polyomavirus infections in transplant recipients

... Medicine > Chapter 126. Infections in Transplant Recipients Infections in Transplant Recipients: Introduction The evaluation of infections in transplant recipients involves consideration of ... corneal transplants. e T. gondii usually causes disease in the brain. In hematopoietic stem cell Chapter 126. Infections in Transplant Recipients (Part 1) Harrison's Internal Medicine ... recipient of the transplanted organ. Infections following transplantation are complicated by the use of drugs that are necessary to enhance the likelihood of survival of the transplanted organ...

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 2) In many transplantation centers, transmission of infections that may be latent or clinically inapparent in the donor organ has resulted in ... latent infections already. Nevertheless, most infections occur in a predictable time frame after transplantation (Table 126-2). Table 126- 2 Common Sources of Infections after Hematopoietic ... and Trypanosoma cruzi (the latter particularly in Latin America). Clinicians caring for prospective organ donors should also consider assessing stool for parasites, should ...

Ngày tải lên: 07/07/2014, 15:20

... becomes available. Promising new drugs that are now being assessed in clinical trials include maribavir, a benzimidazole ribonucleoside that inhibits a viral protein kinase activity (UL97). ... ulcerations occur in both the lower and the upper gastrointestinal tract, and it may be difficult to distinguish diarrhea due to GVHD from that due to CMV infection. The finding of CMV in the liver ... abnormalities. It is interesting that the ocular and neurologic manifestations of CMV infections are uncommon in these patients. Management of CMV disease in HSCT recipients includes strategies...

Ngày tải lên: 07/07/2014, 15:20

... disease. Treatment of CMV pneumonia in HSCT recipients (unlike that in other clinical settings) involves both IV immune globulin (IVIg) and ganciclovir. In patients who cannot tolerate ganciclovir, ... Chapter 126. Infections in Transplant Recipients (Part 5) Like prophylaxis, preemptive treatment, which targets patients with polymerase chain reaction (PCR) evidence of ... antibodies to T cells). Although less likely in autologous transplantation, reactivation can occur in T cell–depleted autologous recipients (e.g., patients being given antibodies to T cells for the...

Ngày tải lên: 07/07/2014, 15:20

... the Chapter 126. Infections in Transplant Recipients (Part 6) PCR can be used to monitor EBV production after hematopoietic stem cell transplantation. High or increasing viral loads predict ... critical in an assessment of posttransplantation infections. to have activity against the different forms of latent EBV infection. Preventing lytic replication in these patients would theoretically ... resulted in disease in HSCT recipients, although some cases of virus-associated marrow aplasia have been reported in the peritransplantation period. The relatively low seroprevalence of KSHV in the...

Ngày tải lên: 07/07/2014, 15:20

... therapy (when indicated), and rapid diagnosis and treatment of infections can be lifesaving in SOT recipients, who, unlike most HSCT recipients, continue to be immunosuppressed. SOT recipients ... acute infections in recipients of SOT are different from those that infect HSCT recipients because SOT recipients do not go through a period of neutropenia. As the transplantation procedure involves ... (Chap. 177). Intranasal pleconaril, a capsid-binding agent, is being studied for the treatment of enterovirus infection. Rhinoviruses and coronaviruses are frequent co-pathogens in HSCT recipients; ...

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 8) Kidney Transplantation (See Table 126-4) Table 126-4 Common Infections after Kidney Transplantation Period after Transplantation Infection ... of Infections in Transplant Recipients Risk Factor Organism Prophylactic Antibiotics Examination(s) a Travel to or residence in area with known risk of fungal infection Coccidioides, ... chest imaging and/or no previous treatment Chest imaging; PPD and/or cell- based assay a Serologic examination, PPD testing, and interferon assays may be less reliable after transplantation....

Ngày tải lên: 07/07/2014, 15:20

... Chapter 126. Infections in Transplant Recipients (Part 9) Middle-Period Infections Because of continuing immunosuppression, kidney transplant recipients are predisposed to lung infections ... virus and JC virus (polyomavirus hominis types 1 and 2) have been cultured from the urine of kidney transplant recipients (as they have from that of HSCT recipients) in the setting of profound ... Legionella pneumophila infection (Chap. 141) led to the closing of renal transplant units in hospitals with endemic legionellosis. About 50% of all renal transplant recipients presenting with fever...

Ngày tải lên: 07/07/2014, 15:20

... 126. Infections in Transplant Recipients (Part 10) Kidney transplant recipients are also subject to infections with other intracellular organisms. These patients may develop pulmonary infections ... cause pulmonary infiltrates or disseminated disease. Late Infections Late infections (>6 months after kidney transplantation) may involve the CNS and include CMV retinitis as well as ... hominis infection is suspected. M. hominis mediastinitis has been cured with a combination of surgical debridement (sometimes requiring muscle-flap placement) and the administration of clindamycin...

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... regimens including pyrazin- amide, 31% received drug regimens including a fluoro- quinolone, and 17% received drug regimens including streptomycin. Induction drug regimens consisted of 2 drugs in 5% ... MTB infection was defined as including lung or mediastinal lymph node involvement. We de- fined multiorgan (ie, miliary) MTB infection as involve- ment of 2 or more organs (lymph nodes draining in- fected ... positive tubercu- lin skin test (TST) result in the absence of symptoms or clinical findings suggestive of active infection. In ana- lyzing LTBI treatment, we included studies reporting 10 or more...

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