Key result
Human adenovirus serotype 14 infection was associated with severe community-acquired pneumonia, with 76% of patients requiring hospitalization, 47% requiring critical care, and 18% dying.
Observational (n=67)
Human adenovirus serotype 14 can cause severe community-acquired pneumonia with high rates of critical illness and mortality, particularly in older patients with chronic conditions.
Raises awareness of adenovirus 14 in severe CAP; leaves open need for prospective studies to guide testing and care.
BACKGROUND: Human adenoviruses (Ads) typically cause mild illnesses in otherwise healthy hosts. We investigated a community-based outbreak that had substantial morbidity caused primarily by Ad14, an uncommon serotype. METHODS: We retrospectively reviewed the medical records of all patients with confirmed cases of Ad infection from 1 November 2006 through 31 July 2007 in Oregon. Isolates were typed by sequencing. We analyzed clinical and laboratory variables to identify risk factors for severe Ad14 disease. RESULTS: Ad14 first emerged in Oregon in 2005. Of 67 cases of Ad infection detected during the study period, 40 (60%) involved Ad14. Most of the 38 Ad14-infected patients who had medical records available for review presented with fever and cough; 29 (76%) required hospitalization, 23 (61%) required supplemental oxygen, 18 (47%) required critical care, 9 (24%) required vasopressors, and 7 (18%) died. Lobar infiltrates on chest radiographs suggestive of bacterial pneumonia were common among those needing hospitalization. Older age, chronic underlying condition, low absolute lymphocyte counts, and elevated creatinine levels were associated with severe illness. Except for 1 case of possible hospital transmission, we identified no epidemiological links among patients. CONCLUSION: Ad14 emerged in Oregon in 2005 and became the predominant circulating type by 2007. Infection with this uncommon virus was primarily associated with a community-acquired pneumonia syndrome and caused substantial morbidity and mortality.
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Lewis et al. (2009) conducted an observational in Human Adenovirus infection (n=67). Human Adenovirus Serotype 14 (Ad14) infection was evaluated on Severe Ad14 disease. Human adenovirus serotype 14 infection was associated with severe community-acquired pneumonia, with 76% of patients requiring hospitalization, 47% requiring critical care, and 18% dying.
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