phenylephrine-hydrochloride and Adenoviridae-Infections

Adenovirus infection is common in childhood and is generally associated with self-limited disease. Cidofovir, a viral DNA polymerase inhibitor, is used to treat adenovirus infection in select populations but is not often recommended for immunocompetent patients because of limited antiviral activity and nephrotoxicity. Here, we report a case of fulminant adenovirus infection associated with lymphopenia and multiple organ failure requiring extracorporeal membrane oxygenation support in a previously healthy child. After 1 week of supportive therapy, the patient had persistent organ failure and continued to have adenoviremia of >560 000 copies per mL. Weekly doses of cidofovir with concurrent probenecid for renal protection was initiated. Adenovirus blood load declined after the first cidofovir dose, becoming undetectable after 3 doses. The patient was successfully decannulated from extracorporeal membrane oxygenation, extubated, and eventually discharged at his functional baseline without need for ongoing respiratory support. Lymphopenia improved after viremia resolved, and a subsequent immunologic workup revealed no evidence of primary immunodeficiency. The viral isolate was genotyped as adenovirus type 7. This case reveals the successful use of cidofovir for management of severe adenovirus infection in a previously healthy child. To date, there are no universally accepted recommendations for the use of cidofovir in this population. Further study is warranted to determine the potential role of cidofovir in treating severe adenovirus infections in immunocompetent children.

Topics: Adenoviridae; Adenoviridae Infections; Antiviral Agents; Child, Preschool; Cidofovir; Combined Modality Therapy; Consciousness Disorders; Extracorporeal Membrane Oxygenation; Humans; Immunocompetence; Male; Multiple Organ Failure; Nose; Patient Acuity; Pneumonia, Viral; Polymerase Chain Reaction; Radiography, Thoracic; Respiratory Distress Syndrome; Shock

Topics: Adenoviridae; Adenoviridae Infections; Antibodies; Antibody Formation; Capsules; Digestive System; Humans; Immunity, Active; Male; Neutralization Tests; Nose; Pharynx; Placebos; Respiratory Tract Infections; Serotyping; Solutions; Species Specificity; Vaccination; Viral Vaccines

This study reports the results of a systematic screening for respiratory viruses in pediatric outpatients from an emergency department (ED) in southern Brazil during two consecutive influenza seasons. Children eligible for enrollment in this study were aged 24-59 months and presented with acute respiratory symptoms and fever. Naso- and oropharyngeal swabs were collected and multiplex reverse transcription PCR (RT-PCR) was performed to identify the respiratory viruses involved. In total, 492 children were included in this study: 248 in 2010 and 244 in 2011. In 2010, 136 samples (55%) were found to be positive for at least one virus and the most frequently detected viruses were human rhinovirus (HRV) (18%), adenovirus (AdV) (13%), and human coronavirus (CoV) (5%). In 2011, 158 samples (65%) were found to be positive for at least one virus, and the most frequently detected were HRV (29%), AdV (12%), and enterovirus (9%). Further, the presence of asthma (OR, 3.17; 95% CI, 1.86-5.46) was independently associated with HRV infection, whereas fever was associated with AdV (OR, 3.86; 95% CI, 1.31-16.52) and influenza infections (OR, 3.74; 95% CI, 1.26-16.06). Ten patients (2%) were diagnosed with pneumonia, and six of these tested positive for viral infection (4 HRV, 1 RSV, and 1 AdV). Thus, this study identified the most common respiratory viruses found in preschool children in the study region and demonstrated their high frequency, highlighting the need for improved data collection, and case management in order to stimulate preventive measures against these infections. J. Med. Virol. 88:1325-1333, 2016. © 2016 Wiley Periodicals, Inc.

