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Human adenovirus presence common in Kawasaki disease
The presence of human adenovirus infection in Kawasaki disease is not uncommon, but viral loads are lower compared with children who have human adenovirus disease, recent study results suggest.
“Adenovirus is one of the major considerations in the differential diagnosis of fever and suspected Kawasaki disease,” Preeti Jaggi, MD, of the department of pediatrics at Nationwide Children’s Hospital, told Infectious Disease News. “Viral detection, even with human adenovirus, in the nasopharynx does not rule out Kawasaki disease. This may be more common now that we use polymerase chain reaction, which is very sensitive. One needs to consider the clinical context when interpreting an adenovirus positive PCR result from the nasopharynx.”
Jaggi and colleagues evaluated how often human adenovirus is detected in patients with Kawasaki disease and the differences in viral loads of human adenovirus between patients with Kawasaki disease and detectable human adenovirus and those with human adenovirus disease. The 77 patients with Kawasaki disease were categorized in two groups. Patients in group I had complete or incomplete Kawasaki disease according to American Heart Association guidelines and group II had incomplete Kawasaki disease but did not meet American Heart Association guidelines. A third group, group III, was also established, which included patients who had human adenovirus infection that clinically resembled Kawasaki disease.
Five patients in group I and five patients in group II tested positive for human adenovirus by PCR. The patients in group I had lower viral loads compared with patients in group III. There was no difference in viral loads between group II and group III. There were 13 specimens available for human adenovirus typing. Seven of seven specimens in group III and one of three in group II were human adenovirus species B. The other five samples could not be cultured, but molecular typing showed that three were human adenovirus species C.
“Quantitative PCR, culture and human adenovirus typing methods may help distinguish human adenovirus disease mimicking Kawasaki disease from Kawasaki disease with accompanying human adenovirus detection,” Jaggi said. “We are currently looking at further samples for analysis.”
Disclosure: Jaggi reports no relevant financial disclosures.