Adenovirus Pneumonia CT Patterns in Adults Who Are Immunocompromised

pneumonia xray
pneumonia xray
What can be learned from temporal CT patterns of adenovirus pneumonia in immunocompromised patients?

The clinical and computed tomography (CT) characteristics of adenovirus pneumonia as well as dynamic changes associated with adenovirus pneumonia in immunocompetent adults were recently examined in a retrospective study. Results of the study were recently published in Clinical Respiratory Journal.

Researchers evaluated data from 20 immunocompetent adults with adenovirus pneumonia (18 males; median age, 36 years old; median interval from illness onset to admission, 6 days), analyzing CT scans, summarizing patterns and changes in CT findings, and calculating patients’ pneumonia severity index (PSI).

The patients’ clinical characteristics included high fever (39.2 ± 0.8°C), a normal white blood cell (WBC) count, decreased lymphocytes, and elevated C-reactive protein. The most

frequent finding on initial CT was bilateral consolidation — with and without ground glass opacities — which showed multilobular or peribronchovascular distribution. Consolidation was a predominant pattern found on CT during the first 2 weeks, which then resolved to minimal consolidation after the fourth week. The abnormal opacity peaked within 2 weeks of illness onset and gradually resolved after the third week. Additionally, there was no significant correlation between CT score and PSI score. In patients with more severe illness, researchers found multilobular involvement, higher CT scores, and pleural effusion. The temporal changes of radiological score are consistent with clinical findings.

Acknowledging that the research was limited by its small sample size, the study authors concluded that “Adenovirus pneumonia in immunocompetent adults mainly manifested as bilateral significant consolidation with or without ground-glass opacities on CT.” They added, “Although these findings are not specific for adenovirus pneumonia, adult patients with high fever, normal WBC count, decreased lymphocyte count, and consolidation with/without [ground glass opacity] on CT may be suspected adenovirus pneumonia.”


Zhang P, Liu M, Zhang L, et al. Clinical and CT findings of adenovirus pneumonia in immunocompetent adults. Clin Respir J. Published online September 9, 2021. doi:10.1111/crj.13439