[Cytomegalovirus arteriolitis: gangrene of the feet and early coronary disease after heart transplantation].
Peripheral arteriolitis of the legs from the 4th postoperative day after cardiac transplantation caused ischemia of the feet and required bilateral transmetatarsal amputations on the 28th postoperative day. The causal condition was cytomegalovirus infection, confirmed by rising IgM antibody titres, the detection of a viraemia on the 33rd postoperative day, and, above all, the presence of cytomegalic inclusion bodies in many endothelial arteriolar cells of the amputated limbs. The patient died four months after transplantation and autopsy revealed major lesions in all the distal coronary vessels of the graft which occluded over 4/5ths of the coronary lumens. An aspergillus septicemia was the direct cause of death.
Laboratoire d'anatomie pathologique, Hôpital cardiologique, Lyon.
R
R
Loire
O
O
Bastien
A
A
Tabib
M
M
Vigneron
D003327:Coronary Disease / Q000209:etiology* / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000473:pathology; D005534:Foot Diseases / Q000209:etiology; D005734:Gangrene / Q000209:etiology*; D006084:Graft Rejection; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014657:Vasculitis / Q000150:complications*