Adenovirus Pneumonia Presenting with Nodular Shadows on Chest X-ray in Two Unrelated Allogeneic Bone Marrow Transplant Recipients

Kanako Mochizuki, Yukio Kondo, Kohei Hosokawa, Kinya Ohata, Hirohito Yamazaki, Akiyoshi Takami, Motoko Sasaki, Yasunori Sato, Yasuni Nakanuma, Shinji Nakao
2014 Internal medicine (Tokyo. 1992)  
Adenoviruses are increasingly recognized as important pathogens following allogeneic stem cell transplantation. We herein report two cases of disseminated adenovirus infection that presented with nodular shadows on chest X-ray after allogeneic bone marrow transplantation from unrelated donors. Both patients died of respiratory failure. Autopsies revealed adenovirus infection of multiple organs. Adenovirus infection should be suspected when nodular lung lesions of unknown origin appear in
more » ... in appear in allogeneic stem cell transplant recipients. Case Reports Case 1 A 50-year-old man was diagnosed with IgA-λ multiple myeloma in March 2006. He achieved a partial response to the VAD (vincristine, doxorubicin and dexamethasone) regimen and received an autologous peripheral blood stem cell transplant following high-dose melphalan therapy. He developed hepatomegaly and systemic lymphadenopathy in June 2007 and was diagnosed with diffuse large B-cell lymphoma due to the transformation of multiple myeloma. Following the administration of chemotherapy with the R-ESHAP (rituximab, etoposide, methylprednisolone, high-dose cytarabine and cisplatin) and R-HyperCVAD (rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone) regimens, he received an allogeneic bone marrow transplant (BMT) from an HLA-matched unrelated donor with a reduced-intensity conditioning regimen in February 2008. He subsequently developed abdominal pain and macroscopic hematuria on day 20 post-transplantation. Com-
doi:10.2169/internalmedicine.53.1192 pmid:24583443 fatcat:nmv4guqvfzhbnjuk4rocd5565i