Case reports in infectious diseases
Very Late-Onset Cytomegalovirus Disease With Pneumocystis jirovecii Pneumonia Coinfection in a Renal Transplant Recipient: A Case Report and Narrative Review of Published Cases
By Wang C, Ajao SO and Bhatt PJ.
Abstract
Background
Cytomegalovirus (CMV) infection is a common and serious complication following renal transplantation. It is associated with significant morbidity and mortality. The introduction of preventive measures with antiviral prophylaxis has reduced the incidence in the immediate posttransplant period, but CMV infection continues to be a prominent complication, especially once antiviral prophylaxis is discontinued. A particularly rare entity is "very late-onset" CMV disease, which we defined as occurring 10 or more years after transplantation.
Methods
We report a case of very late-onset CMV disease presenting 17 years post-renal transplant, complicated by concurrent Pneumocystis jirovecii pneumonia (PJP). We performed a focused narrative review using PubMed for cases of very late-onset CMV disease to document potential risk factors for very late-onset CMV disease.