Very Late‐Onset Cytomegalovirus Disease With Pneumocystis jirovecii Pneumonia Coinfection in a Renal Transplant Recipient: A Case Report and Narrative Review of Published Cases
Year: 2026
Type: review
Abstract: Background: Cytomegalovirus (CMV) infection is a common and serious complication following renal transplantation. It is associated with significant morbidity and mortality. The introduction of preventive measures with antiviral prophylaxis has reduced the incidence in the immediate posttransplant period, but CMV infection continues to be a prominent complication, especially once antiviral prophylaxis is discontinued. A particularly rare entity is "very late-onset" CMV disease, which we defined as occurring 10 or more years after transplantation. Methods: pneumonia (PJP). We performed a focused narrative review using PubMed for cases of very late-onset CMV disease to document potential risk factors for very late-onset CMV disease. Results: Our narrative review did not show a consistent pattern between the traditional risk factors such as prior rejection, impaired renal function, or changes in immunosuppressive therapy and the development of very late-onset CMV disease. However, an absolute lymphocyte count below 610/μL was present in our patient and may represent an area for further investigation as a potential risk factor for very late-onset CMV disease. Conclusion: Early recognition is crucial, as complications such as CMV-PJP coinfection carry high mortality rates and adversely affect long-term graft and patient outcomes. Clinicians should maintain a high index of suspicion for CMV in transplant recipients regardless of the time elapsed since transplantation.
DOI: 10.1155/crdi/6503116
Institution: Rutgers, The State University of New Jersey
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $790
OpenAlex ID: W7224123975