There are three types of organisms that cause infections: bacteria, fungi, and viruses. Understanding the various type of infections can be helpful for you and your new liver. Here is an overview of the various infections.

BACTERIA INFECTIONS

Bacteria infections usually occur in the early stages after transplant and may be caused by central vein catheters, infections inside the abdomen or wounds. Patients may develop pneumonia or urinary tract infections. Ocassionally, abscesses can develop in the liver if the patient develops clots in the major arteries or veins. Another bacterial infection is cholangitis, or an infection in the bile ducts of the liver.

In the case of blood infections, blood samples are sent to the lab to determine the bacterial cause and antibiotics are prescribed.

FUNGAL INFECTIONS

Fungal, or yeast infections, are the most common in the first three months after a transplant. These infections usually do not get into the bloodstream. The most common fungus is called Candida, also known as thrush, which looks like a white plaque or coating on the tongue and inside the mouth. Your mouth may become tender, sore and you might have difficulty swallowing. It is important to treat this fungal infection. If left untreated, it also infects the esophagus, stomach and intestine.

Women may get a vaginal infection with candida. Signs of candida in the vaginal area is itchiness and a thick yellow or white discharge from the vagina.

These types of fungus infections are seen frequently in patients that take high doses of Prednisone. The topical medications, nystatin, lotrimin, or clotrimazole, are typically used as treatment.

Cytomegalovirus

Cytomegalovirus (CMV) is a common community-acquired virus and is not a serious illness for most people who are healthy. However, CMV may be of greater concern for patients who are taking immunosuppressive medications.

CMV is a common infection that usually occurs within two to three months after transplant. Since this infection is such a common infection, most transplant centers usually have treatments to prevent this infection. Most plans to prevent CMV include ganciclovir.

Overall symptoms of CMV includes:

• Fatigue
• Fever
• Low white blood cell count
• Low platelet count
  
• CMV in the lungs
  • Fever
  • Coughing
  • Shortness of breath
  • Wheezing
    
• CMV in gastrointestinal (GI) tract
  • Diarrhea
  • Nauseau
  • Vomiting
  • Abdominal Pain
  • Bloody Stool

If CMV infects your liver, proteins and enzyme counts in your liver may increase and you may think you have a rejection. A liver biopsy will confirm the diagnosis of rejection or CMV infection.

Epstein-Barr Virus (EBV) and
Post -Transplant Lymphoproliferative Disorders (PTLD)

EBV is a very common virus and most adults have been exposed to it at some point in their lives. In transplant recipients who are immunosuppressed , EBV can occur at any time after transplant, but most commonly occurs within the first year. The virus ranges from "mono" to a more serious disease, PTLD, which causes tumors or lymphoma. The virus can cause some cells to multiply or proliferate at a higher rate than usual. This can lead to the development of lymphoma.