INFECTIONS

Immunosuppressive medications interfere with a patient's natural immunity; therefore, the patient will be more susceptible to infections after transplant surgery. The following are some of the most common infections:

Viral Infections:

Cytomegalovirus (CMV) - CMV is one of the viral infections that occur most frequently in transplant patients. The risk of CMV is highest in the first months after transplantation. Signs include fatigue, high temperature, aching joints, headaches, visual disturbances, and pneumonia. Treatment may include hospitalization.

Herpes-simplex virus type I and II - These viruses most often infect the skin but can also occur in other areas such as the eyes and lungs. Type I typically causes cold sores and blisters around the mouth, and type II causes genital sores. Herpes is an infectious disease and can be transmitted sexually. Herpes infections in transplant patients, however, were not necessarily transmitted sexually.

Most herpes-simplex infections are mild, but occasionally they can be severe. Although there is no cure for herpes, it can be treated. Depending on the severity of the infection, the treatment is either topical, oral, or intravenous (IV). A patient should contact the transplant team immediately if he believes he has herpes.

Symptoms of herpes include feeling weak and having painful fluid-filled sores in the mouth or genital area. Women should also be aware of any unusual vaginal discharge.

Herpes zoster (shingles) - Shingles appear as a rash or small water blisters, usually on the chest, back, or hip. The rash may or may not be painful. A patient should notify the transplant office if such a rash ocurs.

Fungal Infections:

Candida (yeast) - Candida is a fungus that can cause a variety of infections in transplant patients. It usually appears in the mouth and throat but may also be in the surgical wound, eyes, or respiratory and urinary tracts. Candida is most severe in the bloodstream. If infection occurs in the mouth or throat, it is called thrush. Thrust produces white, patchy lesions (raw areas), pain or tenderness, a white film on the tongue, and difficulty swallowing. Candida can also infect the esophagus (the tube from your mouth to your stomach) or, in women, the vagina. Vaginal infections usually produce an abnormal discharge that may be yellow or white. A patient should notify the transplant office if a Candida infection ocurs.

Bacterial Infections:

Wound infections - Bacterial wound infections occur at the surgical site. If a patient has a fever or notices redness, swelling, tenderness, or drainage at the incision, he should notify the transplant team. After a wound culture (a test for bacteria) is taken, an antibiotic will be prescribed if infection is present.

Other Infections:

Pneumocystis carinii is a germ similar to a fungus, and it is normally found in the lung. In people whose immune systems are suppressed, it may cause a type of pneumonia (PCP). Early in the illness, a mild, dry cough and a fever may occur. If a patient suspects that he has a cold or flulike illness, he should contact his physician immediately.