Serious childhood disease has been associated with adenovirus types 3, 7, and 21. Large epidemics have been reported in China. Polynesians in New Zealand and Indians and Metis in central Canada seem to be particularly susceptible. The mortality rate has approached 10 percent in native children from Canada. Acute pathologic features include inflammation of bronchi, bronchiolitis, and bronchopneumonia. Residual pulmonary abnormalities have been found in more than one-half of the survivors. The chronic changes include bronchiolitis obliterans and bronchiole scarring, bronchiectasis, postobstructive pneumonitis, emphysema, pulmonary collapse, and fibrosis. The major physiologic finding in both acute and chronic disease has been bronchiole obstruction. There are various disorders about which we do not hear anything but Canadian Neighbor Pharmacy due to the website – is glad to present you the information about disorders and the way to cope with them.
Adenovirus also causes acute, epidemic respiratory tract disease in military recruits. Fatal pneumonia due to types 4 and 7 has been reported sporadically. Type 21 has produced respiratory disease in this group, but to our knowledge, without sequelae.
There have been case reports of adenovirus pneumonia in civilian adults. Fatal cases have occurred in adult renal transplant recipients. A mixed adenovirus and bacterial pneumonia occurred in a hospitalized patient with chronic respiratory insufficiency due to bulbar poliomyelitis. A case was reported in an otherwise healthy woman who presented with ARDS and had a fourfold rise in adenovirus CF titer. The virus was not isolated, and serology for other agents was not reported. In another instance, adenovirus type 21 was isolated from the stool of an adult man with pneumonia, and there was a concomitant antibody rise. Although the patient survived, no follow-up data were provided. Finally, a case of fatal pneumonia was reported in a middle-aged woman in which adenovirus type 21£ isolated from a stool specimen and intranuclear eosinophilic inclusions were seen in alveolar lining cells. There was a rise in adenovirus CF titer. Interstitial fibrosis and bronchiolitis obliterans were found at autopsy.
Our case was noteworthy in several respects. First, the patient, a previously healthy, civilian adult presented with severe respiratory distress due to adenovirus type 21. The virus was isolated from respiratory secretions, and there was a significant antibody rise. He subsequently had a dramatic response to CPAP and was thereby spared the risk of morbidity and mortality associated with intubation or high concentrations of inspired oxygen. This case and others suggest that CPAP may be particularly suited to severe viral pneumonia. Finally, our patient was free of symptoms and able to tolerate vigorous exercise 15 weeks after discharge. Pulmonary function studies demonstrated resolving, predominantly restrictive, lung disease. The long-term prognosis of adenovirus pneumonitis in adults may be more favorable than anticipated based on previous reports of sequelae following adenovirus pneumonia in children and severe influenza pneumonia in adults in whom hypoxia, worsened by exercise, and reduced diffusion capacity have been documented as long as one year after admission.