Fatal disseminated adenoviral infection in a renal transplant patient

Immunosuppressed patients are more susceptible to adenoviral infection and carry a significantly higher mortality than immunocompetent patients. Renal transplant patients with adenoviral infection most often present with infe ction of the kidney and urinary tract within weeks to months of transplant surgery, suggesting reactivation of the latent adenovirus in the immunosupp ressed host as the source of infection. We describe the first case of a fat al adenovirus infection after several years of immunosuppression in a kidne y transplant patient. Postmortem examination of several tissues, using stan dard viral culture and polymerase chain reaction, was positive for adenovir us serotype 21. This case is unusual in that the fatal disseminated viral i nfection occurred after 6 years of immunosuppression, suggesting that the s ource of adenovirus was a novel infection rather than reactivation of laten t infection, or infection from the transplanted tissue. Furthermore, this i s the first report of adenovirus type 21 in an immunosuppressed patient.