Topics: Adenoviridae; Adenoviridae Infections; Brazil; Child; Child, Preschool; Female; Humans; Infant; Influenza A virus; Influenza, Human; Male; Multiplex Polymerase Chain Reaction; Nose; Oropharynx; Outpatients; Respiratory Syncytial Virus Infections; Respiratory Syncytial Viruses; Respiratory Tract Infections; Rhinovirus; Seasons; Virus Diseases; Viruses

Adenovirus (AdV) infections are a frequent cause of morbidity and mortality following allogeneic stem cell transplantation (SCT), and disseminated infection is associated with high mortality, particularly in paediatric SCT. Here, we describe an approach to reduce mortality from adenoviraemia by combining prospective monitoring for the occurrence of adenoviraemia using a sensitive polymerase chain reaction method, early antiviral therapy and prompt withdrawal of immunosuppression. A total of 155 consecutive paediatric SCT procedures were prospectively monitored, of which 113 (73%) transplants involved donors other than matched siblings and 126 (83%) employed T-cell depletion. Adenoviraemia was detected in 26/155 (17%) transplants and developed exclusively in patients who had received T-cell-depleted grafts. Withdrawal of immunosuppression coupled with early antiviral therapy led to resolution of adenoviraemia in 19/26 (81%) patients with only five patients succumbing to disseminate AdV infection. Survival from adenoviraemia was associated with lymphocyte recovery to above 0.3x10(9)/l. Mortality was closely linked with the absence of lymphocyte recovery because of profound T-cell depletion of the graft with CD34+ magnetic-activated cell sorting. Mortality from disseminated AdV infection was 5/26 (19%) in this study, which is significantly lower than previously reported.

Topics: Adenoviridae; Adenoviridae Infections; Adolescent; Antiviral Agents; Child; Child, Preschool; DNA, Viral; Feces; Ganciclovir; Hematologic Diseases; Humans; Immunosuppressive Agents; Infant; Logistic Models; Nasopharynx; Nose; Polymerase Chain Reaction; Prognosis; Prospective Studies; Risk Factors; Stem Cell Transplantation; Transplantation Conditioning; Transplantation, Homologous; Treatment Outcome

Topics: Adenoviridae Infections; Animals; Antibodies, Viral; Lung; Nose; Pasteurella; Pasteurella Infections; Pneumonia; Sheep; Sheep Diseases

Topics: Adenoviridae; Adenoviridae Infections; Animals; Kidney; Lung; Lymph Nodes; Nose; Sheep; Sheep Diseases; Spleen

Topics: Adenoviridae; Adenoviridae Infections; Animals; Germ-Free Life; Lung; Nose; Rectum; Sheep; Sheep Diseases; Specific Pathogen-Free Organisms

To define the role of adenoviruses in the pertussis syndrome, a study was done of a group of 134 children with clinical pertussis and a healthy control population of similar age, race, sex, and socioeconomic status. Adenovirus infections occurred in 30 (22.4%) of 134 patients with the pertussis syndrome and 5 (4.9%) of 101 control subjects (p smaller than 0.001). B. pertussis was recovered from 46 (34.3%) patients, and from 18 (39.1%) of these patients adenoviruses were also isolated. Although adenovirus infections also occurred in patients with the pertussis syndrome with negative cultures for B. pertussis, the rate, 12 of 88 patients (13.6%), was significantly lower (p smaller than 0.001). The clinical course was similar irrespective of the results of bacterial or viral cultures. These data substantiate the frequent association of adenoviruses with the pertussis syndrome, It would appear that adenoviruses do not usually have an independent role in the pathogenesis of the pertussis syndrome since we found them so commonly to be one agent in a mixed infection.

Topics: Adenoviridae; Adenoviridae Infections; Animals; Antibodies, Viral; Bordetella pertussis; Female; Humans; Infant; Leukocyte Count; Macaca mulatta; Male; Nose; Syndrome; Whooping Cough

A three-week-old Arabian filly was admitted to the Large Animal Hospital with a respiratory disorder and died despite symptomatic treatment. The necropsy lesions were suggestive of viral pneumonia. An equine adenovirus were isolated from nasal and pharyngeal swabs and from several tissues after death. Typical adenovirus virions were demonstrated by electron microscopy.

