Virology in potential transplant recipient
Cytomegalovirus (CMV) serology before transplant
- Donor CMV IgG positive
- Recipient CMV IgG negative
Post-transplant
- 7 weeks later
- temp 38.5°C
- general malaise
Differential diagnosis
- Rejection
- Bacterial Sepsis
- Primary CMV infection
Investigations
- FBC
- Haemoglbin 9.7 g/dl
- WCC 3.2 x 109/l (normal)
- Urea normal
- LFTs
- ALT 75 iu
- Bilirubin, alkaline phosphatase, gamma-glutaryltransferase normal
- Chest X-ray normal
- MSU normal
- Sputum - only commensals grown
- blood cultures - no growth at 24 hours
Confirm CMV
- PCR
- in-situ hybridisation of CMV-infected lymphocytes
Management
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