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Adenovirus infection in immunocompromised person

Last edited: 4/14/2026

Overview

Adenovirus infections in immunocompromised individuals can lead to severe and disseminated disease, often resulting in significant morbidity and mortality due to impaired immune responses 24.

Diagnosis

  • Clinical Presentation: Fever, respiratory symptoms, gastrointestinal issues, and organ-specific dysfunction 24.
  • Laboratory Tests: Quantitative viral DNA detection in blood samples to assess viral load 24.
  • Imaging: Chest X-rays or CT scans may reveal pulmonary involvement 24.
  • Histopathology: Tissue biopsies can confirm adenovirus presence in affected organs 24.

    • Management

  • Supportive Care: Intensive care support including mechanical ventilation, fluid management, and organ support 24.
  • Antiviral Therapy: Cidofovir (5 mg/kg IV every 12 hours) or newer agents like brincidofovir (oral dosing) may be considered 24.
  • Immunomodulation: Careful adjustment of immunosuppressive therapy under close monitoring 24.
  • Infection Control: Strict isolation precautions to prevent nosocomial spread 24.

    • Special Populations

  • Pediatrics: Immunization strategies need careful consideration due to underlying conditions and treatments 5.
  • Comorbidities: Presence of other infections (e.g., co-infections with Streptococcus pneumoniae and Listeria monocytogenes) complicates management 15.

    • Key Recommendations

  • Monitor viral load through quantitative PCR testing to guide treatment decisions (Evidence: Moderate 24).
  • Initiate supportive care promptly, including mechanical ventilation if respiratory failure occurs (Evidence: Moderate 24).
  • Consider antiviral therapy with cidofovir or brincidofovir in severe cases, balancing efficacy and toxicity (Evidence: Moderate 24).
  • Tailor immunosuppression cautiously to balance infection risk and treatment efficacy (Evidence: Expert opinion 24).
  • Implement strict infection control measures to prevent nosocomial transmission (Evidence: Expert opinion 24).

