Central nervous system infections after solid organ transplantation

Puthanveedu, Nitin das Kunnathu; Lum, Jessica

doi:10.1097/qco.0000000000000722

Cited by 6 publications

(3 citation statements)

References 90 publications

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“…S olid organ transplant recipients are highly susceptible to infections that sometimes have uncommon clinical manifestations (1)(2)(3). Etiologic diagnosis of hepatitis is even more problematic in organ transplant recipients because a wide range of possible drug toxicities induced by immunosuppressive therapies must be considered (4).…”

mentioning

confidence: 99%

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Pérot¹,

Fourgeaud²,

Rouzaud³

et al. 2023

Emerg. Infect. Dis.

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In March 2022, a 61-year-old woman in France who had received a heart-lung transplant sought treatment with chronic hepatitis mainly characterized by increased liver enzymes. After ruling out common etiologies, we used metagenomic next-generation sequencing to analyze a liver biopsy sample and identified an unknown species of circovirus, tentatively named human circovirus 1 (HCirV-1). We found no other viral or bacterial sequences. HCirV-1 shared 70% amino acid identity with the closest known viral sequences. The viral genome was undetectable in blood samples from 2017–2019, then became detectable at low levels in September 2020 and peaked at very high titers (10 10 genome copies/mL) in January 2022. In March 2022, we found >10 8 genome copies/g or mL in the liver and blood, concomitant with hepatic cytolysis. We detected HCirV-1 transcripts in 2% of hepatocytes, demonstrating viral replication and supporting the role of HCirV-1 in liver damage.

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mentioning

confidence: 99%

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Pérot¹,

Fourgeaud²,

Rouzaud³

et al. 2023

Emerg. Infect. Dis.

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“…Intracranial fungal infections can present as various clinical syndromes such as meningitis, encephalitis, brain abscess, and even rarely as stroke (7,13). Clinical symptoms include nausea, vomiting, headache, fever, confusion, and seizures (6,14), but all are non-specific.…”

Section: Discussionmentioning

confidence: 99%

Cerebral aspergillosis after heart-lung transplantation in a child: Case report with 3-year follow-up and literature review

Zhuang

Kong

Gong

et al. 2023

Front. Cardiovasc. Med.

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There are limited cases of heart-lung transplantation (HLT) in children worldwide owing to lack of donors, demanding surgical teamwork, and arduous post-operative management. Post-transplant management difficulties stem from the possible development of several post-operative complications, with infection being a common complication. Intracranial fungal infections are difficult to diagnose and prone to treatment delays because of their relatively insidious onset and atypical clinical presentation. Here, we present a case of a cerebral infection developed 3 months after HLT in a 10-year-old child, showing no positive results on conventional imaging or cerebrospinal fluid (CSF) examination and culture. On metagenomic next-generation sequencing of the cerebrospinal fluid, the causative organism was finally determined as Aspergillus. After administering 1-year anti-Aspergillus treatment, no recurrence of intracranial fungal infection was noted during the 3-year follow-up. This case illustrates the multifaceted diagnostic techniques for cerebral aspergillosis after HLT and shows the significance of dynamic monitoring of symptoms, such as headache, and of metagenomic sequencing results, trends in intracranial pressure and (1-3)-β-D-glucan levels for guiding diagnosis and treatment.

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“…CNS complications happen in up to 40% of SOT patients; most cases are due to diverse etiologies, from infections to cerebrovascular events, cancer, metabolic disorders, and drug toxicity 1 . Infectious causes are less common, under 10%, and arise at any period after the SOT 2 .…”

Section: Introductionmentioning

confidence: 99%

Central Nervous System Infections in Recipients of Solid Organ Transplant

Morado-Aramburo,

Joseph,

Kaur

et al. 2024

Preprint

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Central nervous system infections after solid organ transplantation

Cited by 6 publications

References 90 publications

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Cerebral aspergillosis after heart-lung transplantation in a child: Case report with 3-year follow-up and literature review

Central Nervous System Infections in Recipients of Solid Organ Transplant

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