Cytomegalovirus infection in kidney transplant patients: clinical manifestations and diagnosis

Zentralbl Bakteriol. 1998 May;287(4):489-500. doi: 10.1016/s0934-8840(98)80190-4.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged

Substances

  • Antibodies, Viral