Title:Severe Adenovirus Pneumonia Followed by Bacterial Septicaemia: Relevance of Co-Infections in Allogeneic Hematopoietic Stem Cell Transplantation
Volume: 16
Issue: 1
Author(s): Ilka Engelmann, Valerie Coiteux, Albert Heim, Leonardo Magro, Anny Dewilde, Remy Dulery, Didier Hober and Ibrahim Yakoub-Agha
Affiliation:
Keywords:
Adenovirus, bacteremia, Adenovirus pneumonia, bone marrow transplantation, coinfection,
hematopoietic, PCR, superinfection, stem cell.
Abstract: Infections are one of the major complications after allogeneic stem cell transplantation
(allo-SCT). Disseminated infections with human adenoviruses species A, B or C are
associated with a lethality of 24 to 36 %. Fatal outcome is usually observed with high viral
loads in blood (median peak HAdV DNAemia 108 copies/mL). Here we report two adult patients with disseminated
infection with human adenovirus C2 after allo-SCT. Interestingly, both patients developed bacterial
septicaemia following the disseminated HAdV infection. Despite lower peak adenoviral loads in blood (<106
copies/mL) than usually reported for fatal cases of HAdV infection and broad spectrum antimicrobial therapy
both patients experienced a rapidly fatal outcome. These cases shared the following similarities: disseminated
adenovirus infection, adenovirus pneumonia, neurological symptoms and bacterial septicaemia. This suggests
that in patients undergoing allo-SCT, viral bacterial co-infections worsen the clinical outcomes.
