Hemorrhagic Cystitis Secondary to Adenovirus or Herpes Simplex Virus Infection Following Renal Transplantation: Four Case Reports

• Published in: Transplantation proceedings 2009-12, Vol.41 (10), p.4416-4419
• Main Authors: Ferreira, G.F, Oliveira, R.A, Lucon, M, de Paula, F.J, Lucon, A.M, Ianhez, L.E, Srougi, M, Sabbaga, E
• Format: Article
• Language: English
• Subjects: Acyclovir - analogs & derivatives; Acyclovir - therapeutic use; Adenovirus Infections, Human - complications; Adenovirus Infections, Human - diagnosis; Adenovirus Infections, Human - drug therapy; Aged; Aged, 80 and over; Antiviral Agents - therapeutic use; Cystitis - drug therapy; Cystitis - etiology; Cystitis - virology; Diabetic Nephropathies - surgery; Herpes Simplex - complications; Herpes Simplex - diagnosis; Herpes Simplex - drug therapy; Humans; Kidney Transplantation - adverse effects; Male; Middle Aged; Surgery; Treatment Outcome; Valine - analogs & derivatives; Valine - therapeutic use
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2009.09.059

Abstract Viral infections are common complications following renal transplantation. However, there have been few reported cases of viral cystitis secondary to herpes simplex virus or adenovirus infection. Herein, we have reported four cases of hemorrhagic cystitis secondary to infections with herpes simplex virus and adenovirus following renal transplantation. The etiology was adenovirus in three cases and herpes simplex virus in the remaining case. In all four cases, the primary cause of the renal dysfunction was diabetic nephropathy. All four patients presented with a clinical profile characterized by dysuria, pollakiuria, macroscopic hematuria, and graft dysfunction. Three of the four patients developed these symptoms within the first 3 months after renal transplantation. In all four cases, there was an increase, albeit slight, in creatinine levels, which returned to normal or near-normal values upon resolution of the symptoms. Acute cellular rejection was observed in only one case. Although rare, hemorrhagic cystitis secondary to infection, which typically occurs early in the posttransplant period, causes pronounced symptoms. The infection appears to be self-limiting, resolving completely within 4 weeks.