Abstract
A signal transducer and activator of transcription-1-deficient patient presented with prolonged fever, cachexia, anemia, hypoalbuminemia and finally relapsing debilitating mycobacterial osteomyelitis while receiving a previously effective antimycobacterial treatment. Progression despite rigorous workup and multiple antibiotics prompted shotgun metagenomics revealing adenovirus in liver samples. Brincidofovir led to a complete, sustained clinical recovery, including osteomyelitis, probably attributed to reversal of adenovirus-induced immune dysregulation.
MeSH terms
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Adenoviridae Infections / diagnosis*
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Adenoviridae Infections / drug therapy*
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Adenoviridae Infections / immunology
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Antiviral Agents / therapeutic use*
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Cytosine / analogs & derivatives*
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Cytosine / therapeutic use
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Humans
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Immunocompromised Host
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Liver / immunology
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Liver / virology
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Male
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Metagenomics
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Organophosphonates / therapeutic use*
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Osteomyelitis / drug therapy
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Osteomyelitis / microbiology
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STAT1 Transcription Factor / deficiency*
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Treatment Outcome
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Young Adult
Substances
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Antiviral Agents
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Organophosphonates
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STAT1 Transcription Factor
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STAT1 protein, human
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brincidofovir
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Cytosine