Radiographic findings of adenoviral pneumonia in children

• Published in: Clinical imaging Vol. 108; p. 110111
• Main Authors: Bayhan, Gülsüm İclal, Gülleroğlu, Nadide Başak, Çetin, Selin, Erat, Tuğba, Yıldız, Selin, Özen, Seval, Konca, Hatice Kübra, Yahşi, Aysun, Dinç, Bedia
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2024
• Subjects: Adenoviruses; Chest radiography; Child; Children; Humans; Multiplex PCR; Pleural Effusion; Pneumonia; Pneumonia - diagnostic imaging; Pneumonia, Bacterial - complications; Pneumonia, Bacterial - diagnostic imaging; Pneumonia, Viral - diagnostic imaging; Radiography; Retrospective Studies; Multiplex PCR; Pneumonia; Children; Chest radiography; Adenoviruses
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2024.110111

Adenovirus pneumonia is a common cause of community-acquired pneumonia in children and can mimic bacterial pneumonia, but there are few publications on its radiographic features. This study has evaluated the chest radiography findings of community-acquired adenovirus pneumonia in children. The frequency of radiological findings mimicking bacterial pneumonia was investigated. The clinical features of patients with adenovirus pneumonia possessing radiological findings mimicking bacterial pneumonia were also evaluated.
The chest radiographs of patients diagnosed with adenovirus pneumonia were retrospectively reviewed. The chest radiographs were interpreted independently by a pediatric infectious disease specialist and a pediatric radiologist. Chest radiography findings mimicking bacterial pneumonia (bacterial-like) were specified as consolidation +/− pleural effusion. Other findings on chest radiography or a completely normal chest X-ray were specified as findings that were compatible with “typical viral pneumonia”.
A total of 1407 patients were positive for adenovirus with respiratory multiplex PCR. The 219 patients who met the study criteria were included in the study. Chest radiographs were normal in 58 (26.5 %) patients. The chest radiograph findings mimicked bacterial pneumonia in 41 (18.7 %) patients.
Adenovirus pneumonia occurs predominantly in children aged five years and younger, as with other viral pneumonias. The radiographic findings in adenovirus pneumonia are predominantly those seen in viral pneumonia. Increasing age and positivity for only adenovirus without other viruses on respiratory multiplex PCR were associated with the chest radiograph being more likely to be “bacterial-like”. Adenovirus may lead to lobar/segmental consolidation at a rate that is not very rare.
•Although it is known that adenovirus pneumonia can radiologically mimic bacterial pneumonia, it is not known how often it does so.•About a quarter of the patients with adenovirus pneumonia had normal chest radiography and a fifth had findings similar to bacterial pneumonia.•The radiographic findings in adenovirus pneumonia are predominantly those seen in viral pneumonia, however, it may lead to lobar consolidation.