J Korean Med Sci.  2017 Feb;32(2):287-295. 10.3346/jkms.2017.32.2.287.

Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012–2016

• Yoon H
• Jhun BW
• Kim H
• Yoo H
• Park SB

• KMID: 2364173
• DOI: http://doi.org/10.3346/jkms.2017.32.2.287

Abstract

Adenovirus (AdV) can cause severe pneumonia in non-immunocompromised host, but limited data exist on the distinctive characteristics of AdV pneumonia in non-immunocompromised patients. We evaluated distinctive clinico-laboratory and radiological characteristics and outcomes of AdV pneumonia (n = 179), compared with non-AdV pneumonia (n = 188) in Korean military personnel between 2012 and 2016. AdV pneumonia patients had a higher rate of consolidation with ground-glass opacity (101/152) in lobar distribution (89/152) on computed tomography (CT) (P < 0.001). Laboratory findings showed a higher incidence of unusual blood profiles such as leukopenia (55/179, P < 0.001) or thrombocytopenia (100/179, P < 0.001). The patients had more systemic symptoms such as myalgia (82/179, P = 0.001) or diarrhea (23/179, P < 0.001), compared with non-AdV pneumonia patients. Bacterial co-infection was identified in 28.5% of AdV pneumonia. Most of the AdV isolates typed (69/72, 95.8%) were AdV-55. Patients with a pneumonia severity index ≥ class III were more commonly observed in AdV pneumonia patients compared with non-AdV pneumonia patients (11.2% vs. 2.1%, P < 0.001), and time to clinical stabilization from admission was longer in the AdV pneumonia patients compared with the non-AdV pneumonia patients (3.8 vs. 2.6 days, P < 0.001). Mechanical ventilation (n = 6) was only required in AdV pneumonia patients, one of whom died due to AdV-55. Our data showed that AdV pneumonia in non-immunocompromised patients had distinct characteristics and most of the isolates typed in our study were AdV-55. It is suggested that AdV-55 is an important pathogen of pneumonia in Korean military personnel.

Keyword

Adenovirus; Consolidation; Pneumonia; Thrombocytopenia

MeSH Terms

Adenoviridae*
Coinfection
Diarrhea
Humans
Incidence
Leukopenia
Military Personnel*
Myalgia
Pneumonia*
Respiration, Artificial
Thrombocytopenia

Figure

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  Fig. 1 Patients included in the study analysis. URI = upper respiratory tract infection, PCR = polymerase chain reaction, AdV = adenovirus.

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  Fig. 2 Time trend of patient number with leukopenia (A) and thrombocytopenia (B) among admitted patients with CAP (patient number per 3 months) (n = 540). CAP = community acquired pneumonia.

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  Fig. 3 Chest CT findings in 2 AdV pneumonia patients. Chest CT shows prominent consolidation in the right lower lobe with an air bronchogram and bilateral patchy ground glass opacities (A and B). CT = computed tomography, AdV = adenovirus.

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