Severe adenovirus pneumonia complicated by acute respiratory distress syndrome in immunocompetent patients: a case report and literature review.

IF 3.1 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Frontiers in Medicine Pub Date : 2025-03-17 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1524783

Lei Zhang, Yuxin Guo, Xudong Wang, Wei Gai, Lina Liu

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Abstract

Background: Human adenovirus (HAdV) is one of the most important pathogens detected in acute respiratory illness in pediatric and immunocompromised patients, but it is relatively rare to develop severe pneumonia in immunocompetent patients. We analyzed the clinical features, as well as the diagnosis and treatment processes, to provide a reference for clinical practice.

Case presentation: We report a case of severe pneumonia caused by HAdV, complicated by acute respiratory distress syndrome (ARDS), in an immunocompetent patient with no underlying conditions. Chest computed tomography (CT) revealed consolidation in the right lower lung. Conventional microbial tests were negative, but metagenomic next-generation sequencing (mNGS) identified a large number of HAdV sequences in blood and sputum. Together with the clinical symptoms, this confirmed the diagnosis of severe pneumonia caused by HAdV. The patient was discharged after timely treatment with cidofovir.

Conclusion: In our study, we described a rare case of severe pneumonia caused by HAdV, complicated by ARDS, in an immunocompetent patient. mNGS proves to be an effective diagnostic tool for guiding treatment decisions.

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免疫功能正常患者严重腺病毒肺炎并发急性呼吸窘迫综合征1例报告并文献复习。

背景：人腺病毒（hav）是儿科和免疫功能低下患者急性呼吸道疾病中检出的最重要病原体之一，但在免疫功能正常的患者中发生严重肺炎的情况相对罕见。分析其临床特点及诊治过程，为临床实践提供参考。病例介绍：我们报告了一例由hav引起的严重肺炎，并发急性呼吸窘迫综合征（ARDS），患者免疫功能正常，无基础疾病。胸部电脑断层扫描显示右下肺实变。传统的微生物检测结果为阴性，但新一代宏基因组测序（mNGS）在血液和痰中发现了大量hav序列。结合临床症状，这证实了由hav引起的严重肺炎的诊断。患者经西多福韦及时治疗后出院。结论：在我们的研究中，我们描述了一例罕见的由hav引起的严重肺炎并发ARDS的病例，患者免疫功能正常。mNGS被证明是指导治疗决策的有效诊断工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Medicine Medicine-General Medicine

CiteScore

5.10

自引率

5.10%

发文量

3710

审稿时长

12 weeks

期刊介绍： Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world