Human adenovirus meningoencephalitis: a 3-years’ overview

  • Luine Rosele Vidal
  • Sérgio Monteiro de AlmeidaEmail author
  • Bárbara Maria Cavalli
  • Tatiana Gutierrez Dieckmann
  • Sonia Mara Raboni
  • Gabriel L. O. Salvador
  • Luciane Aparecida Pereira
  • Indianara Rotta
  • Meri Bordignon Nogueira


Human adenovirus (HAdV) has been recognized as a significant viral pathogen implicated in neurological diseases, particularly in immunocompromised patients. However, its involvement in meningoencephalitis remains unclear. The aim of this study was to investigate HAdV and other viral co-infections in the cerebrospinal fluid (CSF) of patients suspected of having either meningoencephalitis or encephalitis. A total of 373 CSF samples from patients under clinical suspicion of neurological viral infection were included in this study. HAdV was investigated by conventional or multiplex real-time PCR, for different time periods. The frequency of HAdV central nervous system (CNS) infection was 1.08%, predominating in female patients with a predisposing condition, and presented with HAdV encephalitis. HAdV CNS infection was found to occur during the months of autumn and winter. The frequency of HAdV detected in CSF positive samples increased after the change in the diagnostic method from conventional to multiplex real-time PCR. There were no specific NMRI or EEG characteristics and two CSF samples with HAdV encephalitis had normal CSF WBC count. There were two cases of co-infection with HIV; no other co-infections with enterovirus or herpes family viruses were detected. All patients had good outcome. Although HAdV is rarely observable in CNS infectious syndromes, it must be investigated particularly in immunocompromised patients.


Adenovirus Viral meningoencephalitis CSF Nervous system 


Authors’ contributions

Sérgio Monteiro de Almeida: literature search, figures, study design, data collection, data analysis, data interpretation, writing.

Luine Rosele Renaud Vidal: literature search, figures, study design, data collection, data analysis, data interpretation, writing.

Bárbara Maria Cavalli: literature search, data collection, data analysis.

Tatiana Gutierrez Dieckmann: data collection.

Sonia Mara Raboni: study design.

Gabriel L.O. Salvador: neuroimage data collection and interpretation.

Luciane Aparecida Pereira: data collection.

Indianara Rotta: data collection.

Meri Bordignon Nogueira: literature search, figures, study design, data collection, data analysis, data interpretation, writing.

Compliance with ethical standards

Conflict of interest

Luine Rosele Renaud Vidal declares no conflict of interest.

Sérgio Monteiro de Almeida declares no conflict of interest.

Bárbara Maria Cavalli declares no conflict of interest.

Tatiana Gutierrez Dieckmann declares no conflict of interest.

Sonia Mara Raboni declares no conflict of interest.

Gabriel L.O. Salvador declares no conflict of interest.

Luciane Aparecida Pereira declares no conflict of interest.

Indianara Rotta declares no conflict of interest.

Meri Bordignon Nogueira declares no conflict of interest.


