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Development of intrapancreatic abscess — a consequence of CMV pancreatitis?
Authors:Lars Bäckman  Christina Brattström  Finn P Reinholt  Jan Andersson  Gunnar Tydén
Institution:(1) Department of Transplantation Surgery, Huddinge Hospital, S-14186 Huddinge, Sweden;(2) Department of Pathology, Huddinge Hospital, S-14186 Huddinge, Sweden;(3) Department of Infectious Diseases, Danderyd Hospital, Karolinska Institute, S-18288 Stockholm, Sweden
Abstract:Cytomegalovirus (CMV) pancreatitis was diagnosed in eight out of 124 pancreatic transplant recipients. Five of the eight patients developed intrapancreatic abscesses and four of the grafts were lost, but one is still functioning. In the three additional cases of pancreatitis, antiviral treatment with foscarnet or ganciclovir was given as soon as signs of CMV pancreatitis were detected. No such grafts were lost during the acute phase. CMV infection was diagnosed in cells from pancreatic juice, by virus isolation, detection of CMV antigen in cells from pancreatic juice or by CMV serology. The signs and symptoms of CMV pancreatitis included fever, general malaise, abdominal pain, diarrhoea, localized peritonitis, hyperamylasaemia, leukopenia and hyperglycaemia. It is recommended that rapid diagnostic procedures for CMV should be carried out when early signs of pancreatitis develop in pancreatic graft recipients. Antiviral treatment should be given when CMV pancreatitis is suspected or diagnosed in order to prevent the development of intrapancreatic abscesses and graft loss.
Keywords:Pancreas transplantation  CMV  Abscess  pancreas transplantation  CMV  pancreas abscess
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