Adenoviridae ; isolation & purification ; Adenovirus Infections, Human ; diagnosis ; Female ; Humans ; Infant ; Male ; Pneumonia, Viral ; diagnosis

PURPOSE: Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection. METHODS: A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain reaction. In addition, 11 patients having KD with adenovirus, who were treated with intravenous immunoglobulin therapy during the acute phase of KD were also evaluated. RESULTS: Compared with the adenoviral infection group, the KD with adenovirus group was significantly associated with frequent lip and tongue changes, skin rash and changes in the extremities. In the laboratory parameters, higher C-reactive protein (CRP) level and presence of hypoalbuminemia and sterile pyuria were significantly associated with the KD group. In the multivariate analysis, lip and tongue changes (odds ratio [OR], 1.416; 95% confidence interval [CI], 1.151–1.741; P=0.001), high CRP level (OR, 1.039; 95% CI 1.743–1.454; P= 0.021) and sterile pyuria (OR 1.052; 95% CI 0.861–1.286; P=0.041) were the significant predictive factors of KD. In addition, the cutoff CRP level related to KD with adenoviral detection was 56 mg/L, with a sensitivity of 81.8% and a specificity of 75.9%. CONCLUSION: Lip and tongue changes, higher serum CRP level and sterile pyuria were significantly correlated with adenovirus-positive KD.
Adenoviridae ; Adenoviridae Infections ; Adenovirus Infections, Human ; Biomarkers ; C-Reactive Protein ; Discrimination (Psychology) ; Exanthema ; Extremities ; Humans ; Hypoalbuminemia ; Immunization, Passive ; Lip ; Mucocutaneous Lymph Node Syndrome ; Multivariate Analysis ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tongue

Epidemic keratoconjunctivitis is the most common type of infectious conjunctivitis, and is caused by adenoviruses. The mode of transmission is mainly through direct contact with ocular secretions. Epidemic keratoconjunctivitis is generally diagnosed based on a patient's clinical features, and additional measures, such as cell cultures, polymerase chain reaction, and rapid antigen detection tests, can further confirm the diagnosis. The most common symptoms include a foreign body sensation, tearing, and photophobia. The symptoms are usually expressed unilaterally in the initial phase, but gradually become bilateral. Frequently occurring complications include pseudomembrane formation and subepithelial infiltrates. Currently, no antiviral agent has been proven effective to alter the natural course of the disease, and treatment merely has a supportive role instead of a curative role. Therefore, preventive measures in medical offices and in the community are the most important methods of controlling the propagation of this disease.
Adenoviridae ; Adenovirus Infections, Human ; Cell Culture Techniques ; Conjunctivitis ; Conjunctivitis, Viral ; Diagnosis ; Foreign Bodies ; Humans ; Keratoconjunctivitis* ; Photophobia ; Polymerase Chain Reaction ; Sensation ; Tears

OBJECTIVETo develop a rapid, sensitive and specific method in identifying and typing on adenovirus from clinical specimens.

METHODSPrimers were designed using hexon gene of adenovirus as target. One primer pair was designed as universal primers for amplifying a 1278 bp gene fragment located at the hexon gene of adenovirus from all types. Four primer pairs located within the region of this 1278 bp were specifically designed for amplifying types 3, 7, 11 and 21 of adenoviruses, which were used for multiplex nest-PCR in a single tube. The products from this multiplex nest-PCR were 502 bp (for type 3), 311 bp (for type 7), 880 bp (for type 11) and 237 bp (for type 21), respectively. Type of the adenovirus tested could then be determined after agarose electrophoresis analysis of the PCR products.

RESULTSPCR products with predicted sizes were visualized in the agarose gel for prototype strains of adenovirus types 3, 7, 11 and 21, but not for other respiratory viruses, indicating that the technique was specific without cross reaction with other viruses. Out of the 118 clinical specimens which had been proved to be adenovirus positive by tissue culture and/or immunofluerescence assay, 76 belonged to adenovirus type 3 (76/118, 64.4%), 37 to adenovirus type 7 (37/118, 31.4%), 3 to adenovirus type 11 (3/118, 2.5%) but no adenovirus type 21 was detected. Two of the 118 positive specimens which were positive by both tissue culture and immunofluerescence could not be identified, suggesting that these 2 strains (1.7%) were with the types other than types 3, 7, 11 and 21. Out of the 33 specimens which were negative by both tissue culture and immunofluerescence, 3 showed positive by this multiplex PCR (2 of type 3 and 1 of type 7), suggesting this method was more sensitive than tissue culture and immunofluerescence.

CONCLUSIONThis multiplex nest-PCR method had the benefit of rapid,sensitive and specific nature so could be used for identifying types of adenoviruses in the clinical specimens.

Adenoviridae ; classification ; isolation & purification ; Adenovirus Infections, Human ; virology ; DNA Primers ; DNA, Viral ; analysis ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Sequence Analysis, DNA

OBJECTIVETo evaluate the viral pathogen of pneumonia in children.

METHODSA total of 13 642 cases of children pneumonia in 3 years were enrolled in this study. Antigens of viral pathogen in respiratory excretion, including respiratory syncytial virus (RSV), type 1, 2 and 3 parainfluenza virus, type A and B influenza virus, and adenovirus were detected by direct immunofluorescence method.

RESULTSViral pneumonia accounted for 34.3% of all cases, including 25.8% cases of RSV, 4.7% of parainfluenza virus, 2.4% of type A influenza virus, 0.2% of type B influenza virus and 1.3% of adenovirus. Coinfection was found in 20 cases, in which 17 cases (85%) were infected with RSV and another virus. Positive rates of RSV in children < or = 1 year, 1 to 3 years, and >3 years were 33.1%, 19.7% and 5.1% with a significant difference (chi(2)(trend)=763.4, P < 0.001). The positive rate of adenovirus in children < or =1 year (0.7%) was significantly lower than that in children aged 1 to 3 years and in children >3 years (2.3% and 2.5%) (all P<0.01). The positive rate of type A influenza virus in children aged 1 to 3 years was higher than that in children < or =1 year (chi(2)=18.2, P<0.01). Type 1 parainfluenza virus was found in 1.2% children aged 1 to 3 years with most prevalence (P<0.05). Infection rates of type 3 parainfluenza in children < or =1 year, 1 to 3 years, and >3 years were 4.7%, 3.2% and 1.4% respectively with a significant difference (chi(2)(trend)=52.4, P<0.01). Although there were some differences of infection rate of RSV in different years, it tended to increase from November to next April with a highest rate of 62.8%. Type 3 parainfluenza virus and Type A influenza virus were almost sporadic while type A influenza virus was epidemic in August 2003 with an infection rate of 15.7%.

CONCLUSIONThe highest infection rate of viral pathogen of pneumonia in children is RSV and the follows are parainfluenza, influenza and adenovirus in turn.

Adenoviridae ; isolation & purification ; Adenovirus Infections, Human ; virology ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Orthomyxoviridae ; isolation & purification ; Orthomyxoviridae Infections ; virology ; Paramyxoviridae ; isolation & purification ; Paramyxoviridae Infections ; virology ; Pneumonia, Viral ; virology ; Respiratory Syncytial Virus Infections ; virology ; Respiratory Syncytial Viruses ; isolation & purification

This study was performed to monitor the causative agent of patient with respiratory disease in Pusan, 1998-1999. The results obtained were as follows. Among 1,320 cases of specimens from throat swab, influenzavirus infections were detected 232(89.6%), adenovirus infections were in 14(5.4%), coxsackievirus infections were in 11(4.2%), and echovirus infections were in 2(0.8%). The 222 strains out of 232 strains of influenzavirus showed A-type and the rest of them represented B-type. The distribution for sex- and age-groups is as follows. The male distribution was similar to the female distribution: male distribution, 47.1% and female distribution, 52.9%. Most of the patients was less than 10 years old. The monthly influenza distribution was consistent from Dec. 1998 to Apr. 1999. The 113 strains from the A-type isolates was A/Sydney/05/97(H3N2)-like, the 109 strains A/Beijing/262/95(H1N1)-like, and all of the 10 B-type isolates B/Harbin/07/94-like. Electron micrograph of negative-stained showed about 95 nm and about 71 nm with influenzavirus and adenovirus, respectively. Coxsackievirus and echovirus showed non-enveloped, isometric particle of about 30 nm diameter.
Adenoviridae ; Adenoviridae Infections ; Busan* ; Child ; Coxsackievirus Infections ; Echovirus Infections ; Enterovirus B, Human ; Female ; Humans ; Influenza, Human ; Male ; Pharynx

Severe adenovirus pneumonia has a high mortality and incidence of sequelae. Fever and cough are the main symptoms of children's severe adenovirus pneumonia, but such clinical manifestations are lack of specificity. For children with persistent high fever who are in the epidemic age and season, the adenovirus etiology detection, blood routine, cytokines, T cell subsets and imaging examinations are suggested. Children with early manifestations of infiltration of lung segment and lobar parenchyma, obvious emphysema, interstitial pneumonia or a large amount of pleural effusion should be alerted to have severe adenovirus pneumonia. This article reviews the epidemiological characteristics and risk factors of adenovirus pneumonia in different seasons, regions and serology, and the laboratory findings and imaging features of severe adenovirus pneumonia, which would be helpful for the early identification of the disease.
Adenoviridae ; Adenoviridae Infections ; diagnosis ; Fever ; Humans ; Pleural Effusion ; Pneumonia, Viral ; diagnosis ; Research ; trends