Topics: Adenoviridae; Adenoviridae Infections; Animals; Cytopathogenic Effect, Viral; Female; Horse Diseases; Horses; Lung; Nose; Pharynx; Pneumonia

Topics: Adenoviridae; Adenoviridae Infections; Animals; Cells, Cultured; Conjunctiva; Cytopathogenic Effect, Viral; Herpesviridae; Herpesviridae Infections; Horse Diseases; Horses; Kidney; Lung; Microscopy, Electron; Nose; Respiratory Tract Infections; Slow Virus Diseases

Topics: Adenoviridae; Adenoviridae Infections; Animals; Animals, Newborn; Antigens, Viral; Cattle; Cattle Diseases; Conjunctiva; Cytopathogenic Effect, Viral; Hemagglutination Tests; Immunodiffusion; Neutralization Tests; Nose; Palatine Tonsil; Virus Replication

Topics: Adenoviridae; Adenoviridae Infections; Animals; Cattle; Cattle Diseases; Conjunctiva; Feeding and Eating Disorders; Female; Fever; Humans; Nose

Topics: Adenoviridae; Adenoviridae Infections; Animals; Haplorhini; Hemagglutination Inhibition Tests; Monkey Diseases; Neutralization Tests; Nose; Orthomyxoviridae Infections; Paramyxoviridae; Pharynx; Respiratory Tract Infections; Rhinovirus; Time Factors; Virus Diseases

Topics: Adenoviridae Infections; Administration, Oral; Animals; Brain; Germ-Free Life; Meningoencephalitis; Nose; Swine; Swine Diseases

Topics: Adenoviridae; Adenoviridae Infections; Cells, Cultured; Child; Child, Preschool; Enterovirus; Enterovirus Infections; Feces; Gastrointestinal Diseases; Herpesviridae; Herpesviridae Infections; Humans; Infant; Microbial Sensitivity Tests; Nose; Orthomyxoviridae; Orthomyxoviridae Infections; Pharynx; Population Surveillance; Respiratory Tract Infections; Rhinovirus; Virus Cultivation; Virus Diseases; Viruses; Washington

Topics: Adenoviridae Infections; Ampicillin; Anal Canal; Bronchiectasis; Child; Child, Preschool; Cloxacillin; Complement Fixation Tests; Female; Finland; Follow-Up Studies; Gastroenteritis; Heart Diseases; Hemorrhagic Disorders; Hepatomegaly; Humans; Infant; Kidney Diseases; Male; Meningism; Meningoencephalitis; Nose; Parasympatholytics; Penicillins; Pneumonia, Viral; Pulmonary Fibrosis; Radiography

Topics: Adenoviridae; Adenoviridae Infections; Complement Fixation Tests; Culture Techniques; Exudates and Transudates; Fluorescent Antibody Technique; Humans; Influenza, Human; Methods; Mobile Health Units; Mycoplasma; Mycoplasma Infections; Netherlands; Nose; Orthomyxoviridae; Paramyxoviridae Infections; Pharynx; Respiratory Syncytial Viruses; Respiratory Tract Infections; Respirovirus; Sputum; Time Factors; Virus Diseases

Topics: Adenoviridae; Adenoviridae Infections; Adult; Aerosols; Air Conditioning; Disease Outbreaks; Humans; Male; Military Medicine; Nose; Respiratory Tract Infections; United States; Virulence

Topics: Adenoviridae; Adenoviridae Infections; Adolescent; Adult; Bacteriological Techniques; Carrier State; Fever; Humans; Male; Military Personnel; Naval Medicine; Nose; Respiratory Tract Infections; Staphylococcal Infections; Staphylococcus; United States

Topics: Adenoviridae Infections; Child; Infant; Nose; Research