title: Severe community-acquired adenovirus pneumonia treated with oral ribavirin: a case report.
abstract: BACKGROUND
  Adenovirus is a common pathogen of acute upper respiratory infection in children and is generally self-limiting. Severe adenovirus infections have been reported in immunocompromised hosts especially bone marrow transplantation recipients due to hematologic malignancy. Severe adenovirus pneumonia in immunocompetent hosts has rarely been reported and optimal treatment has not been established. We report a case of community-acquired severe adenovirus pneumonia which was successfully treated with early administration of oral ribavirin.
  
  
  METHODS
  A 39 year-old, previously healthy Korean male was admitted with symptoms of cough, myalgia, febrile sensation. Laboratory findings revealed that he had hypoxemia, thrombocytopenia and elevated transaminase. Chest imaging showed a consolidation with pleural effusion, which was rapidly progressed. All microbiological tests were negative except multiplex real-time reverse transcriptase polymerase chain reaction using respiratory specimen, which was positive for human adenovirus. Under the diagnosis of severe adenovirus pneumonia, we started oral ribavirin, which results in complete recovery without any complications.
  
  
  CONCLUSIONS
  This case demonstrates that oral ribavirin, instead of other expensive antiviral treatment, could be a good therapeutic option for the severe adenovirus pneumonia at least occurred in immunocompetent hosts.
authors.affiliation: Department of Internal Medicine, Hanil General Hospital, Seoul, Republic of Korea.
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Hanil General Hospital, Seoul, Republic of Korea.
authors.forename: Yong Geon
authors.initials: YG
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea. humanmd04@hanmail.net.|Department of Pulmonary and Critical Care Medicine, Kyung Hee University School of Medicine, Kyungheedae-ro 23, Dongdaemun-gu, Seoul, 02447, Republic of Korea. humanmd04@hanmail.net.
authors.forename: Seung Hyeun
authors.identifier: http://orcid.org/0000-0002-7666-313X
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000258:Adenovirus Infections, Human / Q000188:drug therapy*; D000260:Adenoviruses, Human; D000284:Administration, Oral; D000328:Adult; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D008297:Male; D011024:Pneumonia, Viral / Q000188:drug therapy*; D013902:Radiography, Thoracic; D060888:Real-Time Polymerase Chain Reaction; D012254:Ribavirin / Q000008:administration & dosage*
chemical_list: D012254:Ribavirin
keywords: Adenovirus; Case report; Pneumonia; Ribavirin