Myung Jin
MJ
Chung
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Kyung Soo
KS
Lee
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Tae Jung
TJ
Kim
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Tae Sung
TS
Kim
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06973, Korea.
Semin
S
Chong
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Jungho
J
Han
D000208:Acute Disease; D000256:Adenoviridae / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000821:virology; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000209:etiology; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013909:Thorax / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
Acute respiratory distress syndrome; Adenovirus; CT; Chest radiograph; Pneumonia