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Critical Care Research and Practice
Volume 2016 (2016), Article ID 9458230, 8 pages
http://dx.doi.org/10.1155/2016/9458230
Research Article

Immunocompromised Children with Severe Adenoviral Respiratory Infection

1Department of Pediatrics, Section of Pediatric Critical Care, Rush University Medical Center, Chicago, Il 60612, USA
2Department of Anesthesiology, Section of Pediatric Critical Care, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
3Department of Pediatrics, Hackensack University Medical Center, Hackensack, NJ 07601, USA
4Division of Pediatric Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD 20201, USA
5Division of Pediatric Critical Care, University of Virginia Children’s Hospital, Charlottesville, VA 22908, USA

Received 30 November 2015; Accepted 18 April 2016

Academic Editor: Robert Boots

Copyright © 2016 Joanna C. Tylka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU) in four children’s hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58%) did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (), multiple organ dysfunction syndrome (), requirement of renal replacement therapy (), ICU admission severity of illness score (), and treatment with cidofovir (). Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (), require renal replacement therapy (), and not survive to hospital discharge (). One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children.