Fatal disseminated adenovirus infection featuring liver necrosis and prolonged viremia in an immunosuppressed child with malignant histiocytosis

Truly disseminated adenovirus disease is rare and appears to be limited to patients with severe combined T and B cell deficiency. This report describes an 18- month-old child with malignant histiocytosis treated with chemotherapy who developed a fatal disseminated type 2 adenovirus infection. Histologic changes in the tissues of multiple organs as well as the presence of typical crystalline structures in sections of the liver seen with electron microscopy provided evidence of viral replication. Adenovirus was recovered from the involved organs and from daily serum samples obtained over a 2-week period prior to death. The possibility that the child may have had virus associated histiocytic disease prior to chemotherapy is discussed.