Trogrlic Antea, Mrcela Dina, Budimir Mrsic Danijela, Jukic Ivana, Sardelic Sanda, Tabain Irena, Hruskar Željka, Nonkovic Diana, Markic Josko, Pavicic Ivelja Mirela
Department of Infectious Diseases, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia.
Department of Pediatrics, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia.
Pathogens. 2024 Dec 17;13(12):1114. doi: 10.3390/pathogens13121114.
Human adenoviruses (HAdVs) are known to be highly contagious pathogens. They are commonly associated with mild respiratory infections in young children but can also cause severe life-threatening infections. Human adenovirus types 4 and 7 have frequently been reported to cause pneumonia in immunocompetent youths and adults. In this retrospective study, we analyzed the clinical, laboratory, radiological, and microbiological features, as well as the treatment and outcomes of an adenovirus outbreak in 185 patients who were admitted to the Emergency Unit of the Departments of Infectious Diseases and Pediatrics, University Hospital of Split, Croatia, between October 2022 and April 2023. An unusual increase in the frequency of adenovirus pneumonia was observed, especially in adults, followed by respiratory failure and complications such as pulmonary embolism. The most common chest X-ray findings were unilateral patchy opacity and unilateral reticulations (11.6%), followed by unilateral lobar pneumonia (7.1%). The predominant CT presentation was unilateral lobar pneumonia with multiple patchy ground glass opacities (23.5%) or lobar pneumonia with mixed opacities (17.6%). We found a low correlation between Brixia score and C-reactive protein in adults and no correlation in children. Adenovirus type 7 was almost exclusively isolated from patients with pneumonia. Most of our patients with severe or critical adenovirus pneumonia were immunocompetent adults without any medical history. So far, only a few studies have presented the radiological features of HAdV pneumonia, which generally did not reveal lobar pneumonia in a substantial percentage. Our research also demonstrated an unusual presentation of adenovirus infection complicated with pulmonary embolism, which has rarely been reported in previous studies. The aforementioned HAdV outbreak indicates the necessity for further research, especially in the context of effective antiviral therapy and infection prevention.
人腺病毒（HAdVs）是已知的高传染性病原体。它们通常与幼儿的轻度呼吸道感染有关，但也可导致严重的危及生命的感染。据报道，4型和7型人腺病毒经常在免疫功能正常的青年人和成年人中引起肺炎。在这项回顾性研究中，我们分析了2022年10月至2023年4月期间入住克罗地亚斯普利特大学医院传染病科和儿科急诊室的185例腺病毒暴发患者的临床、实验室、放射学和微生物学特征，以及治疗情况和结果。观察到腺病毒肺炎的发病率异常增加，尤其是在成年人中，随后出现呼吸衰竭和肺栓塞等并发症。最常见的胸部X线表现是单侧斑片状模糊影和单侧网状影（11.6%），其次是单侧大叶性肺炎（7.1%）。主要的CT表现是单侧大叶性肺炎伴多发斑片状磨玻璃影（23.5%）或大叶性肺炎伴混合性模糊影（17.6%）。我们发现，成人的布瑞夏评分与C反应蛋白之间相关性较低，儿童则无相关性。7型腺病毒几乎仅从肺炎患者中分离出来。我们大多数患有严重或危重型腺病毒肺炎的患者是免疫功能正常的成年人，且无任何病史。到目前为止，只有少数研究展示了人腺病毒肺炎的放射学特征，这些研究通常未显示相当比例的大叶性肺炎。我们的研究还证明了腺病毒感染合并肺栓塞的异常表现，此前的研究很少报道过这种情况。上述人腺病毒暴发表明有必要进一步开展研究，尤其是在有效抗病毒治疗和感染预防方面。
