title: Adenovirus and "Culture-Negative Sepsis" in a Preterm Neonate.
abstract: BackgroundRespiratory viral infections remain an underrecognized cause of morbidity and mortality among preterm infants in the neonatal intensive care unit (NICU).Case ReportAn eight day old, 650 gram birth weight, 23 weeks' gestational age female developed "culture-negative" sepsis manifested by respiratory deterioration, hypoxia, leukocytosis, and thrombocytopenia. She was diagnosed with pneumonia and hepatitis due to adenovirus HAdV-D (H29F9) by polymerase chain reaction (PCR) testing, but died at the age of 18 days despite treatment with cidofovir and immune globulin intravenous.ConclusionAs the ability to diagnosis respiratory viral infections in the NICU has improved greatly with the use of PCR testing, the impact and contribution of these viruses to neonatal disease is now being recognized and the notion of "culture-negative" sepsis needs reassessment. The diagnosis of these infections in high risk infants is important not only for etiologic and epidemiologic reasons but ultimately for informing antimicrobial stewardship efforts.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
authors.forename: Mohannad
authors.initials: M
authors.lastname: Moallem
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
authors.forename: Eunkyung
authors.initials: E
authors.lastname: Song
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
authors.forename: Preeti
authors.initials: P
authors.lastname: Jaggi
authors.affiliation: Department of Pathology, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Conces
authors.affiliation: Infectious Disease Program, Lovelace Respiratory Research Institute, Albuquerque, New Mexico.
authors.forename: Adriana E
authors.initials: AE
authors.lastname: Kajon
authors.affiliation: Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; Division of Pediatric Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sánchez
keywords: adenovirus; neonatal intensive care unit; preterm infant; respiratory virus