01771nas a2200169   4500008003900000245009600039210006900135260000800204300000600212490000700218520126600225100001501491700001301506700002101519700001601540856004501556       2017                          d00aProbable Donor-Derived Cytomegalovirus Disease After Keratolimbal Allograft Transplantation0 aProbable DonorDerived Cytomegalovirus Disease After Keratolimbal  cAug  a60 v363 aPURPOSE:

To report a case of probable donor-derived cytomegalovirus (CMV) infection after keratolimbal allograft (KLAL) transplantation.
METHODS:

Observational case report.
RESULTS:

A 41-year-old man with a history of aniridic keratopathy and limbal stem cell deficiency underwent KLAL in his right eye. Preoperatively, he was negative for CMV IgG and IgM. Postoperatively, he was maintained on tacrolimus and mycophenolate mofetil for systemic immunosuppression; he was also on prophylactic valganciclovir (for CMV) and trimethoprim/sulfamethoxazole (for pneumocystis pneumonia) for 1 month. Approximately 5 weeks postoperatively, he developed a nonproductive cough, rhinorrhea, and dyspnea. His condition did not improve with oral azithromycin or levofloxacin. He developed worsening symptoms over the next 2 weeks despite therapy. The serum CMV polymerase chain reaction was positive, and he was readministered valganciclovir with subsequent resolution of symptoms.
CONCLUSIONS:

We present the first case of CMV disease in a seronegative patient who received a presumed CMV-seropositive donor KLAL. Similar to solid organ transplantation, prophylactic and therapeutic management of CMV infection is necessary in the setting of systemic immunosuppression.1 aCheung, AY1 aGovil, A1 aFriedstrom, S, R1 aHolland, EJ  uhttps://notifylibrary.org/reference/4652