Indiana University Infectious Diseases Fellowship
13 Mar,
10 tweets, 5 min read
#idboardreview 50 M s/p liver transplant cmv D+/R- 28d ago now w/ dyspnea, fever, sore throat, myalgias, cough, yellow sputum x2d➡️hypoxia, ALT3k AST1k TBili2.3. Liver Biopsy: intranuclear eosinophilic inclusions. Dx? #medEd #idmedEd #IDTwitter 
#Adenovirus affects epithelial cells in GI GU & respiratory tracts. In immunocompromised hosts: wide range of clinical presentations, including pneumonia, hepatitis, nephritis & hemorrhagic cystitis with a case fatality of 50%.
#adenovirus IC host acquired by 1)reactivation of latent infection secondary to immunosuppression or 2)primary adenovirus infection; acquired from either ill contacts or from donor organ
#adenovirus dx
-positive serum adenovirus PCR with clinical and laboratory findings of hepatitis favors a probable diagnosis of adenoviral hepatitis.
-Definitive diagnosis requires a liver biopsy demonstrating viral inclusions.
-positive serum adenovirus PCR with clinical and laboratory findings of hepatitis favors a probable diagnosis of adenoviral hepatitis.
-Definitive diagnosis requires a liver biopsy demonstrating viral inclusions.
#adenovirus treatment supportive care & decrease in immunosuppression. The use of antiviral therapy is not supported by prospective RCT. However IV cidofovir is considered standard practice for severe, progressive, or disseminated adenovirus disease in most transplant centers
• • •
Missing some Tweet in this thread? You can try to
force a refresh
