148.2 📚 國考版

148.2.0.1 必背 — Fishman Timeline

• < 1 mo: nosocomial bacterial / fungal / HSV
• 1-6 mo: opportunistic (CMV, PJP, Aspergillus, BK)
• > 6 mo: community + late CMV / PTLD

148.2.0.2 必背 — CMV

• D+/R−: highest risk
• PCR for diagnosis + monitoring
• Tx: ganciclovir IV → valganciclovir PO
• Prophy: valganciclovir 3-6 mo (D+/R−) OR letermovir HSCT
• 22E: Maribavir for refractory

148.2.0.3 必背 — PJP

• TMP-SMX 15-20 mg/kg/d × 21 d + steroid (severe)
• Prophy: TMP-SMX 1 SS daily

148.2.0.4 必背 — Opportunistic per Organ

• Lung tx: Aspergillus, PJP
• Kidney tx: BK virus
• Heart tx: Toxoplasma (D+/R−)
• Liver tx: surgical / cholangitis
• HSCT: CMV (letermovir), HHV-6, BK hemorrhagic cystitis

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