title: Adenovirus-associated pneumonia in South African children: Presentation, clinical course and outcome.
abstract: BACKGROUND
  Viruses have emerged as important aetiological agents of childhood pneumonia.
  
  
  OBJECTIVE
  To investigate the clinical presentation, severity and outcome of adenovirus-associated pneumonia (AVP) in children.
  
  
  METHODS
  A retrospective analysis of AVP cases over 12 months was performed, including demographic, clinical course and outcome (death, persistent lung disease (PLD)) data.
  
  
  RESULTS
  Two hundred and six AVP cases (median age 12 months, interquartile range 6 - 24) were identified; 70 children (34.0%) were malnourished and 14 (6.8%) were HIV-infected. Twenty-nine children (14.1%) developed PLD, which was associated with hypoxia at presentation in 26 cases (89.7%; p=0.01) and necessitated admission to the intensive care unit (ICU) in 18 (62.1%; p&lt;0.01); 18/206 children (8.7%) died. Admission to the ICU (odds ratio (OR) 8.3, 95% confidence interval (CI) 2.3 - 29.0) and a positive blood culture (OR 11.2, 95% CI 2.3 - 54.1) were independent risk factors for mortality.
  
  
  CONCLUSIONS
  Adenovirus is a potential cause of pneumonia and PLD in young children in South Africa. ICU admission and a positive blood culture were associated with poor outcome.
authors.affiliation: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa. m.zampoli@uct.ac.za.
authors.forename: M
authors.initials: M
authors.lastname: Zampoli
authors.forename: Z
authors.initials: Z
authors.lastname: Mukuddem-Sablay
mesh_terms: D000258:Adenovirus Infections, Human / Q000453:epidemiology*; D016470:Bacteremia / Q000453:epidemiology; D002675:Child, Preschool; D002908:Chronic Disease; D060085:Coinfection; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology; D007362:Intensive Care Units; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D009026:Mortality; D016017:Odds Ratio; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology