Survivors may acquire restrictive lung disease, bronchiectasis, and, particularly in children, bronchiolitis obliterans. Mortality in bone marrow transplant patients with adenovirus pneumonia is as high as 60 percent. A variety of serotypes have been recovered from stool, urine, and lower respiratory specimens of immunocompromised patients. Adenoviruses are also associated with extrarespiratory infections, including epidemic keratoconjunctivitis, hepatitis and genitourinary infections in immunosuppressed hosts, myocarditis, arthritis, meningoencephalitis, and, especially in children, hemorrhagic cystitis, mesenteric adenitis, intussusception, and gastroenteritis. The nucleotide cidofovir is active in vitro.
Treatment is otherwise supportive.
Live, attenuated vaccines for adenovirus types 4 and 7 are used in the military but are not licensed for civilian use. These vaccines, which are delivered in entericcoated capsules, have controlled acute respiratory disease in military recruit populations. Other control measures include swimming-pool chlorination, careful hand washing, and, in the instance of nosocomial keratoconjunctivitis, use of gloves and proper sterilization of equipment.