Abstract Purpose: This study aims to provide insights into the clinical medication for suspected ganciclovir-resistant cytomegalovirus (CMV) infection after lung transplantation. Methods: A 60-year-old patient with non-specific interstitial pneumonia underwent bilateral lung transplantation. About 1 month after operation, CMV nucleic acid in bronchoalveolar lavage fluid was positive, and the CT value was 21.47. After 16 days of intravenous infusion of ganciclovir, CMV nucleic acid was still positive, and virus replication increased. Lung CT showed obvious bilateral lung infiltration. Clinical pharmacists suggested intravenous infusion of foscarnet sodium. Results: After 14 days, CMV nucleic acid test turned negative, and the treatment was effective. However, the patient eventually developed septic shock and hemodynamic instability due to post-lung transplantation bronchial anastomotic fistula, pyothorax, and the family abandoned treatment. Conclusions: Clinical pharmacists participated in the whole process of diagnosis and treatment of this case, which reflected the professional ability and service level of clinical pharmacists, and highlighted the rare but potential complexity of ganciclovir-resistant cytomegalovirus infection in patients after lung transplantation.
No takes yet. Share an insight, caveat, or question.
Shao et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: