Abstract
Background Respiratory viral infections remain an underrecognized cause of morbidity and mortality
among preterm infants in the neonatal intensive care unit (NICU).
Case Report An eight day old, 650 gram birth weight, 23 weeks' gestational age female developed
“culture-negative” sepsis manifested by respiratory deterioration, hypoxia, leukocytosis,
and thrombocytopenia. She was diagnosed with pneumonia and hepatitis due to adenovirus
HAdV-D (H29F9) by polymerase chain reaction (PCR) testing, but died at the age of
18 days despite treatment with cidofovir and immune globulin intravenous.
Conclusion As the ability to diagnosis respiratory viral infections in the NICU has improved
greatly with the use of PCR testing, the impact and contribution of these viruses
to neonatal disease is now being recognized and the notion of “culture-negative” sepsis
needs reassessment. The diagnosis of these infections in high risk infants is important
not only for etiologic and epidemiologic reasons but ultimately for informing antimicrobial
stewardship efforts.
Keywords
adenovirus - preterm infant - respiratory virus - neonatal intensive care unit
