tailieunhanh - Chapter 126. Infections in Transplant Recipients (Part 7)

Adenovirus can be isolated from HSCT recipients at rates varying from 5 to 18%. Although hemorrhagic cystitis, pneumonia, gastroenteritis, and fatal disseminated infection have been reported, adenovirus infection, which (like CMV infection) usually occurs in the first or second month after transplantation, is often asymptomatic. A role for cidofovir therapy has been suggested, but the efficacy of this agent is unproven. Infections with parvovirus B19 (presenting as anemia or occasionally as pancytopenia) and enteroviruses (sometimes fatal) can occur. Parvovirus infection may possibly respond to IVIg (Chap. 177). Intranasal pleconaril, a capsid-binding agent, is being studied for the treatment of enterovirus. | Chapter 126. Infections in Transplant Recipients Part 7 Adenovirus can be isolated from HSCT recipients at rates varying from 5 to 18 . Although hemorrhagic cystitis pneumonia gastroenteritis and fatal disseminated infection have been reported adenovirus infection which like CMV infection usually occurs in the first or second month after transplantation is often asymptomatic. A role for cidofovir therapy has been suggested but the efficacy of this agent is unproven. Infections with parvovirus B19 presenting as anemia or occasionally as pancytopenia and enteroviruses sometimes fatal can occur. Parvovirus infection may possibly respond to IVIg Chap. 177 . Intranasal pleconaril a capsid-binding agent is being studied for the treatment of enterovirus infection. Rhinoviruses and coronaviruses are frequent co-pathogens in HSCT recipients however whether they independently contribute to significant pulmonary infection is not known. Rotaviruses are a common cause of gastroenteritis in these patients. The polyomavirus BK virus is found at high titers in the urine of patients who are profoundly immunosuppressed. BK viruria may be associated with hemorrhagic cystitis in these patients. Compared with the incidence among patients with impaired T cell function due to HIV infection progressive multifocal leukoencephalopathy caused by the related JC virus is rare among HSCT recipients Chap. 376 . When transmitted by mosquitoes or by blood transfusion West Nile virus can cause encephalitis and death after hematopoietic stem cell transplantation. Infections in Solid Organ Transplant SOT Recipients Morbidity and mortality among SOT recipients are reduced by the use of effective antibiotics. The organisms that cause acute infections in recipients of SOT are different from those that infect HSCT recipients because SOT recipients do not go through a period of neutropenia. As the transplantation procedure involves major surgery however SOT recipients are subject to infections at .