Rojas-Contreras Christian, Cruz-Ku Gabriel De la, Vilcarromero Stalin, Ayllon Ruben Villacaqui, Valcarcel-Valdivia Bryan
1 Servicio de Infectología, Instituto Nacional Cardiovascular. Lima, Perú.
Sociedad científica de estudiantes de medicina, Universidad Científica del Sur (UCSUR). Lima, Perú.
Rev Peru Med Exp Salud Publica. 2018 Jan-Mar;35(1):145-149. doi: 10.17843/rpmesp.2018.351.3562.
Cytomegalovirus infection after a heart transplant is a recurrent medical condition. Its frequency increases when the donors are serum-positive, and the recipients are serum-negative to this virus. In the pediatric population, the infection only develops in a small percentage and the patients rarely present resistance to conventional treatment with ganciclovir and valganciclovir. We presented the first report of a pediatric case of the cytomegalovirus infection resistant to ganciclovir and valganciclovir after a heart transplant in a Peruvian public hospital with an unusual presentation. The resistance to these drugs was evident after 277 days of evolution of the disease considering the non-remission of the symptomatology and the persistence of an elevated viral load. The administration of foscarnet led to a clinical and laboratory improvement until remission of the disease.
心脏移植后巨细胞病毒感染是一种复发性病症。当供体血清呈阳性而受体血清对此病毒呈阴性时,其感染频率会增加。在儿科人群中,感染仅在一小部分人中发生,并且患者很少对更昔洛韦和缬更昔洛韦的常规治疗产生耐药性。我们报告了秘鲁一家公立医院首例心脏移植后对更昔洛韦和缬更昔洛韦耐药的儿科巨细胞病毒感染病例,其表现不同寻常。考虑到症状未缓解且病毒载量持续升高,在疾病进展277天后,对这些药物的耐药性明显显现。膦甲酸钠的使用使临床和实验室指标得到改善,直至疾病缓解。