CMV NEPHRITIS WITH MULTI-DERMATOMAL HERPES ZOSTER CO-INFECTION IN A KIDNEY TRANSPLANT RECIPIENT: A CASE REPORT AND REVIEW OF THE LITERATURE

Cytomegalovirus (CMV) is a viral pathogen that can cause infection in kidney transplant recipients. We report a case of a 50-year-old Thai male kidney transplant recipient with a history of multiple episodes of urinary tract infection, presented with fever and vesicular rash. He was diagnosed with having CMV nephritis proven by immunohistochemistry stains on kidney biopsy and multi-dermatomal herpes zoster (HZ) co-infection proven by pathological findings on skin biopsy. The infections improved with immunosuppressive therapy reduction and intravenous ganciclovir for 2 weeks, followed by oral valganciclovir for 3 months. CMV nephritis and HZ are fairly common in kidney transplant recipients but have never been reported together as a co-infection. CMV nephritis/HZ co-infection should be considered in transplant recipients who present with impaired renal function and multi-dermatomal vesicular lesions.