Very Late-Onset Cytomegalovirus Disease With Pneumocystis jirovecii Pneumonia Coinfection in a Renal Transplant Recipient: A Case Report and Narrative Review of Published Cases

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.