Cytomegalovirus infection in kidney transplant patients: clinical manifestations and diagnosis.
Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality after solid organ transplantation. CMV infection after kidney transplantation was confirmed in 19 (54.3%) out of 35 patients. 16 of these (84.2%) developed CMV disease. CMV infection was diagnosed based on a fourfold or greater increase of anti-CMV IgG antibody titre, detection of CMV-IgM antibodies and/or virus isolation. Primary infection was observed in 3 patients, reactivation in 9 and an undefined type of infection in 7. In most patients (63%), infection was diagnosed in the first 2 months, and in 3 patients, after 3, 5 and 9 years following kidney transplantation. The most frequent symptoms of CMV disease were fever (58%), pneumonitis (26.3%) and enterocolitis (15.8%). In 53% of the patients, CMV infection co-occurred with other pathogens such as Candida albicans. Cryptococcus neoformans, bacteria or viruses (HBV, HCV, HSV). Treatment with polyvalent globulin (Sandoglobin) or hyperimmune globulin (Cytotect), in combination with ganciclovir in 7 patients, resulted in a regression of CMV disease.
Sułowicz
W
W
Department of Nephrology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
Ignacak
E
E
Kuzniewski
M
M
Szymczakiewicz-Multanowska
A
A
Zawilińska
B
B
Kryczko
E
E
Rojek-Zakrzewska
D
D
Zgórniak-Nowosielska
I
I
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D000914:Antibodies, Viral