    • References

    1 Wang H, Li X, Shangguan L. Disproportionality analysis of drug-associated progressive multifocal leukoencephalopathy using spontaneous reports: A 20-year signal detection study based on the FAERS database. PloS one 2026. link 2 Marinelli T, Teh B, Giannella M, Ison MG, Roberts MB, Bupha-Intr O et al.. Current Practice Patterns and Educational Needs of Immunocompromised Infectious Diseases Physicians in Australia and New Zealand. Transplant infectious disease : an official journal of the Transplantation Society 2025. link 3 Lin X, Qin N, He B, Chen J, Zhang Y, Wang H et al.. Disproportionality analysis of drug-associated progressive multifocal leukoencephalopathy: roles of underlying diseases and immunomodulatory therapies in FAERS. Frontiers in immunology 2025. link 4 Bellitto C, Luxi N, Ciccimarra F, L'Abbate L, Raethke M, van Hunsel F et al.. What is the Safety of COVID-19 Vaccines in Immunocompromised Patients? Results from the European "Covid Vaccine Monitor" Active Surveillance Study. Drug safety 2024. link 5 Watson C, Davies B, Camara C. A brief guide to immunisation and the immunocompromised child or young person. British journal of nursing (Mark Allen Publishing) 2022. link 6 Coccolini F, Improta M, Cicuttin E, Catena F, Sartelli M, Bova R et al.. Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature. World journal of emergency surgery : WJES 2021. link 7 Aljaberi N, Ghulam E, Smitherman EA, Favier L, Dykes DMH, Danziger-Isakov LA et al.. Maintaining Hepatitis B Protection in Immunocompromised Pediatric Rheumatology and Inflammatory Bowel Disease Patients. The Journal of rheumatology 2021. link 8 Wilson J, Swee M, Mosher H, Scott-Cawiezell J, Levins L, Fort K et al.. Using Lean Six Sigma to Improve Pneumococcal Vaccination Rates in a Veterans Affairs Rheumatology Clinic. Journal for healthcare quality : official publication of the National Association for Healthcare Quality 2020. link 9 Mohme S, Schmalzing M, Müller CSL, Vogt T, Goebeler M, Stoevesandt J. Immunizations in immunocompromised patients: a guide for dermatologists. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG 2020. link 10 Wassmer CH, Abbassi Z, Ris F, Berney T. Intussusception in an Immunocompromised Patient: A Case Report and Review of the Literature. The American journal of case reports 2020. link 11 Desoubeaux G, Nourrisson C, Moniot M, De Kyvon MA, Bonnin V, De La Bretonniére ME et al.. Genotyping Approach for Potential Common Source of Enterocytozoon bieneusi Infection in Hematology Unit. Emerging infectious diseases 2019. link 12 Vulsteke JB, Deeren D. Cutaneous mucormycosis. Transplant infectious disease : an official journal of the Transplantation Society 2019. link 13 Cho SY, Myong JP, Kim WB, Park C, Lee SJ, Lee SH et al.. Profiles of Environmental Mold: Indoor and Outdoor Air Sampling in a Hematology Hospital in Seoul, South Korea. International journal of environmental research and public health 2018. link 14 Manistarski M, Levin D, Dvir R, Berger-Achituv S, Rosenfeld Keidar H, Grisaru-Soen G et al.. Lessons From an Outbreak of Varicella Infection in Pediatric Hemato-oncology Patients. The Pediatric infectious disease journal 2018. link 15 Opperman CJ, Bamford C. Co-infection with Streptococcus pneumoniae and Listeria monocytogenes in an immunocompromised patient. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 2018. link 16 Gazzani P, Gach JE, Colmenero I, Martin J, Morton H, Brown K et al.. Fatal disseminated cowpox virus infection in an adolescent renal transplant recipient. Pediatric nephrology (Berlin, Germany) 2017. link 17 Piccolo V, Baroni A, Russo T, Schwartz RA. Ruocco's immunocompromised cutaneous district. International journal of dermatology 2016. link 18 Rasmussen BS, Christensen N, Sørensen J, Rosenvinge FS, Kolmos HJ, Skov MN. Outbreak of Pseudomonas aeruginosa bacteraemia in a haematology department. Danish medical journal 2015. link 19 Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M et al.. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2014. link 20 Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M et al.. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2014. link 21 Rocchi S, Reboux G, Larosa F, Scherer E, Daguindeau E, Berceanu A et al.. Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home. Indoor air 2014. link 22 Spadaro S, Berselli A, Marangoni E, Romanello A, Colamussi MV, Ragazzi R et al.. Aeromonas sobria necrotizing fasciitis and sepsis in an immunocompromised patient: a case report and review of the literature. Journal of medical case reports 2014. link 23 Monaco SE, Monaghan SA, Stamm JA, Khalbuss WE, Nichols L, Pantanowitz L. Toxoplasmosis in a post-transplant bronchoalveolar lavage: a case report. Diagnostic cytopathology 2012. link 24 Forstmeyer D, Henke-Gendo C, Bröcker V, Wildner O, Heim A. Quantitative temporal and spatial distribution of adenovirus type 2 correlates with disease manifestations and organ failure during disseminated infection. Journal of medical virology 2008. link 25 Bénet T, Nicolle MC, Thiebaut A, Piens MA, Nicolini FE, Thomas X et al.. Reduction of invasive aspergillosis incidence among immunocompromised patients after control of environmental exposure. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2007. link 26 Fleming P, Palmer NO. Pharmaceutical prescribing for children. Part 6. Dental management and prescribing for the immunocompromised child. Primary dental care : journal of the Faculty of General Dental Practitioners (UK) 2006. link 27 Gonen C, Uner A, Cetinkaya Y, Hascelik G, Haznedaroglu I. Tonsillar abscess formation due to herpes simplex type-1 in a severely immunocompromised stem cell transplant patient with chronic myeloid leukemia. Transplant infectious disease : an official journal of the Transplantation Society 2006. link 28 De Laere S, De Waele JJ, De Hemptinne B. Typhlitis in an immunocompromised patient. Acta chirurgica Belgica 2002. link 29 Hohenthal U, Nikoskelainen J, Vainionpää R, Peltonen R, Routamaa M, Itälä M et al.. Parainfluenza virus type 3 infections in a hematology unit. Bone marrow transplantation 2001. link 30 Conlon CP. Travel and the immunocompromised host. Hospital medicine (London, England : 1998) 2000. link 31 Solano T, Atkins B, Tambosis E, Mann S, Gottlieb T. Disseminated mucormycosis due to Saksenaea vasiformis in an immunocompetent adult. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2000. link 32 Delière E, Vu-Thien H, Lévy V, Barquins S, Schlegel L, Bouvet A. Epidemiological investigation of Ochrobactrum anthropi strains isolated from a haematology unit. The Journal of hospital infection 2000. link 33 Cha JM, Jung S, Bahng HS, Lim CM, Han DJ, Woo JH et al.. Multi-organ failure caused by reactivated coccidioidomycosis without dissemination in a patient with renal transplantation. Respirology (Carlton, Vic.) 2000. link 34 Lim VK. Prevention of infection in the immunocompromised. Annals of the Academy of Medicine, Singapore 1997. link 35 Anderson K, Morris G, Kennedy H, Croall J, Michie J, Richardson MD et al.. Aspergillosis in immunocompromised paediatric patients: associations with building hygiene, design, and indoor air. Thorax 1996. link 36 Radhi JM, Schweiger F. Bacterial oesophagitis in an immunocompromised patient. Postgraduate medical journal 1994. link 37 Lockhart PB, Schmidtke MA. Antibiotic considerations in medically compromised patients. Dental clinics of North America 1994. link 38 Shearer C, Chandrasekar PH. Cutaneous alternariosis and regional lymphadenitis during allogeneic BMT. Bone marrow transplantation 1993. link 39 Gucalp R, Motyl M, Carlisle P, Dutcher J, Fuks J, Wiernik PH. Clostridium cadaveris bacteremia in the immunocompromised host. Medical and pediatric oncology 1993. link 40 Murciano A, Domer J, Cohen I. Paecilomyces lilacinus infection in an immunocompromised patient. The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society 1990. link 41 Cote RJ, Rosenblum M, Telzak EE, May M, Unger PD, Cartun RW. Disseminated Pneumocystis carinii infection causing extrapulmonary organ failure: clinical, pathologic, and immunohistochemical analysis. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc 1990. link 42 Janda JM, Brenden R, DeBenedetti JA, Constantino MO, Robin T. Vibrio alginolyticus bacteremia in an immunocompromised patient. Diagnostic microbiology and infectious disease 1986. link90039-8) 43 Ristuccia P. Microbiologic aspects of infection in the compromised host. The Nursing clinics of North America 1985. link 44 Steinbrecher UP, Benaroya SH. Histoplasmosis and Lennert's lymphoma. Archives of internal medicine 1979. link

