title: Cytomegalovirus appendicitis in solid organ transplant patients, two cases and a review.
abstract: Cytomegalovirus (CMV) disease is a common complication following solid organ transplantation with a variety of gastrointestinal (GI) tract manifestations. CMV appendicitis, however, is a rare complication in a solid organ transplant patient, having been reported only once previously. We have recently seen two cases in solid organ transplant recipients at our institution, one a liver recipient and the other a heart recipient. Both patients underwent surgical resection. Pathologic evaluation of both resected appendices as well as polymerase chain reaction (PCR) amplification for CMV from the serum revealed the virus as the etiology. Both patients received induction intravenous ganciclovir followed by oral valganciclovir and have done well post-operatively. Tissue-invasive CMV disease should be considered in the differential diagnosis for solid organ transplant patients with symptoms suggesting acute or chronic appendicitis. Both PCR testing as well as pathologic review of tissue specimens should be considered to ensure accurate diagnosis and management.
authors: University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, USA. Electronic address: tmccarty@uabmc.edu.
authors: Todd P
authors: TP
authors: McCarty
authors: University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, USA.
authors: Rachael A
authors: RA
authors: Lee
authors: Tulane University, Department of Pathology and Laboratory Medicine, USA.
authors: Barbara M
authors: BM
authors: Herfel
authors: University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, USA.
authors: Peter G
authors: PG
authors: Pappas
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001064:Appendicitis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology* / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D004279:DNA, Viral / Q000276:immunology; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D066027:Transplant Recipients; D016896:Treatment Outcome; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: Appendicitis; Solid organ transplant