title: BK virus nephropathy complicated with meningoencephalitis after kidney transplantation.
abstract: BK disease is an opportunistic infection in organ transplant recipients and patients with other cellular immunodeficiencies. To the best of our knowledge, we report the second case of BK meningoencephalitis associated with nephropathy in a kidney transplant recipient. A 15-yr-old boy underwent a cadaveric kidney transplant without complications; however, 11 wk after the transplantation, he was admitted to the hospital for graft dysfunction and cytopenia, which were confirmed by BK nephropathy (plasma viral replication and histological evidence). Four days after his hospital admission, he developed a high-grade fever and headache. CSF analysis revealed pleocytosis with a positive PCR for BK virus. Reduction in immunosuppression and supportive care conducting cycles of immunoglobulin and cidofovir were successful in treating the patient. BK meningoencephalitis should be considered in kidney transplant recipients who present with signs and symptoms of meningoencephalitis.
authors.affiliation: Department of Pediatric Nephrology, Centro Hospitalar do Porto, Largo Professor Abel Salazar, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Rocha
authors.forename: Sameiro
authors.initials: S
authors.lastname: Faria
authors.forename: Teresa
authors.initials: T
authors.lastname: Costa
authors.forename: Laura
authors.initials: L
authors.lastname: Marques
authors.forename: Cristina
authors.initials: C
authors.lastname: Freitas
authors.forename: Conceição
authors.initials: C
authors.lastname: Mota
mesh_terms: D000293:Adolescent; D001739:BK Virus; D006801:Humans; D007154:Immune System Diseases / Q000150:complications / Q000209:etiology; D007136:Immunoglobulins / Q000737:chemistry; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000737:chemistry; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008590:Meningoencephalitis / Q000150:complications* / Q000175:diagnosis*; D009395:Nephritis, Interstitial / Q000150:complications* / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D027601:Polyomavirus Infections / Q000150:complications / Q000175:diagnosis; D051437:Renal Insufficiency / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents
keywords: clinical case; immunocompromised; neurotropism; polyomavirus; tubulointerstitial nephritis