Adenovirus pneumonia treated with Cidofovir in an immunocompetent high school senior

Most adenovirus infections are self-limiting in immunocompetent individuals. Here, we report a case of adenovirus pneumonia in a 17-year-old immunocompetent male. He was admitted to our emergency room complaining of a febrile sense, cough, and diarrhea for four days. Crackles in the left lung and a high fever (40.7 °C) were revealed. Initial chest X-ray and computed tomography images showed consolidation in the left lung. We immediately started empirical antibiotic treatment, but his clinical symptoms and pneumonic consolidation in radiography had not improved by hospital day three. Because adenovirus was detected in his sputum using RT-PCR, he was administered Cidofovir. After 24 h of Cidofovir treatment, the symptoms and fever subsided, and the consolidation in his X-ray was significantly reduced by hospital day nine. The early administration of Cidofovir could be beneficial for the treatment of adenovirus infection in immunocompetent patients.

Chest imaging of H7N9 subtype of human avian influenza

Background

Human infection with avian influenza A H7N9 virus is an acute respiratory infectious disease, which usually causes severe pneumonia with a high mortality. Chest radiographs and Computed Tomography (CT) are principal radiological modalities to assess the lung abnormalities.

Objectives

The goal of this study was to investigate the chest images characteristic of H7N9 subtype of human avian influenza.

Materials and methods

The clinical and imaging data of 11 cases diagnosed as H7N9 subtype of human avian influenza were collected from 4 cities in the southern region of the Yangtze River, China. The chest imaging manifestations were analyzed by the assigned expert group. The analyzed cases include 7 males and 4 females aged from 20 to 84 years, with a mean of 55.6 years. The clinical symptoms were mainly fever (100%, 11/11) and cough (72.7%, 8/11).

Results

Segmental or lobar ground-glass opacity (GGO) or consolidation was shown in 8 cases (72.7% or 8/11). Air bronchogram was found in 7 cases (63.6% or 7/11). The lesions developed into multiple or diffuse in both lungs rapidly at the progressive stage. The reticulation shadows were shown after some lesions absorbed at the stable stage.

Conclusions

The characteristic imaging demonstrations of H7N9 subtype of human avian influenza are segmental or lobar exudative lesions at lungs at the initial stage, which rapidly progress into bilateral distribution at lungs at the progressive stage.