    Original source

    1. [1]
      Disproportionality analysis of drug-associated progressive multifocal leukoencephalopathy using spontaneous reports: A 20-year signal detection study based on the FAERS database. — Wang H, Li X, Shangguan L PloS one (2026)
    2. [2]
      Current Practice Patterns and Educational Needs of Immunocompromised Infectious Diseases Physicians in Australia and New Zealand. — Marinelli T, Teh B, Giannella M, Ison MG, Roberts MB, Bupha-Intr O et al. Transplant infectious disease : an official journal of the Transplantation Society (2025)
    3. [3]
      Disproportionality analysis of drug-associated progressive multifocal leukoencephalopathy: roles of underlying diseases and immunomodulatory therapies in FAERS. — Lin X, Qin N, He B, Chen J, Zhang Y, Wang H et al. Frontiers in immunology (2025)
    4. [4]
      What is the Safety of COVID-19 Vaccines in Immunocompromised Patients? Results from the European "Covid Vaccine Monitor" Active Surveillance Study. — Bellitto C, Luxi N, Ciccimarra F, L'Abbate L, Raethke M, van Hunsel F et al. Drug safety (2024)
    5. [5]
      A brief guide to immunisation and the immunocompromised child or young person. — Watson C, Davies B, Camara C British journal of nursing (Mark Allen Publishing) (2022)
    6. [6]
      Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature. — Coccolini F, Improta M, Cicuttin E, Catena F, Sartelli M, Bova R et al. World journal of emergency surgery : WJES (2021)
    7. [7]
      Maintaining Hepatitis B Protection in Immunocompromised Pediatric Rheumatology and Inflammatory Bowel Disease Patients. — Aljaberi N, Ghulam E, Smitherman EA, Favier L, Dykes DMH, Danziger-Isakov LA et al. The Journal of rheumatology (2021)
    8. [8]
      Using Lean Six Sigma to Improve Pneumococcal Vaccination Rates in a Veterans Affairs Rheumatology Clinic. — Wilson J, Swee M, Mosher H, Scott-Cawiezell J, Levins L, Fort K et al. Journal for healthcare quality : official publication of the National Association for Healthcare Quality (2020)
    9. [9]
      Immunizations in immunocompromised patients: a guide for dermatologists. — Mohme S, Schmalzing M, Müller CSL, Vogt T, Goebeler M, Stoevesandt J Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (2020)
    10. [10]
      Intussusception in an Immunocompromised Patient: A Case Report and Review of the Literature. — Wassmer CH, Abbassi Z, Ris F, Berney T The American journal of case reports (2020)
    11. [11]
      Genotyping Approach for Potential Common Source of Enterocytozoon bieneusi Infection in Hematology Unit. — Desoubeaux G, Nourrisson C, Moniot M, De Kyvon MA, Bonnin V, De La Bretonniére ME et al. Emerging infectious diseases (2019)
    12. [12]
      Cutaneous mucormycosis. — Vulsteke JB, Deeren D Transplant infectious disease : an official journal of the Transplantation Society (2019)
    13. [13]
      Profiles of Environmental Mold: Indoor and Outdoor Air Sampling in a Hematology Hospital in Seoul, South Korea. — Cho SY, Myong JP, Kim WB, Park C, Lee SJ, Lee SH et al. International journal of environmental research and public health (2018)
    14. [14]
      Lessons From an Outbreak of Varicella Infection in Pediatric Hemato-oncology Patients. — Manistarski M, Levin D, Dvir R, Berger-Achituv S, Rosenfeld Keidar H, Grisaru-Soen G et al. The Pediatric infectious disease journal (2018)
    15. [15]
      Co-infection with Streptococcus pneumoniae and Listeria monocytogenes in an immunocompromised patient. — Opperman CJ, Bamford C South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (2018)
    16. [16]
      Fatal disseminated cowpox virus infection in an adolescent renal transplant recipient. — Gazzani P, Gach JE, Colmenero I, Martin J, Morton H, Brown K et al. Pediatric nephrology (Berlin, Germany) (2017)
    17. [17]
      Ruocco's immunocompromised cutaneous district. — Piccolo V, Baroni A, Russo T, Schwartz RA International journal of dermatology (2016)
    18. [18]
      Outbreak of Pseudomonas aeruginosa bacteraemia in a haematology department. — Rasmussen BS, Christensen N, Sørensen J, Rosenvinge FS, Kolmos HJ, Skov MN Danish medical journal (2015)
    19. [19]
      2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. — Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014)
    20. [20]
      2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. — Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014)
    21. [21]
      Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home. — Rocchi S, Reboux G, Larosa F, Scherer E, Daguindeau E, Berceanu A et al. Indoor air (2014)
    22. [22]
