Echenique I A, Stosor V, Gallon L, Kaufman D, Qi C, Zembower T R
Division of Infectious Disease, Cleveland Clinic Florida, Weston, Florida, USA.
Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Transpl Infect Dis. 2016 Feb;18(1):98-104. doi: 10.1111/tid.12472. Epub 2015 Nov 25.
Norovirus is a major cause of self-limited gastroenteritis worldwide. Prevention and treatment are thwarted by rapid viral evolution, and thus supportive care remains the mainstay of therapy. Chronic infection in immunocompromised hosts is increasingly described. We report a case of norovirus infection lasting 2543 days in a pancreas transplant recipient. Serial fecal specimens were obtained, from which a map of genetic relatedness was derived. The clinical course was complicated by renal failure that progressed to end-stage renal disease. Minimization of immunosuppression was associated with resolution of the infection. Subsequently, the patient experienced a suspected allograft rejection that did not compromise pancreas function. The patient later underwent living-related renal transplantation without recurrence of enteritis.
诺如病毒是全球范围内导致自限性胃肠炎的主要原因。病毒的快速进化阻碍了预防和治疗，因此支持性护理仍然是治疗的主要手段。免疫功能低下宿主中的慢性感染越来越多地被描述。我们报告了一例胰腺移植受者诺如病毒感染持续2543天的病例。采集了系列粪便标本，并由此绘制了遗传相关性图谱。临床过程因肾衰竭进展至终末期肾病而复杂化。免疫抑制的最小化与感染的消退相关。随后，患者经历了一次疑似移植排斥反应，但未损害胰腺功能。该患者后来接受了亲属活体肾移植，肠炎未复发。
