Schistosoma mansoni Infection Following Allogeneic Bone Marrow Transplantation

Area of Science:

• Infectious Diseases
• Transplantation Medicine
• Hepatology

Background:

• Allogeneic bone marrow transplantation (BMT) is a complex procedure with potential complications.
• Schistosoma mansoni infection can present with varied clinical manifestations, including portal hypertension and hematuria.
• Immunocompromised states post-BMT can exacerbate parasitic infections.

Purpose of the Study:

• To report a fatal case of Schistosoma mansoni infection in a post-BMT patient.
• To highlight the diagnostic challenges and management complexities of schistosomiasis in immunocompromised individuals.
• To emphasize the critical need for pre-transplant screening and timely treatment of parasitic infections.

Main Methods:

• Case report of a 28-year-old male post-allogeneic BMT.
• Diagnosis of Schistosoma mansoni infection confirmed by parasitic identification in stool.
• Clinical monitoring of patient's response to praziquantel treatment and post-transplant complications.

Main Results:

• The patient presented with portal hypertension and gross hematuria.
• Parasites were identified in stool, and the patient did not respond to other treatments.
• Praziquantel administration led to toxic shock syndrome, resulting in death from acute renal failure 39 days post-transplant.

Conclusions:

• Pre-transplant screening, including stool, urine cultures, and serologic tests, is vital for patients from endemic areas.
• Schistosomiasis must be treated effectively at least 3-7 weeks prior to transplantation.
• Delayed diagnosis and treatment of schistosomiasis in BMT recipients can lead to fatal outcomes.