title: Clinical Features and Courses of Adenovirus Pneumonia in Healthy Young Adults during an Outbreak among Korean Military Personnel.
abstract: BACKGROUND
  The number of pneumonia patients increased suddenly in Korean military hospitals in late December 2014, indicating the urgent need for an epidemic outbreak investigation.
  
  
  METHODS
  We conducted a prospective study of pneumonia etiology among immunocompetent young adults admitted to Daejeon Armed Forces hospital. Patient blood and sputum samples were subjected to conventional culture, serology, and polymerase chain reaction tests for respiratory viruses and atypical pathogens.
  
  
  RESULTS
  From January to May 2015, we enrolled 191 (189 male) adults with pneumonia; the mean age was 20.1 ± 1.3 years. Five patients had severe pneumonia, and one died. Pathogenic human adenoviruses were most common (HAdV, 153/191 [80.1%]), indicating a HAdV pneumonia outbreak. Genotyping of 35 isolates indicated that 34 matched HAdV-55 and one matched HAdV-2. HAdV pneumonia infected recruit trainees most frequently. High and prolonged fever, nasal congestion, sore throat, and pharyngeal inflammation were significantly more common in the HAdV pneumonia group, compared to patients with other or unknown causes of pneumonia. Only 12% of HAdV pneumonia patients displayed leukocytosis, whereas febrile leukopenia (62.7%) and thrombocytopenia (41%) were commonly observed. HAdV pneumonia patient chest CT scans displayed ground glass opacity (with or without septal thickness) with consolidation in 50.0% of patients.
  
  
  CONCLUSIONS
  An outbreak of HAdV respiratory infection occurred at the Korean military training center. HAdV pneumonia exhibited specific laboratory and clinical features, and although most patients were cured without complication, some progressed to respiratory failure and fatality. Therefore, HAdV vaccine should be provided to military trainees in Korea.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.|Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea.|Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Bong-Joon
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Chungcheongnam-Do Institute of Health and Environment Research, Daejeon, Korea.
authors.forename: Kwi Sung
authors.initials: KS
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Hee Sun
authors.initials: HS
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Jung
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Ju Ock
authors.initials: JO
authors.lastname: Kim
mesh_terms: D000258:Adenovirus Infections, Human / Q000150:complications / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D011024:Pneumonia, Viral / Q000150:complications / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult