There are three types of infections:

1. Bacterial infection
2. Fungal infection
3. Viral infection

• Bacterial infection:

It usually occurs in the hospital as a result of urinary tract catheter or IV insertion or hospital-acquired pneumonia which will be treated by intravenous antibiotics medication.

• Fungal infection:

This type of infection is especially common in the first month after transplantation. The most common of these is thrush, which, if left untreated, can spread to your esophagus and stomach. Fungal infections can affect women’s genitals, which appear as redness, white plaques, and vaginal discharge. Most fungal infections of the mouth or genital area would be treated with topical medications, but fungal infections such as abscesses in the liver and the like, require hospitalization and intravenous treatment.

• Viral infection:

1. Cytomegalovirus infection:

Cytomegalovirus is a common virus in the society that does not cause severe and significant infections in healthy individuals, but can be problematic in transplant recipients. The virus is usually activated in transplant patients in the first two to three months after transplantation or in case of taking high amount of weakening immune system drugs. Therefore, in order to prevent the virus from becoming active, in some patients, Gancyclovir is given as an injection in the ward, and after being discharged, Valcyte or Valganciclovir, is given for oral administration. This medication should be continued for three months. Symptoms of CMV infection include fever, low white blood cell, nausea, vomiting, diarrhea, and abdominal pain. Special tests are needed to diagnose this type of infection, which your doctor will ask for that in case.

2. Epstein-Barr virus infection:

Epstein-Barr virus is from herpes family that most adults may encounter during their lifetime, but do not become seriously ill. This type of infection occurs in the first year after transplantation and is more common in children. Liver recipients are at high risk for being infected with this virus if the donor’s EBV is positive or the recipient take a large amount of immunosuppressive drugs or the recipient has taken ATG.

In transplanted patients, the virus causes a specific type of lymph node tumor which called post-transplant lymphoproliferative disease. Post-transplant lymphoproliferative or a cancerous PTLD would affect 20% of patients after transplantation.

The most common symptom of this disease is inflammation of the lymph nodes, which is more common in ​​the area of lymph nodes of the neck, but it can also occur in the lymph nodes of the tonsils, armpits, and groin. These symptoms can be accompanied by fever. Although it is a type of cancer, in most cases, if it is diagnosed early, it will respond well to treatment, so don’t worry too much, but consult your doctor frequently, especially when you have a lump in your armpits, neck or groin.

For a definitive diagnosis, your lymph nodes should be sampled through a minor surgery. If the presence of PTLD is verified, then the patient is hospitalized, immunosuppressive drugs are reduced as much as possible under supervision of physician, and Rituximab is given to the patient through IV, and the enzymes should be checked regularly.

3. Herpes and shingles:

Most adults in our country have suffered from herpes at least once in their lifetime. Herpes mostly manifests itself as a small, painful sore in the corner of the mouth, on the lips or around the nose. The disease is caused by one of the herpes virus family and remains in the body after the initial infection, and following the weakening of the body’s immune system (especially after transplantation), the disease is likely to flare up.

The herpes virus is called herpes simplex I, and the other type, herpes simplex virus II causes genital warts, which is very similar to lip herpes. Herpes is a contagious disease, and any contact with an infected person (even when the herpes is dehydrated and so-called clogged) can transmit the virus and cause the disease.

Shingles: Includes numerous red, juicy skin lesions, accompanied by severe pain that may occur as a belt in different areas of the body, from head and face to chest and abdomen, back or even the genitals and limbs. It is important to inform medical team to start the treatment for you. This condition is more likely in the first month after transplantation, when the patient takes large amounts of immunosuppressive drugs and is under severe stress. In fact, shingles occurs in people who have had chickenpox in the past. When a person gets chickenpox, the virus remains dormant in the person’s body for the rest of their lives, and as soon as the body’s immune system is weakened (for example after transplantation), the virus becomes active and manifests itself as shingles. Both herpes and shingles can be treated with Aciclovir and, more recently, Valaciclovir. These medications should usually injected for 15 days and then orally for up to three months after that. Be careful to drink plenty of water to avoid probable kidney damages. When injecting the drug, it should be considered not to inject the drug too fast, because if it comes out of the vein, it will severely damage the skin and cause extensive wounds.

Note: If you haven’t had chickenpox in the past, avoid contacting closely with infected ones.