Abstract
Herpesvirus infections in solid organ transplant (SOT) recipients are a significant cause of morbidity and mortality. We report a case of herpes zoster (HZ) in a kidney transplant recipient while receiving belatacept, a CTLA-4 inhibitor that prevents acute rejection. The patient presented with oropharyngolaryngeal mucosal lesions that subsequently disseminated resulting in pneumonitis and meningo-encephalitis. Very late-onset HZ can occur and can present atypically in SOT recipients. Delayed recognition and treatment may result in poor outcomes, as illustrated by this case.
Keywords:
disseminated VZV; kidney transplant; late-onset infection.
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
MeSH terms
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Abatacept / administration & dosage
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Anti-Inflammatory Agents / therapeutic use
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Antiviral Agents / therapeutic use
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Autopsy
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Fatal Outcome
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Female
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Herpes Zoster / diagnosis*
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Herpes Zoster / etiology
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Herpes Zoster / pathology
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Herpes Zoster / virology
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Herpesvirus 3, Human / isolation & purification*
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Humans
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Immunosuppressive Agents / administration & dosage
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Kidney Transplantation / adverse effects*
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Laryngeal Edema / diagnosis
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Laryngeal Edema / pathology
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Laryngeal Edema / virology*
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Late Onset Disorders / diagnosis*
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Late Onset Disorders / etiology
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Late Onset Disorders / pathology
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Late Onset Disorders / virology
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Middle Aged
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Prednisone / therapeutic use
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Transplant Recipients
Substances
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Anti-Inflammatory Agents
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Antiviral Agents
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Immunosuppressive Agents
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Abatacept
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Prednisone