Severe adenovirus-associated pneumonia complicated by biopsy-evaluated acute kidney injury in an immunocompetent adult: a case report
Abstract
Background: Adenovirus infection is typically self-limited in immunocompetent individuals. Severe adenovirus-associated pneumonia with renal involvement is uncommon and has been predominantly reported in immunocompromised hosts. Acute kidney injury (AKI) during viral infections may occur through inflammatory or tubular mechanisms even in the absence of immune-complex-mediated glomerular disease.
Case presentation: An 18-year-old previously healthy immunocompetent woman presented with severe pneumonia. Upper respiratory tract PCR was positive for adenovirus, while blood and urine cultures were negative. Laboratory findings showed marked systemic inflammation (CRP 256 mg/L; procalcitonin 15 ng/mL). Serum creatinine was elevated to 4.0 mg/dL prior to antibiotic therapy. Urinalysis revealed leukocyturia, microscopic hematuria, and proteinuria below the nephrotic range. Due to severe acute kidney injury at presentation and diagnostic uncertainty, a kidney biopsy was performed. Light microscopy demonstrated preserved glomerular architecture without proliferative or crescentic changes. Immunofluorescence staining was negative for IgG, IgA, IgM, C3, and C1q. Mild tubular alterations, including focal granular-hyaline casts, were observed, without specific vascular pathology. Overall findings were compatible with infection-associated acute kidney injury. Mini-pulse corticosteroid therapy and empirical broad-spectrum antibiotics were administered. Renal function subsequently improved,…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.