A rare case of adenovirus infection in post renal transplant patient

Abstract

Human adenovirus is a linear, non-enveloped, double-stranded DNA virus that can cause opportunistic infections. Typically, adenovirus infections result in self-limiting respiratory, gastrointestinal or ocular infections. However, it can cause severe disseminated disease in immunocompromised patients, especially in post-transplant recipients. In kidney transplant recipients, adenovirus infections have an incidence of up to 4.1%, usually manifested as hemorrhagic cystitis and tubulointerstitial nephritis, in the first three months post-transplant. Renal biopsy shows necrotizing granulomatous interstitial nephritis and other features consistent with the viral infection. Investigations like immunohistochemistry and polymerase chain reaction (PCR) help in confirmation of the diagnosis. Resolution of the disease with the reduction in immunotherapy alone supports the role of immunosuppression as a risk factor for adenovirus infection.

Keywords: Adenovirus, Hemorrhagic cystitis, Immunocompromised, Necrotizing granuloma, Tubulointerstitial