PMC6354651_01
Serial chest radiographs of a 17-year-old high school male with adenovirus pneumonia. (A) Radiograph at admission showing a dense consolidation (arrow) in the left upper and lower lung. (B) Extent of left lung consolidation progressed (arrow), with newly developed patchy consolidation in the right upper lung (arrow head) on hospital day three. (C) Consolidation in the left lung (arrow) was improved, and another right upper lung lesion (arrow head) had almost completely disappeared on hospital day nine. (D) Presumed pneumonic consolidation in both the upper and left lower lung zones (arrow) improved without definite residual lesions in chest radiographs two weeks after the initial study (after discharge).
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An initial chest X-ray and computed tomography (CT) confirmed dense consolidation and centrilobular nodules in the left upper and lower lungs (Fig. 1-A, Fig. 2-A, B). His chest radiography showed infiltration and rapid progression in the left upper and lower lung fields and a newly developed consolidation in the right upper lung field (Fig. 1-B). On hospital day nine, he complained of only a mild cough and showed significant improvement in the chest X-ray (Fig. 1-C) and normalization of laboratory markers such as CRP (1.0 mg/dL), platelets (478 x 109/L), neutrophil (55.9%), and lymphocyte (29.5%) fraction (55.9%). The patient showed complete improvement of residual pneumonic consolidation in follow-up chest X-rays taken two weeks after discharge (Fig. 1-D).
Chest and abdominopelvic computed tomography (CT) images of a 17-year-old male high school student with adenovirus pneumonia and gastroenteritis. (A) Dense consolidation with infiltration was revealed in the left upper lung (arrow) on the chest CT. (B) In the superior segment of the left lower lung (arrow head), patchy consolidation and centrilobular nodules are shown. (C) On the abdominopelvic CT scan, diffuse wall thickening and mucosal enhancement are noted in the rectosigmoid colon, suggesting the possibility of proctocolitis. (D) Mild hepatosplenomegaly was also noted.
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An abdomen X-ray and CT showed diffuse bowel wall swelling, mucosal enhancement of the rectosigmoid colon, and mild hepatosplenomegaly (Fig. 2-C, D).
Clinical course from admission to discharge of the 17-year old patient. HD, hospital day; CRP, C-reactive protein.
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His fever subsided after 24 h of Cidofovir administration, and his other clinical symptoms also improved rapidly (Fig. 3); however, his radiologic and laboratory findings, including CRP (13.05 mg/dL) and platelet (139 x 109/L) levels, did not improve until hospital day five.