Adenovirus a rare cause of central nervous system disease in children

A recent study has found more cases of adenovirus in the respiratory tract than the cerebrospinal fluid (CSF), but most patients have the virus detected in both.

“The lack of adenovirus in the CSF does not exclude central nervous system (CNS) involvement,” the investigators said, adding that viral detection results in the CSF do not seem useful as an indicator of the severity of CNS disease.

A retrospective analysis was conducted on clinical, laboratory outcomes and the relationship between clinical characteristics and viral detection results in the CSF in children with adenovirus-related CNS dysfunction.

Twenty-one patients (1.5 percent) had adenovirus-related CNS manifestations (median age, 1.4 years; 95 percent were <5 years of age; 28 percent male). Altered consciousness (100 percent) was the most frequently reported CNS symptom, followed by seizure (14.3 percent).

Fourteen (73.7 percent) and six (37.5 percent) patients had abnormal electroencephalogram examination and abnormal imaging, respectively.

None of the patients had been treated with cidofovir. Twenty of them recovered without sequelae and one died of respiratory failure.

Children with positive adenovirus polymerase chain reaction (n=11) presented lower onset age than those with negative adenovirus polymerase chain reaction (n=10) in the CSF. No significant between-group differences were observed in clinical manifestation, laboratory findings, imaging studies, and electroencephalogram.

A frequent aetiology of acute respiratory tract infections, adenovirus is a rare cause of CNS disease in children, primarily causing altered consciousness.