Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: Possible therapeutic effect of human immune serum globulin containing specific neutralizing antibody

Adenoviruses account for 4 to 10% of childhood pneumonia, but severe disease rarely occurs in im-munocompetent individuals.1 Recent evidence suggests that immunocompromised hosts may have more severe adenovirus disease with fulminant, rapidly progressive and often fatal illness. Such illness has been seen in patients immunocompromised by malignancy, steroid therapy and immunosuppressive therapy, as well as in patients with primary immunodeficiency disease.1-3 The precise role that antibody-and cell-mediated immune mechanisms play in the host resistance to adenovirus infection has not been defined. Evidence does exist that the lack of neutralizing an-tibody and the inability to produce adenovirus type-specific antibody are associated with more severe and fatal disease.2 The possibility that passively acquired antibody may ameliorate adenoviral disease in the immunocompromised host is raised by the followingcase.