Sakakura Akie, Akashi Yusaku, Shiigai Masanari, Isono Hiroki, Suzuki Hiromichi, Hirose Yumi
Department of General Medicine and Primary Care, Tsukuba Medical Center Hospital, Ibaraki, 305-8558, Japan.
Department of General Medicine and Primary Care, University of Tsukuba Hospital, Ibaraki, 305-8576, Japan.
IDCases. 2020 Nov 19;23:e01011. doi: 10.1016/j.idcr.2020.e01011. eCollection 2021.
Severe infection with human adenovirus (HAdV) is uncommon in adults, and the lack of reliable point-of-care testing makes the diagnosis challenging. A 39-year-old immunocompetent Indian man developed severe pneumonia, and his condition became life-threatening despite antimicrobial therapy. While sputum and blood cultures remained negative, a multiplex PCR respiratory panel (Filmarray Respiratory Panel), which is only approved for use with nasopharyngeal samples, detected HAdV in the serum and tracheal aspirates on day 5. We therefore initiated ganciclovir, steroids, and intravenous immunoglobulin. The patient's respiratory condition improved significantly, and he eventually recovered without complications. We later confirmed that conventional PCR of serum detected HAdV-B7. Our case illustrated that a respiratory panel using multiplex PCR successfully detected HAdV in unapproved samples. Such off-label analyses may support the early diagnosis of infections caused by pathogens that are difficult to identify by routine microbiological examination.
成人严重感染人腺病毒（HAdV）的情况并不常见，且缺乏可靠的即时检测手段使得诊断颇具挑战性。一名39岁免疫功能正常的印度男子患上了严重肺炎，尽管接受了抗菌治疗，其病情仍危及生命。痰培养和血培养均为阴性，但一种仅被批准用于鼻咽样本的多重PCR呼吸道检测板（Filmarray呼吸道检测板）在第5天检测出血清和气管吸出物中存在HAdV。因此，我们开始使用更昔洛韦、类固醇和静脉注射免疫球蛋白进行治疗。患者的呼吸状况显著改善，最终康复且未出现并发症。我们后来证实，血清常规PCR检测出HAdV - B7。我们的病例表明，使用多重PCR的呼吸道检测板成功地在未经批准的样本中检测出了HAdV。这种超说明书分析可能有助于早期诊断由常规微生物检查难以识别的病原体引起的感染。