  1. Almeida SM, Raboni SM, Nogueira MB, Vidal LR (2016) Red blood cells in cerebrospinal fluid as possible inhibitory factor for enterovirus RT-PCR. Arq Neuropsiquiatr 74:810–815CrossRefGoogle Scholar
  2. Anders KH, Park CS, Cornford ME, Vinters HV (1990) Adenovirus encephalitis and widespread ependymitis in a child with AIDS. Pediatr Neurosurg 16:316–320CrossRefGoogle Scholar
  3. Avellón A, Pérez P, Aguilar JC, Lejarazu R, Echevarrı́a JE (2001) Rapid and sensitive diagnosis of human adenovirus infections by a generic polymerase chain reaction. J Virol Methods 92:113–120CrossRefGoogle Scholar
  4. Awosika OO, Lyons JL, Ciarlini P, Phillips RE, Alfson ED, Johnson EL, Koo S, Marty F, Drew C, Zaki S, Folkerth RD, Klein JP (2013) Fatal adenovirus encephalomyeloradiculitis in an umbilical cord steam cell transplant recipient. Neurology 80:1715–1717CrossRefGoogle Scholar
  5. Baschat AA, Towbin J, Bowles NE, Harman CR, Weiner CP (2003) Adenovirus a fetal pathogen? Am J Obstet Gynecol 189:758–763CrossRefGoogle Scholar
  6. Brasil, Ministério da Saúde, Sistema de Informação de Agravos de Notificação–SINAN. Access on: Accessed: 13/02/2017
  7. Chou SM, Roos R, Burnell R et al (1973) Subactue focal adenovirus encephalitis. J Neuropathol Exp Neurol 32:34–50CrossRefGoogle Scholar
  8. Echavarria M (2008) Adenoviruses in immunocompromised hosts. Clin Microbiol Rev 21:704–715CrossRefGoogle Scholar
  9. Feraco P, Porretti G, Marchiò G, Bellizzi M, Recla M (2018) Mild encephalitis/encephalopathy with reversible Splenial lesion (MERS) due to Cytomegalovirus: case report and review of the literature. Neuropediatrics 49:68–71. CrossRefGoogle Scholar
  10. Frange P, Latour RP, Arnaud C (2011) Adenoviral infection presenting as an isolated central nervous system disease without detectable viremia in two children after steam cell transplantation. J Clin Microbiol 49:2361–2364CrossRefGoogle Scholar
  11. Glaser CA, Honarmand S, Anderson LJ, Schnurr DP, Forghani B, Cossen CK, Schuster FL, Christie LJ, Tureen JH (2006) Beyond viruses: clinical profiles and etiologies associated with encephalitis. Clin Infect Dis 43:1565–1577CrossRefGoogle Scholar
  12. Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D, Cunningham R, Zuckerman M, Mutton KJ, Solomon T, Ward KN, Lunn MP, Irani SR, Vincent A, Brown DW, Crowcroft NS, UK Health Protection Agency (HPA) Aetiology of Encephalitis Study Group (2010) UK health protection agency (HPA) aetiology of encephalitis study group. Causes of encephalitis and differences in their clinical presentations in England: a multicentre population based prospective study. Lancet Infect Dis 10:835–844CrossRefGoogle Scholar
  13. Huang YC, Huang SL, Chen SP, Huang Y et al (2013) Adenovirus infection associated with central nervous system dysfunction in children. J ClinVirol 57:300–307Google Scholar
  14. Koskiniemi M, Rantalaiho T, Piiparinen H et al (2001) Infections of the central nervous system of suspected viral origin: a collaborative study from Finland. J Neuro-Oncol 7:400–408Google Scholar
  15. Lema CL, Cisterna DM, Freire MC (2005) Enfermedad neurologica por adenovirus. Medicina 65:196–200Google Scholar
  16. Linssen WH, Gabreëls FJ, Wevers RA (1991) Infective acute transverse myelopathy. Report of two cases. Neuropediatrics 22:107–109CrossRefGoogle Scholar
  17. Lion T (2014) Adenovirus infections in immunocompetent and immunocompromised patients. Clin Microbiol Rev 27:441–462CrossRefGoogle Scholar
  18. Manos MM, Ting Y, Wright DK et al (1989) The use of polimerase chain reaction amplification for the detection of genital human papillomaviruses. Cancer Cells 7:209–214Google Scholar
  19. McCarthy T, Lebeck MG, Capuano AW et al (2009) Molecular typing of clinical adenovirus specimens by an algorithm which permits detection of adenovirus coinfection and intermediate adenovirus strains. J ClinVirol 46:80–84Google Scholar
  20. McGill F, Griffiths MJ, Solomon T (2017) Viral meningitis: current issues in diagnosis and treatment. Curr Opin Infect Dis 30:248–256CrossRefGoogle Scholar
  21. Raboni SM, Nogueira MB, Tsuchiya LR et al (2003) Respiratory tract viral infections in bone marrow transplant patients. Transplantation 76:142–146CrossRefGoogle Scholar
  22. Reyes-Andrade J, Sánchez-Céspedes J, Olbrich P et al (2014) Meningoencephalitis due to adenovirus in a healthy infant mimicking severe bacterial sepsis. Pediatr Infect Dis J 33:416–4219CrossRefGoogle Scholar
  23. Schmidt-Hieber M, Schwender J, Heinz WJ, Zabelina T, Kuhl JS, Mousset S, Schuttrumpf S, Junghanss C, Silling G, Basara N, Neuburger S, Thiel E, Blau IW (2011) Viral encephalitis after allogeneic stem cell transplantation: a rare complication with distinct characteristics of different causative agents. Haematologica 96:142–149CrossRefGoogle Scholar
  24. Schnurr D, Bollen A, Crawford-Miksza L, Dondero ME, Yagi S (1995) Adenovirus mixture isolated from the brain of an AIDS patient with encephalitis. J Med Virol 47:168–171CrossRefGoogle Scholar
  25. Simepar. Dados meteorológicos. Sistema Meteorológico do Paraná (Simepar). Accessed: 13/11/2018
  26. Tan LV, Thai LH, Phu NH, Nghia HDT, Chuong LV, Sinh DX, Phong ND, Mai NTH, Man DNH, Hien VM, Vinh NT, Day J, Chau NVV, Hien TT, Farrar J, de Jong MD, Thwaites G, van Doorn HR, Chau TTH (2014) Viral Aetiology of central nervous system infections in adults admitted to a tertiary referral Hospital in Southern Vietnam over 12 years. PLoS Negl Trop Dis 8: Accessed: 13/02/2017:e3127CrossRefGoogle Scholar
  27. Tsuchiya LR, Costa LM, Raboni SM et al (2005) Viral respiratory infection in Curitiba, southern Brazil. J Inf Secur 51:401–407Google Scholar
  28. Vidal LR, Almeida SM, Messias-Reason IJ et al (2011) Enterovirus and herpesviridae family as etiologic agents of lymphomonocytary meningitis, southern Brazil. Arq Neuropsiquiatr 69:475–481CrossRefGoogle Scholar
  29. Zagardo MT, Shanholtz CB, Zoarski GH, Rothman MI (1998) Rhombencephalitis caused by adenovirus: MR imaging appearance. Am J Neuroradiol 19:1901–1903Google Scholar

Copyright information

© Journal of NeuroVirology, Inc. 2019

Authors and Affiliations

  • Luine Rosele Vidal
    • 1
  • Sérgio Monteiro de Almeida
    • 1
    Email author
  • Bárbara Maria Cavalli
    • 1
  • Tatiana Gutierrez Dieckmann
    • 1
  • Sonia Mara Raboni
    • 1
  • Gabriel L. O. Salvador
    • 2
  • Luciane Aparecida Pereira
    • 1
  • Indianara Rotta
    • 1
  • Meri Bordignon Nogueira
    • 1
  1. 1.Virology Laboratory, Clinical Pathology Laboratory - Hospital de ClínicasUniversidade Federal do ParanáCuritibaBrazil
  2. 2.Radiology Unity-Hospital de Clínicas, UFPRComplexo Hospital de Clínicas da Universidade Federal do ParanáCuritibaBrazil

Personalised recommendations