Infections after transplantation - Infections: patient with cancer - DONE (mainly the important stuff)

Question 1

Pre-transplant factors:

Answer 1

• transplantation at a young age has been associated with higher rates of infection during the first few years after transplantation
• infants and toddlers undergoing SOT experience greater morbidity and mortality with community-acquired viruses

Question 2

Type on infection after 0-30 days post transplantation:

early infections

Answer 2

• mostly “surgical” infections
  
  • bacteria and yeast are the most common pathogen recovered
  • cause by technical difficulties
  • CMV (in the abcence of prophylaxis), EBV, Pneumocystis jirovecii pneumonia and toxoplasmosis

Question 3

Type on infection after 1-6 months post transplantation:

intermediate period

Answer 3

• opportunistic pathogens, cmv, pneumocystis, nocardia, aspergillus

Question 4

Type on infection after 6 months onward post transplantation:
late infections

Answer 4

• common community infections

* people with diabetes mellitus, and malignancies, may increase the risk for infection during this period

Question 5

Infections to be the most common cause of death during this period after lung or lung-heart transplantation is during which period?

Answer 5

• 1-6 months after transplantation

- intermediate period

Question 6

Viruses transmitted by transplantation:

Answer 6

• CMV and other herpes viruses
• HIV
• Hepatitis A, B, C, D
• HTLV-1
• Rabies

Question 7

Fungi transmitted by transplantation:

Answer 7

• Histoplasma
• Coccidoides
• Cryptococcus

Question 8

Protozoa transmitted by transplantation:

Answer 8

• Toxoplasma
• Malaria
• T. Cruzii

Question 9

Bacteria transmitted by transplantation:

Answer 9

• TB
• nosocomial pneumonia agents (lung)
• urinary bacteria (kidney)
• bacteremic donor

Question 10

Prions transmitted by transplantation:

Answer 10

Creutzfield-Jakob disease (cornea)

Question 11

What may reduce the risk of post transplant malignancy and CMV?

Answer 11

rapamycin

Question 12

How many transplant recipients get herpes zoster?

Answer 12

1/3

Question 13

Can a transplant recipients get chicken pox?

Answer 13

yes, but chicken pox in that case can be fatal

Question 14

What is Epstein-Barr associated with?

Answer 14

lymphoma

Question 15

Kaposi sarcoma =

Answer 15

human herpes virus 8

Question 16

How do you treat CMV?

Answer 16

• IV ganciclovir is standard therapy

- decrease immunosuppression

Question 17

What do you use for ganciclovir-resistant CMV disease?

Answer 17

foscarnet

Question 18

Cryptococcal infection after transplantation:

Answer 18

• commonly pulmonary or central nervous system disease

- symptoms: headache, meningitis, skin lesions

Question 19

How is cryptococcal infection diagnosed?

Answer 19

• bronchoscopy
• lumbar puncture
• cryptococcal antigen

Question 20

What are the risk factors of polyomavirus (BKV) nephropathy after transplantation?

Answer 20

• older age
• male gender
• caucasian ethnicity