Page 322 - Essential Haematology

308 / Chapter 23 Stem cell transplantation

and mouth antiseptics and treatment in units with an indication to commence systemic antifungal

high efficiency particulate (HEPAR) air fi ltration. therapy with amphotericin B, caspofungin or vori-
Prophylactic therapy with aciclovir, antifungal conazole (see p. 171) . Fungal infections, especially
agents and oral antibiotics is often added. If a fever Candida and Aspergillus species (Fig. 23.9 ), are a
or other evidence of an infection occurs, broad - particular problem because of the prolonged
spectrum intravenous antibiotics are commenced neutropenia.
immediately after blood cultures and other appro- Viral infections, particularly with the herpes
priate microbiological specimens have been taken. group of viruses, are frequent with herpes simplex,
Failure of response to antibacterial agents is usually cytomegalovirus (CMV) and varicella zoster virus

(a)

Figure 23.9 (a) Chest radiograph
showing an aspergilloma in a
patient following stem cell
transplantation. (b) Cytology of
sputum illustrates the branching
septate hyphae of Aspergillus
(b) (methenamine silver stain).