PDF(Pubmed)
Abstract：
JC polyomavirus (JCPyV) is a human polyomavirus that can establish lifelong persistent infection in the majority of adults. It is typically asymptomatic in immunocompetent individuals. However, there is a risk of developing progressive multifocal leukoencephalopathy (PML) in immunocompromised or immunosuppressed patients. Though JCPyV commonly resides in the kidney-urinary tract, its involvement in urinary system diseases is extremely rare. Here, we reported a case of a 60-year-old male patient with coronavirus disease 2019 (COVID-19) infection who developed hemorrhagic cystitis after receiving treatment with nirmatrelvir 300 mg/ritonavir 100 mg quaque die (QD). Subsequent metagenomic next-generation sequencing (mNGS) confirmed the infection to be caused by JCPyV type 2. Then, human immunoglobulin (PH4) for intravenous injection at a dose of 25 g QD was administered to the patient. Three days later, the hematuria resolved. This case illustrates that in the setting of compromised host immune function, JCPyV is not limited to causing central nervous system diseases but can also exhibit pathogenicity in the urinary system. Moreover, mNGS technology facilitates rapid diagnosis of infectious etiology by clinical practitioners, contributing to precise treatment for patients.
摘要：
JC多瘤病毒（JCPyV）是一种人类多瘤病毒，可以在大多数成年人中建立终身持续感染。它在有免疫能力的个体中通常是无症状的。然而,免疫功能低下或免疫抑制患者存在发生进行性多灶性白质脑病(PML)的风险.虽然JCPyV通常存在于肾泌尿道，它与泌尿系统疾病的关系极为罕见。这里,我们报道了1例2019年冠状病毒病(COVID-19)感染的60岁男性患者,在接受尼马特雷韦300mg/利托那韦100mg治疗后出现出血性膀胱炎(QD).随后的宏基因组下一代测序（mNGS）证实感染是由2型JCPyV引起的。然后，以25gQD的剂量给予患者用于静脉注射的人免疫球蛋白(PH4).三天后,血尿消失了.这个案例说明在宿主免疫功能受损的情况下，JCPyV不限于引起中枢神经系统疾病,还可以在泌尿系统中表现出致病性。此外，mNGS技术有助于临床医生快速诊断感染性病因，有助于患者的精确治疗。