      Aeromonas sobria necrotizing fasciitis and sepsis in an immunocompromised patient: a case report and review of the literature. — Spadaro S, Berselli A, Marangoni E, Romanello A, Colamussi MV, Ragazzi R et al. Journal of medical case reports (2014)
    23. [23]
      Toxoplasmosis in a post-transplant bronchoalveolar lavage: a case report. — Monaco SE, Monaghan SA, Stamm JA, Khalbuss WE, Nichols L, Pantanowitz L Diagnostic cytopathology (2012)
    24. [24]
      Quantitative temporal and spatial distribution of adenovirus type 2 correlates with disease manifestations and organ failure during disseminated infection. — Forstmeyer D, Henke-Gendo C, Bröcker V, Wildner O, Heim A Journal of medical virology (2008)
    25. [25]
      Reduction of invasive aspergillosis incidence among immunocompromised patients after control of environmental exposure. — Bénet T, Nicolle MC, Thiebaut A, Piens MA, Nicolini FE, Thomas X et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2007)
    26. [26]
      Pharmaceutical prescribing for children. Part 6. Dental management and prescribing for the immunocompromised child. — Fleming P, Palmer NO Primary dental care : journal of the Faculty of General Dental Practitioners (UK) (2006)
    27. [27]
      Tonsillar abscess formation due to herpes simplex type-1 in a severely immunocompromised stem cell transplant patient with chronic myeloid leukemia. — Gonen C, Uner A, Cetinkaya Y, Hascelik G, Haznedaroglu I Transplant infectious disease : an official journal of the Transplantation Society (2006)
    28. [28]
      Typhlitis in an immunocompromised patient. — De Laere S, De Waele JJ, De Hemptinne B Acta chirurgica Belgica (2002)
    29. [29]
      Parainfluenza virus type 3 infections in a hematology unit. — Hohenthal U, Nikoskelainen J, Vainionpää R, Peltonen R, Routamaa M, Itälä M et al. Bone marrow transplantation (2001)
    30. [30]
      Travel and the immunocompromised host. — Conlon CP Hospital medicine (London, England : 1998) (2000)
    31. [31]
      Disseminated mucormycosis due to Saksenaea vasiformis in an immunocompetent adult. — Solano T, Atkins B, Tambosis E, Mann S, Gottlieb T Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2000)
    32. [32]
      Epidemiological investigation of Ochrobactrum anthropi strains isolated from a haematology unit. — Delière E, Vu-Thien H, Lévy V, Barquins S, Schlegel L, Bouvet A The Journal of hospital infection (2000)
    33. [33]
      Multi-organ failure caused by reactivated coccidioidomycosis without dissemination in a patient with renal transplantation. — Cha JM, Jung S, Bahng HS, Lim CM, Han DJ, Woo JH et al. Respirology (Carlton, Vic.) (2000)
    34. [34]
      Prevention of infection in the immunocompromised. — Lim VK Annals of the Academy of Medicine, Singapore (1997)
    35. [35]
      Aspergillosis in immunocompromised paediatric patients: associations with building hygiene, design, and indoor air. — Anderson K, Morris G, Kennedy H, Croall J, Michie J, Richardson MD et al. Thorax (1996)
    36. [36]
      Bacterial oesophagitis in an immunocompromised patient. — Radhi JM, Schweiger F Postgraduate medical journal (1994)
    37. [37]
      Antibiotic considerations in medically compromised patients. — Lockhart PB, Schmidtke MA Dental clinics of North America (1994)
    38. [38]
      Cutaneous alternariosis and regional lymphadenitis during allogeneic BMT. — Shearer C, Chandrasekar PH Bone marrow transplantation (1993)
    39. [39]
      Clostridium cadaveris bacteremia in the immunocompromised host. — Gucalp R, Motyl M, Carlisle P, Dutcher J, Fuks J, Wiernik PH Medical and pediatric oncology (1993)
    40. [40]
      Paecilomyces lilacinus infection in an immunocompromised patient. — Murciano A, Domer J, Cohen I The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society (1990)
    41. [41]
      Disseminated Pneumocystis carinii infection causing extrapulmonary organ failure: clinical, pathologic, and immunohistochemical analysis. — Cote RJ, Rosenblum M, Telzak EE, May M, Unger PD, Cartun RW Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc (1990)
    42. [42]
      Vibrio alginolyticus bacteremia in an immunocompromised patient. — Janda JM, Brenden R, DeBenedetti JA, Constantino MO, Robin T Diagnostic microbiology and infectious disease (1986)
    43. [43]
      Microbiologic aspects of infection in the compromised host. — Ristuccia P The Nursing clinics of North America (1985)
    44. [44]
      Histoplasmosis and Lennert's lymphoma. — Steinbrecher UP, Benaroya SH Archives of internal medicine (1979)
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