Disseminated adenovirus infection in a 10-year-old renal allograft recipient
이보라, 박유진, 하종원, 하일수, 정해일, 강희경,
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이보라 ( Lee Bo-Ra )
Seoul National University College of Medicine Department of Pediatrics
박유진 ( Park Eu-Jin )
Hallym University Medical Center Department of Pediatrics
하종원 ( Ha Jong-Won )
Seoul National University College of Medicine Department of Surgery
하일수 ( Ha Il-Soo )
Seoul National University College of Medicine Department of Pediatrics
정해일 ( Cheong Hae-Il )
Seoul National University College of Medicine Department of Pediatrics
강희경 ( Kang Hee-Gyung )
Seoul National University College of Medicine Department of Pediatrics
Abstract
Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.
키워드
Adenoviridae; Kidney transplantation; Opportunistic infections; Pediatrics
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