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Adenovirus Infection After Bone Marrow Transplant

What is adenovirus?

Adenovirus is a virus that can cause chest colds, cough, pink eye, ear infections, and pneumonia in children. It can also cause diarrhea. An adenovirus usually causes a mild infection in a healthy person.

An adenovirus can be spread by:

  • Having close contact with someone who is sick
  • Breathing in droplets from a sick person sneezing or coughing
  • Touching things that a sick person has touched and then touching the eyes or mouth
  • Contact with poop, such as by changing a baby’s diaper

Most adenovirus infections only affect 1 part of the body. But a person with a weak immune system can have an infection that spreads to more than 1 part of the body. This can be fatal.

Read more about common infections in children with weak immune systems.

Patients who have had bone marrow transplants have a higher risk of serious illness from adenovirus infections.

Children can get a new adenovirus infection during the transplant process. Or the virus may already be in the body. A child’s immune system is weaker during transplant. So, the immune system may not be able to prevent the virus from reproducing. Then the virus can cause serious problems. Before transplant, your child will have tests to check for adenovirus.

Symptoms of adenovirus infection

Some children do not have any symptoms. But some may have any of the following:

Respiratory symptoms Digestive symptoms Urinary symptoms Eye symptoms
Runny nose
Shortness of breath
Stomach pain
Pain with urination
Blood in urine
Eye discharge
Eye redness or itching

Risk factors for adenovirus infection after bone marrow transplant

Children with healthy immune systems are less likely to have serious illness from adenovirus infections. During a bone marrow transplant, your child gets medicines that weaken the immune system. This is called immunosuppressive therapy. It involves high doses of chemotherapy and other medicines.

Immunosuppressive therapy keeps the body from rejecting a transplant. During transplant, the body cannot fight viruses well. Adenovirus is more likely to cause sickness.

Adenovirus can become active after a bone marrow transplant. This may cause health problems. Adenovirus can affect the lungs, digestive system, liver, and brain.

Diagnosis of adenovirus infection after bone marrow transplant

Your child has lab tests at many points during the transplant process. They have a blood and stool (poop) test before the transplant to check for adenovirus.

After their bone marrow transplant, blood lab tests are done to monitor adenovirus. Your care team tests your child at least once a week for 100 days or longer after transplant. This test looks for the amount of virus in the blood.

If your child develops symptoms of illness, your care team may test for adenovirus. Depending on what symptoms your child has, doctors may take samples of stool (poop), nasal swab, or blood.

Treatment of adenovirus infection after bone marrow transplant

Your child’s treatment depends on their infection and their individual needs. Your care team may reduce the doses of medicines that lower the immune response. This allows your child’s body to fight off the infection naturally.

Your provider may also prescribe a medicine to fight the virus. The only medicine that treats adenovirus is an antiviral medicine called cidofovir.

Antivirals can cause other health concerns like kidney problems. Your child will get medicine to protect their kidneys. The care team will also make sure your child gets enough liquids to prevent kidney problems. Your child may get fluids through an IV. The care team will watch for other infections that can happen.

Prognosis for adenovirus infection after bone marrow transplant

Successful treatment of adenovirus depends on many factors. Your child’s care team tests for adenovirus before, during, and after the transplant. This helps them catch the infection and treat it as soon as possible.

Adenovirus symptoms can range from mild to life threatening. The symptoms can also last for a few days or for several weeks.

Adenovirus infection that spreads to more than 1 part of the body is often harder to treat. Your care team works to treat the infection and to prevent transplant rejection or complications.

Support for patients with adenovirus infection after bone marrow transplant

Your child’s care team will tell you the treatment plan. They tell you how your child will receive treatment. Ask your care team how best to care for your child. They can answer any questions you have about your child’s treatment or how to find support.

Questions to ask your care team

  • How will my child be tested for adenovirus before, during, and after transplant?
  • How can I help prevent my child from getting infections like adenovirus?
  • How will the results of the adenovirus tests be shared with me?
  • What risk factors does my child have with adenovirus?
  • What treatment is best for my child’s adenovirus infection?
  • What are the possible side effects of adenovirus treatment?
  • How can I help reduce side effects of treatment?
  • What should I know about caring for my child while they receive treatment?

Key points about adenovirus infection after bone marrow transplant

  • Adenovirus can cause respiratory, gastrointestinal, urinary, or eye disease.
  • Symptoms of adenovirus depend on which body system is infected.
  • Depending on what symptoms your child has, your provider may take stool samples, nasal swab, or blood to diagnose adenovirus in specific organ systems.
  • Treatment for adenovirus infection often includes reducing the dose of medicines that lower the immune response. Your child may also get antiviral medicines.
  • Your care team often tests for adenovirus. This is so they can diagnose and treat this infection as soon as possible.

Reviewed: November 2023