Fatal Pneumonia Associated with Adenovirus Type 7 in Three Military Trainees

Abstract

Despite its relatively common occurrence in infants and young children, fatal pneumonia associated with adenovirus Type 7 (ADV-7) in previously healthy adults appears to be very rare. We observed three fatal cases in young male adults, previously in good health, while they were undergoing Army basic training. Each case was associated with absolute lymphopenia and followed a similar clinical course. In the terminal stages, multisystem disease, including disseminated intravascular coagulation, developed in all three. Post-mortem findings revealed extensive pulmonary damage, with bronchial epithelial necrosis, interstitial alveolar thickening and hyaline membranes; small vessels contained hyaline thrombi. ADV-7 was recovered from the upper respiratory tract of each man shortly after hospitalization and again, in high titer, from lung tissue obtained after death. Serum specimens obtained before death revealed high titers of ADV-7 neutralizing antibody.