CMV Polymerase Chain Reaction analysis was positive for both serum and bile and a diagnosis of CMV acalculous cholecystitis with haemobilia was established. The patient was treated with intravenous ganciclovir for 25 days followed by 18 days of oral valganciclovir. T-Tube cholangiogram 2 weeks following initial insertion demonstrated no flow out of the common bile duct into the duodenum. A Magn...

Cytomegalovirus is a double stranded DNA virus that can be present in nearly all organs and body fluids. The primary infection is usually asymptomatic in the immunocompetent host and it is common among adolescents and young adults. The symptomatic form appears, in the majority of cases, as a mononucleosis syndrome with full recovery without specific treatment. We report a case of a 25 years old...

In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-rel...

BACKGROUND Kaposi sarcoma (KS) flare may occur following therapy with corticosteroids, as part of the immune reconstitution inflammatory syndrome seen with highly active antiretroviral therapy (HAART), and after rituximab therapy. The exact mechanism responsible for iatrogenic KS flare is unclear. METHODS A case of AIDS-associated cutaneous KS flare following rituximab therapy was compared to...

BACKGROUND Valganciclovir (VGC) has recently been proved efficacious for the prophylaxis and treatment of cytomegalovirus (CMV) infection in transplant recipients. Leucopenia is a troublesome complication of VGC but the possible risk factors are unknown. METHODS AND RESULTS Once a cardiac recipient's quantitative real-time CMV-polymerase chain reaction result showed positive, VGC was administ...

Valganciclovir is equally efficacious in preventing CMV disease when used as prophylaxis or as pre-emptive treatment (Level 2 evidence but not designed for this outcome) Pre-emptive treatment of CMV infection results in significantly less leukopenia than prophylaxis, however, there is no difference in other adverse events. Pre-emptive treatment with 1⁄2 dose ganciclovir and 1⁄2 dose foscarnet r...

BACKGROUND Management of a number of significant viral pathogens in transplant recipients remains challenging. OBJECTIVES To define an optimal antiviral approach to the management of cytomegalovirus (CMV), human herpes virus-6 (HHV-6), Epstein-Barr (EBV)-associated post-transplant lymphoproliferative disorder (PTLD), and polyoma virus-associated nephropathy in transplant recipients. METHODS...