Page 321 - Essential Haematology

Chapter 23 Stem cell transplantation / 307

Figure 23.7 Widespread

erythematous skin rash in acute
graft - versus - host disease
following bone marrow
transplantation.

i.v. catheter-associated infections

BACTERIA Late:
S. pneumoniae
Gr+ and Gr- organisms If GVHD or graft failure S. aureus
FUNGI
Candida, Aspergillus If GVHD or graft failure

VIRUSES
HSV
CMV
12 months
Varicella-zoster
PROTOZOA
Pneumocystis

Idiopathic pneumonia

-15 0 15 30 45 60 75 90 105 120
Days post-transplant

Figure 23.8 Time sequence for development of different types of infection following allogeneic bone marrow
transplantation. CMV, cytomegalovirus; Gr + , Gr – , Gram - positive or - negative; GVHD, graft - versus - host disease;
HSV, herpes simplex virus.

infection. Malabsorption and pulmonary abnor- Infections
malities are frequent. Drugs such as ciclosporin,
corticosteroids, mycophenolate mofetil or In the early post - transplant period, bacterial or
thalidomide are used although response may be fungal infections are frequent (Fig. 23.8 ). Th ese
poor. may be reduced by barrier nursing, the use of skin