Intravenous Ribavirin Therapy for Disseminated Adenovirus Infection

Adenovirus infections are common in children, accounting for 5 to 8% of all pediatric respiratory infections. These infections are usually mild, resolving spontaneously without any specific therapy. They are, however, a frequent cause of hospitalization because of their propensity to cause prolonged fevers.1 In the immunocompromised patient adenovirus infection can have a varied course. Although usually self-limiting this disease can cause significant morbidity, with conditions such as bronchiolitis, interstitial pneumonia, hepatitis, colitis and hemorrhagic cystitis. The reported incidence of infection after bone marrow transplant (BMT) is 5%, with 1 in 10 being serious or fatal. There have been a number of publications relating to the successful role of intravenous ribavirin in treating adenovirus hemorrhagic cystitis after BMT2 but little on its role in treating disseminated infection. We describe a case of a young infant whose only clinical manifestation of disseminated adenovirus infection was a persistent high fever and who was treated successfully with intravenous ribavirin.