Disseminated adenoviral infection masquerading as lower urinary tract voiding dysfunction in a kidney transplant recipient

Ahmed Aboumohamed, Stuart M. Flechner, Andres Chiesa-Vottero, Titte R. Srinivas, Sherif B. Mossad

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Viral infections continue to cause significant morbidity in immunosuppressed kidney transplant patients. Although cytomegalovirus, Epstein-Barr virus and polyoma "BK" virus are more frequently encountered, the Adenovirus can cause multi-organ system infections, and may be difficult to diagnose because it is not often considered in the initial work up in kidney transplant recipients. We present an unusual case of a kidney recipient 1 year post-transplant with disseminated adenoviral infection, who had an initial presentation of lower urinary tract voiding dysfunction with hematuria and sterile pyuria. This progressed to a severe tubulointerstitial nephritis and acute kidney injury that improved with reduction of immunosuppression. Serial blood viral loads are useful for monitoring the course of infection. Urinary adenoviral infection should be considered in the differential diagnosis whenever a kidney transplant recipient presents with unexplained lower tract voiding dysfunction, hematuria, and sterile pyuria. The allograft kidney and bladder can be targets of viral proliferation. Early diagnosis with reduction of immunosuppressive therapy is essential to clear the virus and maintain allograft function.

Original languageEnglish (US)
Pages (from-to)332-336
Number of pages5
JournalClinical Nephrology
Volume82
Issue number5
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Urinary Tract
Kidney
Pyuria
Infection
Hematuria
Allografts
BK Virus
Transplants
Interstitial Nephritis
Polyomavirus
Virus Diseases
Immunosuppressive Agents
Viral Load
Cytomegalovirus
Human Herpesvirus 4
Acute Kidney Injury
Adenoviridae
Immunosuppression
Early Diagnosis
Urinary Bladder

Keywords

  • Adenoviral infection
  • Hemorrhagic cystitis
  • Kidney transplant

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Disseminated adenoviral infection masquerading as lower urinary tract voiding dysfunction in a kidney transplant recipient. / Aboumohamed, Ahmed; Flechner, Stuart M.; Chiesa-Vottero, Andres; Srinivas, Titte R.; Mossad, Sherif B.

In: Clinical Nephrology, Vol. 82, No. 5, 01.01.2014, p. 332-336.

Research output: Contribution to journalArticle

Aboumohamed, Ahmed ; Flechner, Stuart M. ; Chiesa-Vottero, Andres ; Srinivas, Titte R. ; Mossad, Sherif B. / Disseminated adenoviral infection masquerading as lower urinary tract voiding dysfunction in a kidney transplant recipient. In: Clinical Nephrology. 2014 ; Vol. 82, No. 5. pp. 332-336.
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