Development of intrapancreatic abscess--a consequence of CMV pancreatitis?
Cytomegalovirus (CMV) pancreatitis was diagnosed in eight out of 124 pancreatic transplant recipients. Five of the eight patients developed intrapancreatic abscesses and four of the grafts were lost, but one is still functioning. In the three additional cases of pancreatitis, antiviral treatment with foscarnet or ganciclovir was given as soon as signs of CMV pancreatitis were detected. No such grafts were lost during the acute phase. CMV infection was diagnosed in cells from pancreatic juice, by virus isolation, detection of CMV antigen in cells from pancreatic juice or by CMV serology. The signs and symptoms of CMV pancreatitis included fever, general malaise, abdominal pain, diarrhoea, localized peritonitis, hyperamylasaemia, leukopenia and hyperglycaemia. It is recommended that rapid diagnostic procedures for CMV should be carried out when early signs of pancreatitis develop in pancreatic graft recipients. Antiviral treatment should be given when CMV pancreatitis is suspected or diagnosed in order to prevent the development of intrapancreatic abscesses and graft loss.
Bäckman
L
L
Department of Transplantation Surgery, Huddinge Hospital, Sweden.
Brattström
C
C
Reinholt
F P
FP
Andersson
J
J
Tydén
G
G
D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000956:Antigens, Viral / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D016035:Pancreas Transplantation; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*
D000956:Antigens, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G