McCarty Todd P, Lee Rachael A, Herfel Barbara M, Pappas Peter G
University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, USA.
University of Alabama at Birmingham, Department of Medicine, Division of Infectious Diseases, USA.
J Clin Virol. 2015 May;66:48-50. doi: 10.1016/j.jcv.2015.03.004. Epub 2015 Mar 7.
Cytomegalovirus (CMV) disease is a common complication following solid organ transplantation with a variety of gastrointestinal (GI) tract manifestations. CMV appendicitis, however, is a rare complication in a solid organ transplant patient, having been reported only once previously. We have recently seen two cases in solid organ transplant recipients at our institution, one a liver recipient and the other a heart recipient. Both patients underwent surgical resection. Pathologic evaluation of both resected appendices as well as polymerase chain reaction (PCR) amplification for CMV from the serum revealed the virus as the etiology. Both patients received induction intravenous ganciclovir followed by oral valganciclovir and have done well post-operatively. Tissue-invasive CMV disease should be considered in the differential diagnosis for solid organ transplant patients with symptoms suggesting acute or chronic appendicitis. Both PCR testing as well as pathologic review of tissue specimens should be considered to ensure accurate diagnosis and management.
巨细胞病毒（CMV）疾病是实体器官移植后常见的并发症，有多种胃肠道表现。然而，CMV阑尾炎在实体器官移植患者中是一种罕见的并发症，此前仅报道过一例。我们最近在本机构的实体器官移植受者中见到了两例，一例是肝脏移植受者，另一例是心脏移植受者。两名患者均接受了手术切除。对切除的阑尾进行病理评估以及对血清中的CMV进行聚合酶链反应（PCR）扩增，结果显示该病毒为病因。两名患者均接受了静脉注射更昔洛韦诱导治疗，随后口服缬更昔洛韦，术后恢复良好。对于有提示急性或慢性阑尾炎症状的实体器官移植患者，鉴别诊断时应考虑组织侵袭性CMV疾病。应考虑进行PCR检测以及对组织标本进行病理检查，以确保准确诊断和治疗。
