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Pediatric Nephrology

, Volume 32, Issue 3, pp 533–536 | Cite as

Fatal disseminated cowpox virus infection in an adolescent renal transplant recipient

  • Paul GazzaniEmail author
  • Joanna E Gach
  • Isabel Colmenero
  • Jeff Martin
  • Hugh Morton
  • Kevin Brown
  • David V Milford
Brief Report

Abstract

Background

A 17-year-old boy on long-term immunosuppression following renal transplantation for chronic kidney disease (CKD), the result of dysplastic kidneys, initially presented with a swelling in his neck while attending hospital for an unrelated problem. A clinical diagnosis of tonsillitis was made, and he was treated with broad-spectrum antibiotics. Over a few days, his condition deteriorated, and he developed multiple vesicopustular skin lesions and required an emergency tonsillectomy due to respiratory distress.

Case diagnosis/treatment

Histological investigation of the skin and tonsillar tissue suggested a viral aetiology, and subsequent electron microscopy and polymerase chain reaction (PCR) tissue examination proved disseminated cowpox infection. The family cat, which was reported as having self-resolving sores on its skin, was likely the source of the infection. The child failed to respond to antiviral treatment and succumbed to multiorgan failure within a month of admission.

Conclusions

We report this case of fatal disseminated cowpox infection to highlight an increasing risk of this illness in the post-transplant population and to detail some unusual features not previously described, such as tonsillar involvement, disseminated skin lesions and multiorgan failure.

Keywords

Cow pox Immunosuppression Transplant Paediatric Fatal/death 

Notes

Acknowledgments

Thank you to Matthew Hannah at the Viral Reference department, Colindale, for providing the EM image.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest

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Copyright information

© IPNA 2016

Authors and Affiliations

  • Paul Gazzani
    • 1
    Email author
  • Joanna E Gach
    • 1
  • Isabel Colmenero
    • 2
  • Jeff Martin
    • 3
  • Hugh Morton
    • 4
  • Kevin Brown
    • 5
  • David V Milford
    • 6
  1. 1.Dermatology DepartmentBirmingham Children’s HospitalBirminghamUK
  2. 2.Histopathology DepartmentBirmingham Children’s HospitalBirminghamUK
  3. 3.Intensive Care DepartmentBirmingham Children’s HospitalBirminghamUK
  4. 4.Microbiology DepartmentWorcestershire Royal HospitalWorcesterUK
  5. 5.Virus Reference DepartmentPublic Health EnglandLondonUK
  6. 6.Nephrology DepartmentBirmingham Children’s HospitalBirminghamUK

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