TAILIEUCHUNG - Chapter 126. Infections in Transplant Recipients (Part 9)

Middle-Period Infections Because of continuing immunosuppression, kidney transplant recipients are predisposed to lung infections characteristic of those in patients with T cell deficiency (., infections with intracellular bacteria, mycobacteria, nocardiae, fungi, viruses, and parasites). The high mortality rates associated with 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 1–4 months after transplantation have evidence of CMV disease; CMV itself accounts for the fever in more than two-thirds of cases and thus is the predominant pathogen during this period. . | Chapter 126. Infections in Transplant Recipients Part 9 Middle-Period Infections Because of continuing immunosuppression kidney transplant recipients are predisposed to lung infections characteristic of those in patients with T cell deficiency . infections with intracellular bacteria mycobacteria nocardiae fungi viruses and parasites . The high mortality rates associated with 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 1-4 months after transplantation have evidence of CMV disease CMV itself accounts for the fever in more than two-thirds of cases and thus is the predominant pathogen during this period. CMV infection Chap. 175 may also present as arthralgias myalgias or organ-specific symptoms. During this period this infection may represent primary disease in the case of a seronegative recipient of a kidney from a seropositive donor or may represent reactivation disease or superinfection. Patients may have atypical lymphocytosis. Unlike immunocompetent patients however they often do not have lymphadenopathy or splenomegaly. Therefore clinical suspicion and laboratory confirmation are necessary for diagnosis. The clinical syndrome may be accompanied by bone marrow suppression particularly leukopenia . CMV also causes glomerulopathy and is associated with an increased incidence of other opportunistic infections. Because of the frequency and severity of disease a considerable effort has been made to prevent and treat CMV infection in renal transplant recipients. An immune globulin preparation enriched with antibodies to CMV was used by many centers in the past in an effort to protect the group at highest risk for severe infection seronegative recipients of seropositive kidneys . However with the development of highly effective oral antiviral agents CMV immune globulin is no longer used. Ganciclovir valganciclovir is .

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• Infections in Transplant Recipients
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• Transplant infections
• Specific sites of infection
• Bacterial infections
• Immunosuppressive agents
• Transplant Infections in developing countries
• Infections in kidney transplant recipients
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care