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Chapter 6 : Adenovirus
Category: Clinical Microbiology
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Adenovirus infections are most common among children, people living in close quarters or closed populations, such as college students and military recruits, and immunocompromised patients. Among immunocompromised patients, infection is most commonly described for transplant recipients; adenovirus infection in such patients is the primary focus of this chapter. In hematopoietic stem cell transplantation (HSCT) recipients, adenovirus is commonly associated with upper and/or lower respiratory tract infection, gastrointestinal (GI) disease, hepatitis, and cystitis. Adenovirus infection has been reported for a wide variety of solid organ transplant (SOT) recipient populations, including those receiving heart, lung, liver, intestinal, and renal transplants. The diagnostic approach to patients with adenovirus disease is complex. Sensitivities for immunofluorescence assays performed on primary specimens have ranged from 28 to 75%, while other antigen detection methods have had sensitivities that ranged from 43 to 89%. Electron microscopy may be used to identify adenovirus, particularly in stool. In summary, definitive diagnosis typically combines pathologic evidence of invasive adenoviral disease with positive culture or polymerase chain reaction (PCR) from the site of infection. Few labs are able to perform antiviral susceptibility testing.
Typical adenovirus cytopathic effect in hybrid cell line composed of A549 and mink lung (Mv1Lu) cells. (Photograph courtesy of M. Bankowski.)
Transmission electron microscopy of AdV41 negatively stained with uranyl acetate. (Photograph courtesy of Karin Boucke, University of Zürich.)
Approach to screening for adenovirus disease in pediatric stem cell transplant recipients. (Adapted from reference 14 with permission of the publisher.)
Approach to diagnosis of suspected adenovirus disease ( 45 ).
Infections associated with adenovirus species and serotype
FDA-approved rapid diagnostic tests for adenovirus