BK virus nephropathy complicated with meningoencephalitis after kidney transplantation

Abstract

BK disease is an opportunistic infection in organ transplant recipients and patients with other cellular immunodeficiencies. To the best of our knowledge, we report the second case of BK meningoencephalitis associated with nephropathy in a kidney transplant recipient. A 15-yr-old boy underwent a cadaveric kidney transplant without complications; however, 11 wk after the transplantation, he was admitted to the hospital for graft dysfunction and cytopenia, which were confirmed by BK nephropathy (plasma viral replication and histological evidence). Four days after his hospital admission, he developed a high-grade fever and headache. CSF analysis revealed pleocytosis with a positive PCR for BK virus. Reduction in immunosuppression and supportive care conducting cycles of immunoglobulin and cidofovir were successful in treating the patient. BK meningoencephalitis should be considered in kidney transplant recipients who present with signs and symptoms of meningoencephalitis.

Late-Onset BK Viral Nephropathy in a Kidney Transplant Recipient

“…BK virus has also been described to cause encephalitis, hepatitis, pneumonia, inflammatory polyneuropathy, and tubulointerstitial nephritis. When the disease is due to secondary reactivation, it can manifest as ureteric stenosis, retinitis, meningoencephalitis, and desquamative interstitial pneumonia, as well as the usual presentation of tubulointerstitial nephritis [11,12]. Because the seroprevalence in North America is high, BK viral reactivation is seen more commonly than primary infection [13].…”

Neurological Disease-Affected Patients, including Multiple Sclerosis, Are Poor Responders to BKPyV, a Human Polyomavirus

“…In immune-suppressed patients, BKPyV may reactivate causing severe diseases, such as nephropathies and hemorrhagic cystitis, which were reported in the kidney and bone marrow transplant patients [ 16 ]. Moreover, in severe immunosuppressed hosts, together with other predisposing factors, BKPyV may induce meningoencephalitis [ 17 ].…”

Infections Following Kidney Transplant in Children: A Single-Center Study

“…The cornerstone of the treatment of BKV infection is to decrease the immunosuppressive therapy. In our patient with a disseminated disease we also administered cyprofloxacin, cidofovir and intravenous immunoglobulin with a successful outcome [18].…”