Disseminated Adenovirus Infection After Combined Liver-Kidney Transplantation

Hemmersbach‐Miller, Marion; Bailey, Emily S.; Kappus, Matthew R.; Prasad, Vinod K.; Gray, Gregory C.; Alspaugh, J. Andrew

doi:10.3389/fcimb.2018.00408

Cited by 6 publications

(7 citation statements)

References 32 publications

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“…Adenoviridae include human adenoviruses (HAdV) A to G, each of which produces a different clinical pattern. In immunocompromised patients, HAdV can cause life-threatening multiorgan damage [68]. Risk factors change over time with the changes in immunosuppression [69].…”

Section: Viral Pneumoniamentioning

confidence: 99%

Diagnosis of severe respiratory infections in immunocompromised patients

et al. 2020

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An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections (Aspergillus, Mucorales, and Pneumocystis jirovecii) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.

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Section: Viral Pneumoniamentioning

confidence: 99%

Diagnosis of severe respiratory infections in immunocompromised patients

et al. 2020

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“…Among solid organ transplant recipients, brincidofovir (CMXOO1) use for the treatment of adenoviral infection has been reported in two published studies in intestinal transplant recipients with gastrointestinal disease and one published study in a liver-kidney recipient [17-19]. The first study was a retrospective analysis among a multi-center cohort of eight pediatric and five adult patients with severe AdV disease who were refractory to or intolerant of other therapies.…”

Section: Discussionmentioning

confidence: 99%

“…In the second published study, brincidofovir was used to successfully treat adenoviral enteral infection in two intestinal transplant recipients [18]. In the third study, a liver-kidney transplant recipient who presented with a viral syndrome, had detection of adenovirus in blood and urine using a PCR, and no other end-organ involvement was successfully treated with brincidofovir for twelve weeks [19]. Doses and duration of treatment were variable in all in the studies.…”

Section: Discussionmentioning

confidence: 99%

Brincidofovir (CMX001) for the Treatment of Severe Adenoviral Pneumonia in Kidney Transplant Recipient

Sudhindra¹,

Knoll²,

Nog³

et al. 2019

Cureus

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Adenovirus causes significant morbidity and mortality in solid organ and hematological transplant recipients. Treatment of adenovirus infections includes supportive care, reduction of immune suppression, and in patients with severe disease, intravenous cidofovir. Brincidofovir (CMX001) is a lipid conjugate of cidofovir, with good oral bioavailability, no associated nephrotoxicity, and higher intracellular levels of the active drug compared to cidofovir. We describe a case of severe adenoviral pneumonia in an adult renal transplant recipient who was successfully treated with oral brincidofovir after developing renal insufficiency with intravenous cidofovir. Brincidofovir (CMX001) along with other supportive therapy, may offer an efficacious, safe, and well-tolerated treatment for severe adenoviral infections in solid organ transplant recipients.

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“…Adenovirus (AdV) infection is common after allogeneic hematopoietic stem cell transplant with reported incidences as high as 15% and 42% in adult and pediatric populations, respectively . Disseminated AdV, however, is rare after autologous stem cell or solid organ transplantation . Consequently, early detection of disseminated AdV can be challenging, with resultant mortality rates as high as 26% .…”

Section: Introductionmentioning

confidence: 94%

Disseminated adenovirus infection after autologous stem cell transplant

Kim

Hyun

Pergam

et al. 2020

Transplant Infectious Dis

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Adenovirus is an infrequent but challenging viral complication of transplantation that is rarely reported after autologous stem cell transplant. We present a case of disseminated adenovirus infection in a woman who received an autologous stem cell transplant for treatment of multiple sclerosis. After presenting with post‐transplant episodic diarrhea and viremia, endoscopic biopsies and immunohistochemical staining confirmed the diagnosis of disseminated adenovirus infection. Her symptoms and viremia resolved after treatment with cidofovir. This case demonstrates that a high index of suspicion, a systematic clinical approach, and immunohistochemical tissue staining are necessary to diagnose disseminated adenovirus infection in an unexpected host.

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Disseminated Adenovirus Infection After Combined Liver-Kidney Transplantation

Cited by 6 publications

References 32 publications

Diagnosis of severe respiratory infections in immunocompromised patients

Diagnosis of severe respiratory infections in immunocompromised patients

Brincidofovir (CMX001) for the Treatment of Severe Adenoviral Pneumonia in Kidney Transplant Recipient

Disseminated adenovirus infection after autologous stem cell transplant

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