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Severe recurrent cytomegalovirus disease revealed by a colocutaneous fistula in a kidney transplant recipient
Author(s) -
Dumoulin A.,
Boulmerka H.,
Tran Van Nhieu J.,
Lang P.,
Baron C.
Publication year - 2003
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1034/j.1399-3062.2003.00014.x
Subject(s) - medicine , cytomegalovirus , immunosuppression , gastroenterology , transplantation , immunology , enterocolitis , kidney transplantation , inflammatory bowel disease , disease , herpesviridae , virus , viral disease
Intestinal disorders are classical complications of cytomegalovirus (CMV) infection in kidney transplant recipients ( H elderman JH , G oral S. Gastrointestinal complications of transplant immunosuppression. J Am Soc Nephrol 2002: 13: 277–287). Severe ulcerative colitis that is sometimes lethal has been reported ( F oucar E , M ukai K , F oucar K , S utherland DE , V an B uren CT. Colon ulceration in lethal cytomegalovirus infection. Am J Clin Pathol 1981: 76: 788–801 and F rankel AH , B arker F , W illiams G , B enjamin IS , L echler R , R ees AJ . Neutropenic enterocolitis in a renal transplant patient. Transplantation 1991: 52: 913–914). The immunosuppressive drugs currently used, and notably mycophenolate mofetil (Cellcept ® ), cause significant changes in the incidence, duration, and viral load of CMV infections with severe atypical forms of CMV disease ( D e M aar EF , V erschuuren EA , H oman vd H eide JJ, et al. Effects of changing immunosuppressive regimen on the incidence, duration and viral load of cytomegalovirus infection in renal transplantation: a single center report. Transpl Infect Dis 2002: 4: 17–24 and P erez V alentin MA , C ofan F , S ole M, et al. Atypical cytomegalovirus in renal transplantation: a new form of presentation. Nefrologia 2002: 22: 381–385). This report describes a patient who suffered from several episodes of colitis due to an unusual and late‐appearing CMV infection.