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Kunze and coauthors nicely describe the clinical and laboratory characteristics in 106 ADV-positive, 32 ADV-negative, and 33 influenza virus-positive children with respiratory symptoms. ADV-positive patients shows significant elevated concentrations for Crp, IL-6 and elevated leukocyte counts.
The association between adenovirus infection and elevated CRP (and IL-6) concentrations (mimicking bacterial infection) is intriguing but has been in part shown already in some earlier studies. Nevertheless, the data of Kunze contribute new insights into the pathogenesis of ADV infections
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The authors should discuss possible therapeutic consequences in severe cases: cidofovir, i.v. immunoglobulins, adoptive immunotherapy.
The paper examines the clinical picture of adenovirus infection of the respiratory tract with special interest for acute phase proteins. This is an important practical issue as acute phase proteins are often used as a decision maker for the use of antibiotics. If C-reactive protein or Interleukin 6 are high enough an antibiotic is usually prescribed. Kunze and co-workers found adenovirus infection with similar findings like bacterial infections. For that reason the exclusively use of acute phase proteins for deciding to use an antibiotic is not useful in routine clinical care.
Expert in the field of pediatric infectiology and pediatric pulmonology
I think, this is a interesting and important topic for the pediatric infectiologist. The finding,that adenovirus infection can mimic bacterial infections is of practical importance.
I am a pediatric infectiologist
In this study, respiratory adenoviral infections of children are analyzed by clinical laboratory. The message is that such adenovirus infection may mimic bacterial infections, a finding of therapeutical relevance. Adenoviruses induce some immunologic escape mechanisms, so that a chronic course of (subclinic) infection may occur. Thus an additional check of antibody response (seroconversion, titre rise) may support the evaluation of adenovirus detection. Nevertheless, the paper merits attention as it stands.
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