Year: 2024
Type: article
Study design: Case Report
Abstract: IntroductIonHuman adenoviruses (HAdV), members of the Adenoviridae family, are medium-sized viruses (70-100 nm) with a double-stranded deoxyribonucleic acid (DNA) genome. 1 HAdv infections are very common in children under 5 years of age, with a peak incidence in those under 2 years old. 2 Viral infections are known to cause disturbances in all aspects of the coagulation cascade-primary hemostasis, coagulation, and fibrinolysis.As a result, both thrombotic and hemorrhagic events can occur.3 We report a case of a 12-year-old boy with HAdv pneumonia complicated by splenic infarction (SI). case descrIptIonA 12-year-old boy presented with fever and cough of 2 weeks' duration.His past medical history was uneventful except for focal epilepsy with impaired awareness, for which he had been on lacosamide, perampanel, and clobazam for the past few years.On presentation, he was hemodynamically stable with bilateral crepitations and wheezing on auscultation.Laboratory tests revealed a white cell count of 7120 cells/mm 3 , C-reactive protein >200 mg/L, erythrocyte sedimentation rate (ESR) 60 mm/hour, and procalcitonin of 3.63 ng/mL.Chest radiograph showed haziness in bilateral upper lobes.He was initially treated with piperacillin-tazobactam for presumed bacterial pneumonia.A computed tomography (CT) scan of the chest confirmed consolidation in the bilateral upper lobes.Bacterial cultures of blood and urine were negative.Sputum for acid-fast bacilli and Mantoux test were also negative.Nasal swab for respiratory polymerase chain reaction (PCR) panel was positive for adenovirus.Five days after admission, his fever remitted for 48 hours, but he developed left hypochondriac pain with a relapse of fever.Serum amylase and lipase levels were within normal limits.Ultrasound of the abdomen showed hypoechoic areas in the peripheral aspects of the spleen and altered echogenicity in the subcapsular region, suggesting SI with adjacent subcapsular hemorrhage.Doppler scan revealed normal color flow in the splenic hilar artery and vein but no color flow in intrasplenic vessels.These ultrasound findings were confirmed with contrast-enhanced CT of the abdomen (Figs 1 and 2).As part of 1,
Source: Pediatric Infectious Disease
Institution: Rainbow Children's Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404077632