Cytomegalovirus appendicitis in solid organ transplant patients, two cases and a review

Untitled

“…Notwithstanding, opportunistic organisms (eg, Cytomegalovirus) should also be considered as a possible cause of AA in solidorgan transplant recipients. 12,13 Regarding duration of antimicrobial therapy, because all patients in our study had evidence of localized peritonitis or a periappendiceal abscess, every patient had an excellent response with a 5-to 7-day antibiotic course as recommended by current guidelines. 14 Although every patient continued their basal immunosuppressive therapy, further studies are required to determine whether there is any benefit in withholding or substituting some of them, particularly for patients under mammalian target of rapamycin inhibitor (sirolimus, everolimus) therapy and wound healing.…”

Cytomegalovirus appendicitis after hematopoietic stem cell transplantation

“…CMV disease is quite common following hematopoietic SCT (HSCT) and solid organ transplantation (SOT) with a variety of gastrointestinal manifestations, CMV appendicitis, however, is a rare complication, with only a handful of cases reported in the literature. Previous reported cases of CMV appendicitis are limited to cases in patients with advanced human immunodeficiency virus (HIV) and solid organ transplant recipients . In patients with HIV, CMV appendicitis can be a manifestation of immune reactivation inflammatory syndrome (IRIS) after starting antivirals, and has been associated with higher mortality than other etiologies of appendicitis .…”

“…Alternate drugs such as foscarnet and cidofovir can be used for treatment in refractory or GCV‐resistant cases. In addition, appendectomy was performed in prior case reports of CMV appendicitis, in addition to antiviral therapy . In cases where no perforation or urgent need for appendectomy is indicated, it is not known if antiviral treatment alone would be effective for resolution of CMV appendiceal disease.…”

“…Previous reported cases of CMV appendicitis are limited to cases in patients with advanced human immunodeficiency virus (HIV) and solid organ transplant recipients. 1,2 In patients with HIV, CMV appendicitis can be a manifestation of immune reactivation inflammatory syndrome (IRIS) after starting antivirals, and has been associated with higher mortality than other etiologies of appendicitis. 3 We are also reporting the first case, to our knowledge, of CMV appendicitis following HSCT.…”

Enfermedad por citomegalovirus en pacientes receptores de trasplante de corazón en un centro de referencia nacional

“…Entre las manifestaciones clínicas de la enfermedad por CMV se encuentra comúnmente la gastrointestinal en pacientes con posterioridad a trasplante de órganos sólidos 29,30 ; similar situación se presenta en los trasplantes de corazón 31 . En nuestra serie, un paciente de los dos que desarrollaron la enfermedad tuvo un compromiso gastrointestinal manifestado por dolor abdominal difuso y deposiciones acuosas.…”