Question

Four months after a renal transplant, a patient is most likely to develop infection with which of the following organisms?

• A. Epstein-Barr virus (EBV)
• B. Cytomegalovirus (CMV)
• C. Candida
• D. Histoplasma

Hint:

Which virus reactivates and peaks in the 1 to 6 month window after solid-organ transplant?

Answer 1

The Correct Option is B

Time-line trick. Group post-transplant infections by when they strike.
First month: surgical and nosocomial bugs, including Candida and line sepsis.
One to six months: the opportunistic and viral phase, where CMV reigns supreme.
After six months: community-acquired infections plus late opportunists.
Apply it: the patient is at four months, which lands in the one to six month bracket, so CMV is the expected pathogen. It is the most common and most clinically significant opportunistic infection of this period and a textbook cause of graft dysfunction. Candida is too early, while EBV-related lymphoproliferative disease and Histoplasma are either later or much rarer. Therefore CMV is correct. Ref: Bailey and Love, Short Practice of Surgery, 27th edition, 2018.