Co-Infection of Parvovirus B19, CMV and BK Virus after Renal Transplantation

Background: Parvovirus B19 is the agent causing a regenerative anemia in organ transplant recipients, due to their immunodepressive status. The diagnosis is usually confirmed by the presence of virus in the blood and bone marrow via the PCR technique. There is a potential co-infection with other opportunistic viruses in the transplanted patients. However, this population is not routinely screened for Parvovirus B19 infection. Case Report: A 14-year-old male patient who received living-donor kidney transplantation developed a severely progressive and aregenerative anemia four weeks later. PCR of Parvovirus B19 was positive from bone marrow aspiration. There were concomittant CMV and BK virus co-infection. The treatment included a reduction of immunosuppressants, intravenous gamma globulin. Valganciclovir has been prescribed for three months that could negativate the CMV blood load. At the end, there was an eradication of parvovirus in the bone marrow. Conclusion: This first reported case in Viet Nam which informed that infection with Parvovirus B19 should be investigated in the transplanted population when a regenerative anemia is present. Otherwise, a screening strategy for Parvovirus B19 should also be considered.