Disseminated varicella infection in adult renal allograft recipients: four cases and a review of the literature.

Abstract:

:Disseminated varicella-zoster (VZV) infection is a rare complication after renal allotransplantation in adults. We report four patients, among them one with combined VZV and cytomegalovirus infection. The main complications were hepatitis, pneumonitis, and disseminated intravascular coagulation. A review of the literature from 1981 to 2000 revealed 34 additional cases of disseminated varicella infection in adult renal allograft recipients with an overall mortality of 34%. Among these patients 82% suffered from primary varicella, 18% had a reactivation. High-dose acyclovir therapy combined with reduction of immunosuppression lead to reduction of mortality from 53% before 1990 to 22% after 1990. No immunosuppressive drug is significantly associated with a higher risk of disseminated VZV infection. Immunization against VZV in adults is still a matter of controversy. Whereas passive immunization is performed only for prophylactic but not therapeutic purpose, active immunization is routinely performed in children and may also be recommended for adults before renal transplantation.

journal_name

Transplantation

journal_title

Transplantation

authors

Fehr T,Bossart W,Wahl C,Binswanger U

doi

10.1097/00007890-200202270-00023

subject

Has Abstract

pub_date

2002-02-27 00:00:00

pages

608-11

issue

4

eissn

0041-1337

issn

1534-6080

journal_volume

73

pub_type

杂志文章
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    pub_type: 社论,评审

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