Varicella zoster virus and cytomegalovirus coinfection in a live related kidney transplant recipient: A case report.

Autor: Bari A; Department of Nephrology Kidney Foundation Hospital and Research Institute Dhaka Bangladesh., Begum NAS; Department of Nephrology Kidney Foundation Hospital and Research Institute Dhaka Bangladesh., Nobi F; Department of Nephrology Kidney Foundation Hospital and Research Institute Dhaka Bangladesh., Rashid HU; Department of Nephrology Kidney Foundation Hospital and Research Institute Dhaka Bangladesh., Akhter N; Research Wing Kidney Foundation Hospital and Research Institute Dhaka Bangladesh., Islam S; Department of Gastroenterology Delta Medical College and Hospital Dhaka Bangladesh.
Jazyk: angličtina
Zdroj: Clinical case reports [Clin Case Rep] 2024 Jun 16; Vol. 12 (6), pp. e9089. Date of Electronic Publication: 2024 Jun 16 (Print Publication: 2024).
DOI: 10.1002/ccr3.9089
Abstrakt: Key Clinical Message: The immunomodulatory effect of CMV makes coinfection with other microbes, like VZV possible and potentially deadlier in the post kidney transplant period. Treatment should be started promptly. Both infections can be treated with Valganciclovir.
Abstract: Infections are common complications in kidney transplant recipients owing to the lifelong immunosuppression. Cytomegalovirus (CMV) and Varicella Zoster Virus (VZV) infections are quite common in the posttransplant period. Coinfection with both however has been reported only once. The immunomodulatory effect of CMV makes their interaction with other organisms like VZV potentially sinister. This is a case of a young woman who developed coinfection with HZV and CMV in the first month following a live related kidney transplantation from her mother. Transplant surgery went well with good urine output, but serum creatinine did not fall below 1.7 mg/dL. Immunosuppression consisted of intravenous (IV), followed by oral prednisolone, Mycophenolate Sodium (MPS) and Tacrolimus. 25 days after an uneventful surgery, she developed fever, followed by pain and vesicular eruption on the forehead, typical of VZV infection, along with rising creatinine. CMV PCR yielded 300 copies/mL of DNA, which was undetectable in both donor and recipient pre-transplant. Total white blood cell count fell to 2 × 10 9 /L. MPS was temporarily stopped. Treatment with Valgancyclovir led to resolution of fever, skin lesions and brought serum creatinine down to baseline over 2 weeks.
Competing Interests: On behalf of all authors, I declare that there is no conflict of interest.
(© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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