title: Hyperbaric oxygen therapy in BKV-associated hemorrhagic cystitis refractory to intravenous and intravesical cidofovir: case report and review of literature.
abstract: Hemorrhagic cystitis is a common complication in hematopoietic stem cell transplant recipients. We report here a case of severe BKV-associated hemorrhagic cystitis who did not respond to intravenous cidofovir. Overt hematuria successfully resolved after a few days on hyperbaric oxygen and intravesical instillations of cidofovir, while BK viruria dropped after a few weeks and remained low. We review the literature for therapeutic options in hemorrhagic cystitis and try to explain how hyperbaric oxygen stimulates mucosal repair in the urinary bladder.
authors.affiliation: Division of Hematology, Department of Oncology, Transplantations and New Technologies in Medicine, University of Pisa, Italy. dfocosi@tin.it
authors.forename: Daniele
authors.initials: D
authors.lastname: Focosi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Maggi
authors.forename: Donatella
authors.initials: D
authors.lastname: Pistolesi
authors.forename: Edoardo
authors.initials: E
authors.lastname: Benedetti
authors.forename: Federico
authors.initials: F
authors.lastname: Papineschi
authors.forename: Sara
authors.initials: S
authors.lastname: Galimberti
authors.forename: Luca
authors.initials: L
authors.lastname: Ceccherini-Nelli
authors.forename: Mario
authors.initials: M
authors.lastname: Petrini
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D000998:Antiviral Agents / Q000008:administration & dosage*; D001739:BK Virus; D000077404:Cidofovir; D003556:Cystitis / Q000209:etiology / Q000628:therapy*; D003586:Cytomegalovirus Infections / Q000628:therapy; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018380:Hematopoietic Stem Cell Transplantation; D006417:Hematuria / Q000209:etiology / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D015470:Leukemia, Myeloid, Acute / Q000628:therapy / Q000821:virology; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage*; D027601:Polyomavirus Infections / Q000150:complications / Q000628:therapy / Q000652:urine; D014412:Tumor Virus Infections / Q000150:complications / Q000628:therapy / Q000652:urine
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir