Unusual Infections following Haploidentical Hematopoietic Stem cell Transplant in a Case with severe Aplastic...

We report a case of very severe aplastic anemia who developed from an uncommon bacterial, recalcitrant parasitic infection and viral reactivation after haploidentical hematopoietic stem cell transplant. The risk factors for multiple infections in this setting included immunocompromised state due to pretransplant prolonged immunosuppression, viral reactivation and graft-versus-host disease (GVHD) requiring multiple immunosuppressive agents. The index case was successfully treated for pulmonary nocardiosis, refractory giardiasis, cytomegalovirus, and adenovirus reactivation highlighting significant challenges during the management of underlying GVHD and these infections.