Adenovirus-induced obstructive uropathy with acute renal failure in an immunodeficient child.
Viral infections represent severe complications in immunodeficient patients, associated with significant morbidity and mortality. We report a case of a bone marrow-transplanted adolescent with hemorrhagic cystitis 4 weeks after transplant, associated with renal failure because of obstructive pyelonephritis. Diagnostic workup finally revealed adenovirus infection. A double-J stent was inserted with spontaneous favorable evolution thereafter. Adenovirus infection in an immunocompromised patient can cause hemorrhagic cystitis without specific symptoms and might evolve toward obstructive pyelonephritis because of tubular necrosis. Diagnosis is made by urine culture and/or blood polymerase chain reaction. In case of fatal dissemination, diagnosis might only be revealed on autopsy.
Division of Paediatric Surgery, Department of Paediatrics, University Children's Hospital of Geneva, Geneva, Switzerland. Electronic address: ernesto.montaruli@hcuge.ch.
Ernesto
E
Montaruli
Division of Paediatric Surgery, Department of Paediatrics, University Children's Hospital of Geneva, Geneva, Switzerland.
Barbara E
BE
Wildhaber
Division of Paediatric Oncology, Department of Paediatrics, University Children's Hospital of Geneva, Geneva, Switzerland.
Marc
M
Ansari
Division of Paediatric Surgery, Department of Paediatrics, University Children's Hospital of Geneva, Geneva, Switzerland.
Jacques
J
Birraux
D058186:Acute Kidney Injury / Q000821:virology*; D000257:Adenoviridae Infections / Q000150:complications*; D000293:Adolescent; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011704:Pyelonephritis / Q000821:virology*; D014517:Ureteral Obstruction / Q000821:virology*