A Clinical features of Severe Adenovirus Pneumonia among Members of the Korea Military: A Case Series

Jung Yeon Heo; Hye Kang Kim; Yong Jun Cha; Ji Eun Lee; Young Soo Shim; Kang-Won Choe

doi:10.3947/ic.2012.44.5.372

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Heo, Kim, Cha, Lee, Shim, and Choe: A Clinical features of Severe Adenovirus Pneumonia among Members of the Korea Military: A Case Series

Original Article

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(5): 372-376.

Published online: 31 October 2012

DOI: https://doi.org/10.3947/ic.2012.44.5.372

A Clinical features of Severe Adenovirus Pneumonia among Members of the Korea Military: A Case Series

Jung Yeon Heo¹, Hye Kang Kim¹, Yong Jun Cha², Ji Eun Lee¹, Young Soo Shim¹, Kang-Won Choe¹

¹Department of Internal Medicine, Armed Forces Capital Hopital, Sungnam, Korea.

²Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Correspondence to Kang-Won Choe, M.D. Department of Internal Medicine, Armed Forces Capital Hospital, 2 Gil 66 Ho Yul-dong, Bundang-Gu, Sungnam-si, Kyunggi-do 463-040, Korea. Tel: +82-31-725-6315, Fax: +82-31-706-0987, choekw@snu.ac.kr

Received 7 June 2012 Revised 6 August 2012 Accepted 10 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Adenoviral diseases generally present as self-limiting upper respiratory illnesses. However, in some cases, adenovirus can cause fatal outcomes, even in healthy adults. Severe pneumonia caused by adenovirus in young soldiers at basic military training sites have been reported.

Materials and Methods

We conducted a retrospective review of the medical records of patients with pneumonia who were hospitalized in the Intensive Care Unit of the Armed Forces Capital Hospital between January 2011 and March 2012.

Results

Nine patients with pneumonia who required ventilator treatment were analyzed. Adenovirus was proved to be the causative agent of the illness in six out of nine patients, three of whom died due to severe adenoviral pneumonia or adenovirus-related illness. Among these six patients, three were military trainees. Clinical features were characterized by fever (100%) and cough (100%). Other important findings included thrombocytopenia (83.3%), leukopenia (66.6%), and radiologically lobar consolidation (66.7%).

Conclusions

Adenovirus appeared to be the most important pathogen of young Korean soldiers, particularly among military trainees with severe pneumonia requiring mechanical ventilation. Outbreak surveillance for adenovirus associated illness is necessary.

Keywords: Adenovirus, Severe pneumonia, Military personnel

Figures and Tables

Figure 1

Serial Chest X-ray of Case No. 2 on the (A) 1st hospital day, (B) 3rd hospital day, and (C) 5th hospital day, and (D) chest CT scan on the 5th hospital day: Despite antibiotics and antiviral treatment, pneumonia on the right lung field showed rapid deterioration.

Table 1

Characteristics, Clinical Feature and Outcome of Patients with Severe Adenovirus Pneumonia

BAL, Bronchoalveolar lavage; ARDS, Acute respiratory distress syndrome; HD, Hospital day

Table 2

Laboratory Values and Radiological Findings of Six Pneumonia Patients on Admission to Intensive Care Unit

WBC, White blood cell; Hgb, Hemoglobin; ESR, Erythrocyte sedimentation rate; CRP, C-reactive protein

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ORCID iDs: Jung Yeon Heo
https://orcid.org/http://orcid.org/0000-0002-6548-1939
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