Panresistant cytomegalovirus in a kidney transplant recipient

Sarah E. Yost, Angela Echeverria, Tun Jie, Bruce Kaplan

Research output: Contribution to journalArticle

Abstract

Cytomegalovirus (CMV) is an important pathogen often encountered after solid organ transplantation and is associated with increased morbidity and mortality. Resistance of CMV to antiviral agents is becoming more common but with few treatment strategies. Two specific mutations in the CMV genome - the UL97 and UL54 genes - correlate with antiviral drug resistance. We describe a 49-year-old, CMV-seronegative woman who received a CMV-seropositive donor kidney transplant and appropriate CMV prophylaxis. Approximately 1 month after transplantation, the patient developed CMV viremia that responded to valganciclovir. She was later diagnosed with recurrent CMV infection, CMV resistance, and both the UL97 and UL54 gene mutations. The patient responded to foscarnet and significant reduction of immunosuppression; she was negative for CMV viremia for the next 12 months. This case illustrates the importance of having heightened awareness for the possibility of panresistant CMV early and decreasing immunosuppression as the cornerstone of treatment.

Original languageEnglish (US)
JournalPharmacotherapy
Volume34
Issue number1
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Cytomegalovirus
Kidney
Viremia
Immunosuppression
Viral Drug Resistance
Transplant Recipients
Foscarnet
Mutation
Cytomegalovirus Infections
Organ Transplantation
Genes
Antiviral Agents
Transplantation
Tissue Donors
Genome
Morbidity
Transplants
Mortality
Therapeutics

Keywords

  • Antivirals
  • Cytomegalovirus
  • Immunology
  • Infectious disease
  • Transplant

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Panresistant cytomegalovirus in a kidney transplant recipient. / Yost, Sarah E.; Echeverria, Angela; Jie, Tun; Kaplan, Bruce.

In: Pharmacotherapy, Vol. 34, No. 1, 2014.

Research output: Contribution to journalArticle

Yost, Sarah E. ; Echeverria, Angela ; Jie, Tun ; Kaplan, Bruce. / Panresistant cytomegalovirus in a kidney transplant recipient. In: Pharmacotherapy. 2014 ; Vol. 34, No. 1.
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