-
Intravenous acyclovir
(400 mg, bid) was added to the medical regimen, which also
included ganciclovir.
-
Cyclosporine was discontinued
5 days after onset of visual loss.
-
Cyclophosphamide, 50
mg, po, qd, and tacrolimus, 1 mg, po, qd, were prescribed.
-
The prednisone dose
was increased to 30 mg, po, bid.
11
DAYS AFTER INITIAL
EVALUATION: Ganciclovir was withdrawn
because we believed that the patient did not have a CMV-induced
infection. Acyclovir was also temporarily withdrawn in preparation
for a diagnostic vitreous tap on the 11th day of follow-up. After
the diagnostic procedure, the renal transplant team resumed
administration of acyclovir as routine prophylactic therapy
following renal transplantation.
CLINICAL COURSE:
Over the next 3 weeks, the patient’s visual acuity progressively
deteriorated to hand motion at 1foot (OD) and counting fingers
at 1 foot (OS).
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