Chest
Volume 80, Issue 2, August 1981, Pages 127-131
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Chronic Lung Damage Caused by Adenovirus Type 7: A Ten-Year Follow-up Study

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Twenty-seven children aged 0.6 to 7.0 (mean 2.1) years were admitted to the hospital in 1967 and 1968 with type 7 adenoviral pneumonia. All ran a prolonged course. Type 7 adenovirus was isolated from 14 children, and in the other 13, the rise in the titer of complement-fixing antibodies to adenovirus was fourfold or greater. The outcome of the disease in these 27 children was reassessed in 1979, 9.6 to 12.1 (mean 10.7) years after the adenovirus type 7 pneumonia. Twenty-two were examined clinically and roentgenographically and all had lung function tests. Twelve had abnormal chest roentgenograms, and of these, six had bronchiectasis. Six of the ten children with normal chest x-ray films and ten of the 12 with abnormal chest roentgenograms had abnormal pulmonary function tests. Of the six patients with bronchiectasis, four showed no discernible cause of bronchiectasis other than the antecedent type 7 adenoviral infection. The other two patients had bronchial asthma, which can be a risk factor for bronchiectasis.

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MATERIAL AND METHODS

The study population consisted of 27 children (seven girls and 20 boys) with adenovirus type 7 pneumonia, treated in the Department of Pediatrics, University of Oulu, from January 1967 to December 1968. Ages, diagnostic criteria, clinical manifestations, laboratory findings, and roentgenologic pulmonary changes of 25 of these children have been described earlier.7 Two additional children, a girl and a boy, aged seven years and three months, respectively, treated in the same hospital during 1976

RESULTS

Abnormal chest roentgenogram was demonstrated in 12 of the 22 children (Table 1). Of those 12 patients, eight were selected for subsequent bronchography. Bronchiectasis was demonstrated with contrast medium in four patients (Table 2, cases 1 to 4). In two additional patients, bronchiectasis had been diagnosed earlier (cases 5 and 6, Table 2). One of them (case 6) had chronic pulmonary disease with a normal α1-antitrypsin serum level with genotype PiMZ. Lobectomy of the upper right lobe and

DISCUSSION

Several adenoviruses, especially types 1, 3, 4, 7, and 21, can cause serious pneumonia.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 The clinical syndrome of adenovirus pneumonia has been summarized by James et al13 as follows: cough, dyspnea, wheeze, and fever occur during the week of onset in children who are mostly under the age of three years, often under 18 months. Roentgenograms show widespread patchy or confluent pulmonary opacification, extensive bronchial wall thickening, and streaky

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  • Cited by (0)

    This work was supported by the Tuberculosis Foundation of Tampere, Finland.

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