OBJECTIVE: To study the clinical features of children with severe adenovirus pneumonia (SAP) and hemophagocytic syndrome (HPS). METHODS: A retrospective analysis was performed from the chart review data of 30 children with SAP and HPS who were admitted from January 2014 to June 2019. According to the prognosis, the children were divided into a good prognosis group (n=18) and a poor prognosis group (n=12). RESULTS: Among the 30 children with SAP and HPS, the ratio of male to female was 2:1. The median age of onset was 1 year and 3 months (range 3 months to 5 years), and the mean course of fever was 19±7 d. Of the 30 children, 28 (93%) experienced disease onset in January to June. High-throughput gene detection of serum pathogens showed that 16 (53%) children were positive for human adenovirus type 7 (HAdV-7), and the other 14 (47%) children were positive for HAdV antigen based on immunofluorescence assay for throat swab, with unknown type. Of all 30 children, 29 (97%) had respiratory complications, 24 (80%) had cardiovascular complications, 16 (53%) had gastrointestinal complications, and 9 (30%) had toxic encephalopathy. Eighteen children (60%) improved or recovered and 12 (40%) did not recover (3 died). Compared with the good prognosis group, the poor prognosis group had a significantly longer course from onset to diagnosis of HPS (P<0.05), significantly higher levels of fibrinogen and tumor necrosis factor-α (P<0.05), and a significantly lower level of interferon-γ (P<0.05). The mean follow-up time was 6±2 months; 11 (41%) children recovered, 1 (4%) experienced recurrence of HPS, and 15 (56%) had the sequela of post-infectious bronchiolitis obliterans (PIBO). CONCLUSIONS HPS may be observed in children with SAP, and PIBO is the most common sequela of SAP.
Adenoviridae ; Adenoviridae Infections ; Child, Preschool ; Female ; Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; Male ; Pneumonia, Viral ; Retrospective Studies

Adenoviridae Infections ; Allografts ; Hematopoietic Stem Cell Transplantation ; Humans

PURPOSE: To describe the radiologic features of lower respiratory infections associated with adenovirus inchildren and to determine whether these can be differentiated from other lower respiratory infections. MATERIALS AND METHODS: We retrospectively reviewed the radiologic features of 48 lower respiratory tract infectionsassociated with adenovirus in children and diagnosed between December 1990 and August 1996 at Seoul NationalUniversity Children's Hospital. Adenovirus was identified by either viral culture or immunofluorescent staining ofnasal aspirates and/or pleural fluid, and serotested by microneutralization. They were divided into three groups,as follows: type 7 epidemic infection (group I); type 3 sporadic infection (group II); and other(types 1, 2, 4,5, 6) sporadic infection (group III). Each radiological finding was tested for differences among three groups withFisher's exact test. RESULTS: The major radiologic features of adenoviral lower respiratory infection(n=48) werebilateral parahilar peribronchial infiltration(90%), hyperaeration(73%), consolidation(58%), atelectasis(56%) andpleural effusion (31%). In group I(n=27), II(n=8), and III(n=13), bilateral parahilar peribronchialinfiltration(93%, 88%, 85%, respectively), hyperaeration(63%, 88%, 85%), atelectasis(52%, 38%, 77%), pulmonaryconsolidation(81%, 63%, 8%) and pleural effusion(44%, 38%, 0%) were seen. In groups I and II, pulmonaryconsolidation was multiple(82%, 80%, respectively), bilateral(55%, 60%), or extensive(36%, 40%). The prevalence ofconsolidation and pleural effusion in groups Iand II was significantly higher than in group III(p < .05). CONCLUSION: Pulmonary consolidation and pleural effusion, regarded as characteristics of bacterial pneumonia,were common findings in types 7 and 3 adenovirus infections. Parahilar peribronchial infiltration, hyperaeration,and bilateral, multiple, extensive consolidation may be features which can determine whether an infection isadenoviral or due to bacterial pneumonia.
Adenoviridae Infections ; Adenoviridae* ; Child* ; Humans ; Pleural Effusion ; Pneumonia, Bacterial ; Prevalence ; Respiratory System* ; Respiratory Tract Infections* ; Retrospective Studies ; Seoul