Cytomegalic inclusions in pancreatic allograft after simultaneous pancreas-kidney transplantation: case report and literature review

The incidence of cytomegalovirus (CMV) infection has increased in the past years due to the use of more potent immunosuppressors, such as tacrolimus and mycophenolate. This is related to the early post transplantation period, when immunosuppressive regimen is more intense. Other well-known risk factors for CMV infection include the serological status of donor (D) and recipient (R) and the use of monoclonal or polyclonal antibodies for induction therapy or for treating acute rejection. In the present study, it was reported a case of an invasive CMV infection in the parenchyma of pancreatic allograft after simultaneous pancreas-kidney transplantation. Upon diagnosis of CMV infection, the patient also presented other clinical complications related to the transplant, such as bacterial and fungal infection, as well as enteric fistula. The occurrence of invasive CMV infection is a rare event, but it should be suspected if high risk factors for this infection are present or if there are concomitant clinical or surgical complications.