Simsir A, Greenebaum E, Nuovo G, Schulman L L
Department of Pathology, Columbia University, New York, New York 10032, USA.
Transplantation. 1998 Feb 27;65(4):592-4. doi: 10.1097/00007890-199802270-00027.
Adenovirus (ADV) is increasingly recognized as a cause of morbidity and mortality in transplant recipients, but ADV pneumonitis has rarely been reported after lung transplantation. The few reported instances of ADV pneumonitis occurred mostly in children immediately after lung transplantation suggesting "primary" infection. We report a fatal case of ADV pneumonitis occurring in an adult, 4 years after unilateral lung transplantation, in whom the premortem diagnosis was not determined. Autopsy revealed severe necrotizing bronchitis, bronchiolitis, and interstitial pneumonitis. Characteristic smudgy intranuclear inclusions, immunohistochemistry for viral protein, in situ hybridization for viral genome, and postmortem lung cultures established ADV as the etiologic agent. ADV can cause fatal, occult respiratory infection in adult lung transplant recipients, remote from transplant surgery.
腺病毒（ADV）越来越被认为是移植受者发病和死亡的一个原因，但肺移植后腺病毒肺炎鲜有报道。少数已报道的腺病毒肺炎病例大多发生在肺移植后的儿童身上，提示为“原发性”感染。我们报告一例成人单侧肺移植4年后发生的致命性腺病毒肺炎病例，生前未明确诊断。尸检显示严重的坏死性支气管炎、细支气管炎和间质性肺炎。特征性的核内模糊包涵体、病毒蛋白免疫组化、病毒基因组原位杂交以及死后肺组织培养确定腺病毒为病原体。腺病毒可在远离移植手术的成年肺移植受者中引起致命的隐匿性呼吸道感染。
