Recognizing and Preventing Infections

We will be lowering/suppressing your immune system with the immunosuppressive medications. This will make you more susceptible to infections. The following guidelines will help you prevent infections.

• Wash your hands frequently.
• Keep your hands away from your mouth and eyes.
• Stay away from people with colds and other infections.
• Avoid crowded enclosed areas for the first three months post transplant and after any treatment for rejection.
• Ask friends to visit only when they are well.
• Wash your hands after coughing and sneezing. Throw tissues into the trash immediately.
• Do not eat or drink using the same glass or eating utensils after friends or family members.
• Family or friends who live with you should follow the same guidelines when they are sick.
• Avoid working in the soil or gardening for the first 6 months.
• When you are allowed to work in the soil you must wear gloves.
• Avoid handling animal waste and avoid contact with animals who roam outside. Do not clean bird cages, fish or turtle tanks, or cat litter. The cat litter box should be covered.
• Avoid vaccines that consist of live viruses, such as Sabin oral polio, measles, mumps, German measles, yellow fever or smallpox. The live virus can cause infection. If you or any family member intends to receive any vaccinations, notify your transplant team.
• The mouth and teeth can be a source of infection. Daily mouth care (brushing and flossing) are essential to staying healthy. You must have regular dental checkups.

You must learn the warning signs of infection:

• Fever over 100 degrees F.
• Flu symptoms: chills, aches, fatigue, headaches, dizziness, nausea, and vomiting.
• "Wet" productive cough and/or shortness of breath.
• Nasal congestion with thick greenish or yellow drainage.
• Sore throat.
• Diarrhea.
• Pain, burning during urination, or feeling constant urge to urinate.
• Any wound that is red, swollen with some drainage.
• Mouth sores or thrush.
• Rashes or skin lesions.

If you develop any of these symptoms report them to your transplant team immediately.

As a transplant recipient you are more susceptible to certain types of infections. Below are some of the most common.

Viral infections

1. Cytomegalovirus (CMV): Approximately 30-80% of the population (depending on where you live) has had this virus at some time in their life. This virus is not dangerous in the general public, but can be serious in the transplant recipient due to their lowered immune system. Signs can include fatigue, high fever, aching joints, headaches, nausea, vomiting, visual disturbances, and pneumonia.
2. Herpes-simplex virus type I and II: Type I herpes generally causes cold sores and blisters around the mouth. Type II herpes causes genital sores. Most herpes infections are mild, but occasionally they can be severe. There is no cure for herpes, but it can be treated. The treatment depends on the severity of the infection. The treatment may be oral or intravenous. Notify your transplant team immediately if you believe you have herpes.
3. Herpes zoster (shingles): Shingles appear as a rash or small water blisters. They appear usually on the chest, back, or hip. The rash may or may not be painful. Notify your transplant team immediately if you believe you have shingles. The severity of the infection determines whether treatment will be oral or intravenous.

Fungal infections

Candida is a fungus that can cause a variety of infections in transplant recipients. It most commonly infects the mouth and throat, but can also be found in surgical wounds, eyes, respiratory and urinary tracts, or the bloodstream. Candida that infects the mouth and throat is called Thrush. Thrush produces white, patchy lesions, pain or tenderness, a white coating on the tongue, and difficulty swallowing. You will take mycelex troches 10 mg three times per day to prevent thrush. Candida that infects the vagina is called a "yeast infection." Symptoms are abnormal white or yellow discharge from the vagina. Notify your transplant team if you suspect you have a candida infection.

Bacterial infections

There are many different types of bacterial infections. Different types of bacteria can affect any area of the body. Most common are urinary tract infections, bronchitis, pneumonia, sinusitis, wound infections, and blood infections. It is important as a transplant recipient that you contact your transplant team if you believe you have an infection (Review the signs and symptoms of infections previously listed.).

Parasitic infections

Pneumocystis carinii is a parasitic infection that is normally found in the lungs. It can cause a type of pneumonia called PCP. PCP can be prevented by taking Bactrim. If you are allergic to Bactrim another medication will be substituted. Symptoms of PCP are shortness of breath, dry cough, and fever. Notify the transplant team immediately if you have these symptoms.