Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [fever/malaise/myalgia] in the context of recent renal transplantation. History significant for CMV D+/R- mismatch status. Currently reporting [rising serum creatinine/decreased urine output/graft tenderness]. Review of systems positive for [GI symptoms/respiratory distress/constitutional symptoms].
Clinical Examination Findings
Patient appears [ill/febrile/lethargic]. Vitals: T [temp], HR [rate], BP [pressure]. Skin: No rashes or petechiae. Lymphadenopathy: [present/absent]. Graft site: [tender/non-tender], no overlying erythema or fluctuance.
Treatment Protocol
Initiate IV Ganciclovir [dose/frequency] adjusted for renal function. Consider reduction of immunosuppressive regimen (e.g., MMF/Tacrolimus dose adjustment). Monitor CMV PCR viral load weekly. Prophylaxis with Valganciclovir to be re-evaluated post-clearance.