Intravenous ribavirin therapy for adenovirus cystitis after allogeneic bone marrow transplantation

Acute hemorrhagic cystitis due to adenovirus infections may be more severe or protracted in immunocompromised patients. This patient with chronic graft-versus-host disease following allogeneic marrow transplantation for acute myelogenous leukemia developed painful hematuria due to adenovirus infection that failed to respond to diuresis and narcotic analgesics. Intravenous ribavirin, administered for a total of 9 days, produced rapid resolution of symptoms while urine cultures became negative for adenovirus. No adverse drug reactions were observed. We conclude that controlled clinical trials of intravenous ribavirin therapy for serious adenovirus infections following bone marrow transplantation are warranted.