Disseminated adenovirus infection in a 10-year-old renal allograft recipient.
- Author:
Bora LEE
1
;
Eujin PARK
;
Jongwon HA
;
Il Soo HA
;
Hae Il CHEONG
;
Hee Gyung KANG
Author Information
- Publication Type:Case Report
- Keywords: Adenoviridae; Kidney transplantation; Opportunistic infections; Pediatrics
- MeSH: Adenoviridae Infections*; Adenoviridae*; Allografts*; Biopsy; Cerebrospinal Fluid; Child*; Cystitis; Dysuria; Emergencies; Ganciclovir; Hematuria; Humans; Immunization, Passive; Immunocompromised Host; Immunosuppressive Agents; Kidney Transplantation; Mass Screening; Mortality; Nephritis, Interstitial; Opportunistic Infections; Pediatrics; Renal Dialysis; Renal Insufficiency; Seizures; Sputum
- From:Kidney Research and Clinical Practice 2018;37(4):414-417
- CountryRepublic of Korea
- Language:English
- Abstract: Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.
