ADENOVIRUS PULMONARY INFECTIONS IDENTIFIED BY PCR AND IN-SITU HYBRIDIZATION IN BONE-MARROW TRANSPLANT RECIPIENTS

Aims-To investigate adenovirus pulmonary infections in bone marrow tra nsplant (BMT) recipients. Methods-Formalin fixed, paraffin wax embedde d lung tissue was examined from 13 necropsy cases after BMT using PCR and in situ hybridisation to detect adenovirus DNA. The E1A region of the adenoviral genome was targeted for PCR. In situ hybridisation was performed only in the PCR positive cases. Results-Of the 13 lung speci mens analysed, nine cases were negative for adenoviral nucleic acid. F our (30%) PCR and two (15%) in situ hybridisation positive cases were found. In some of the patients there were clinical and pathological in dications that some diseases might be associated with adenovirus infec tion-haemorrhagic cystitis (three cases); necrotising pneumonia (one c ase). In necrotising pneumonia in which no pathogenic agents had been shown by conventional histological study, the in situ hybridisation te chnique showed positive staining for adenovirus. In a patient who died of renal failure caused by adenovirus nephritis, both PCR and in situ hybridisation were positive in the lung as well as in the kidney, alt hough no histological change was found. Two PCR positive cases lacked positive sites for adenovirus by in situ hybridisation. Conclusions-Th e combination of PCR and in situ hybridisation could be useful for dia gnosing adenovirus infection of the lung in BMT recipients. These resu lts provide a basis for exploring further the clinical use of PCR and in situ hybridisation to diagnose adenovirus infection.