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Hemorrhagic cystitis induced by JC polyomavirus infection following COVID-19: a case report

Yuanjie Lv1, Xiaoping Liu2

  • 1Department of Infection, Hospital of Traditional Chinese Medicine, Xinchang County, No.188 Shijiu Feng Road, Qixing Street, Shaoxing, 312500, China. lvyuanjie134@163.com.

BMC Urology
|April 16, 2024
PubMed

Insights

JC polyomavirus (JCPyV) can cause urinary tract disease in immunocompromised patients, as seen in a COVID-19 case. Rapid diagnosis via metagenomic sequencing led to effective treatment with immunoglobulin therapy.

Area of Science:

  • Virology
  • Immunology
  • Urology

Background:

  • JC polyomavirus (JCPyV) establishes persistent infections, typically asymptomatic in immunocompetent individuals.
  • JCPyV is primarily associated with central nervous system diseases like progressive multifocal leukoencephalopathy (PML) in immunosuppressed patients.
  • While JCPyV resides in the kidney-urinary tract, its role in urinary system diseases is exceptionally rare.

Observation:

  • A 60-year-old male with COVID-19 developed hemorrhagic cystitis after treatment with nirmatrelvir/ritonavir.
  • Metagenomic next-generation sequencing (mNGS) identified JCPyV type 2 as the causative agent.
  • Intravenous human immunoglobulin (PH4) therapy resulted in the resolution of hematuria within three days.

Findings:

  • This case demonstrates JCPyV's potential pathogenicity in the urinary system, beyond its known neurological effects.
  • The study highlights the importance of considering JCPyV in urinary tract infections, particularly in immunocompromised hosts.
  • Metagenomic next-generation sequencing (mNGS) proved crucial for rapid and accurate diagnosis of the infectious etiology.

Implications:

  • The findings suggest that JCPyV should be considered in the differential diagnosis of hemorrhagic cystitis in immunocompromised individuals.
  • Rapid diagnostic tools like mNGS can significantly improve patient outcomes by enabling timely and targeted therapies.
  • This case expands the understanding of JCPyV's clinical manifestations and the utility of immunoglobulin therapy in managing JCPyV-associated diseases.
Keywords:
Coronavirus disease 2019Hemorrhagic cystitisJC polyomavirusMetagenomic next-generation sequencing

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