To the Editor: In their report on adenovirus infections in patients undergoing bone marrow transplantation, Shields et al. (Feb. 28 issue)1 conclude that the most likely source of infection was endogenous viral reactivation. Alternatively, this agent may be nosocomially derived, as illustrated below. A 19-year-old man with the X-linked lymphoproliferative syndrome had a reactivation of Epstein–Barr virus seven years after the primary infection. In sequence, he had anemia with erythroblastopenia; signs, symptoms, and laboratory manifestations of acute infectious mononucleosis; and acquired agammaglobulinemia.2 Recurrent bouts of opportunistic infections and persistent erythroblastopenia and agammaglobulinemia prompted grafting of HLA-matched bone marrow from his.
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