Infectious Disease Compendium

BK Virus

Microbiology

A Pollyanna virus, it always sees the best in everyone. Sorry. It’s a polyomavirus.

It results in decoy cells in the urine.

Epidemiologic Risks

80% of people are infected and the primary infection is asymptomatic or a mild URI. It then spreads to the kidneys.

Reactivates in renal transplant kidneys (PubMed), usually 9 to 12 months after transplant. Not found in the Whopper, despite the name (BK was the initials of the first patient in which it was discovered).

Syndromes

Hemorrhagic cystitis, reactivation with nephritis can accelerate kidney transplant rejection and ureteral stenosis.

Diagnose with urine PCR.

It can also have decoy cells on the UA: epithelial cells infected with the virus.

Treatment

Maybe cidofovir (PubMed) (PubMed) but it is very nephrotoxic, so likely a 'destroy the village to save it' situation.

Fluoroquinolone antibiotics and Leflunomide, an immunosuppressant with antiviral properties, can inhibit BKV in vitro. Whether they really do much in the patient is uncertain as no clinical trials.

Notes

Last update: 01/28/20