BK virus‐induced nephritis and cystitis after matched unrelated donor stem cell transplantation: A case report

Abstract

BACKGROUND This case report demonstrates the importance of rapid treatment for BK virus infection in immunocompromised patients following matched unrelated donor (MUD) stem cell transplantation. Currently, very little case data are available, so there is no established standard treatment for a BK virus infection of the urogenital tract. The lack of data on the treatment and prognosis of BK virus infections of the urogenital tract requires long-term observations that should serve as a basis for future recommendations. 2 | CASE PRESENTATION A 39-year-old patient presents in November 2018 with myelodysplastic syndrome with excess of blasts (MDS-EB2). Therefore, the patient was treated with an allogenic stem cell transplantation from a matched unrelated donor in March 2019. Immunosuppression was conducted with cyclosporin A, alemtuzumab, and short-course methotrexate (MTX). He developed extensive disease chronic graft-versus-host disease (GVHD) with mucositis and infestation of the hands, feet, and oral mucosa. Systemic methylprednisolone therapy (60 mg/d) was initiated for treatment. The initial presentation in July 2019 was acute due to thoracic complaints with dyspnoea, tachycardia, and deterioration of general condition in hyperosmolar hyperglycemia with blood sugar values of 45 mmol/L. Under inpatient conditions, insulin therapy and volume substitution were initiated. The cause of the blood sugar derailment was, eg, a therapy with methylprednisolone in the context of chronic GVHD therapy since June. During the inpatient stay and after

BK Polyomavirus Hemorrhagic Cystitis in Hematopoietic Cell Transplant Recipients

“…Previous reports describing this association are rare. [ 26 27 ] BKPyV-damaged urothelium may favor bacterial colonization or invasion, leading to bacterial infection. Similar sialic acid-containing ganglioside receptors are known to mediate epithelial attachment for both BKPyV[ 28 ] and certain bacteria such as Escherichia coli,[ 29 ] but direct viral–bacterial interactions facilitating coinfection are not known.…”