Invasive aspergillosis (IA) is increasingly diagnosed in high-risk patients. The lesions are usually located in the lungs and/or sinuses, and the fungus may spread haematogenously to different organs; however, involvement of the heart during IA is very rare. We describe a unique case of invasive aspergillosis of the heart septum and the lungs in the allogeneic haematopoietic stem cell transplant recipient.
Fecal microbiota transplantation (FMT) was performed to decolonize gastrointestinal tract from antibiotic‐resistant bacteria before allogeneic hematopoietic cells transplantation (alloHCT). AlloHCT was complicated by norovirus gastroenteritis, acute graft‐versus‐host disease, and eosinophilic pancolitis. Norovirus was identified in samples from FMT material. Symptoms resolved after steroids course and second norovirus‐free FMT from another donor.
Acute graft-versus-host disease (aGvHD), together with infections, constitute the two main early complications of allogeneic hematopoietic cell transplantation (alloHCT). 1 The mainstay of first-line therapy in aGvHD is systemic administration of high-dose glucocorticoids, but only 40%-60% of patients respond to this treatment depending on the grade of severity of the disease. 1 At present, there is no established standard-of-care second-line therapy. The high mortality rate of steroid-refractory/dependent (sr/d) aGvHD, especially in patients with grade III-IV lower gastrointestinal (GI) tract involvement, 2 is a major drive for exploring novel therapeutic strategies.One of them, ruxolitinib, a selective Janus kinase (JAK1 and JAK2) inhibitor, is associated with significant general improvement, and improved remission rates in patients with sr/d aGvHD. 3 A second, emerging therapy is fecal microbiota transplantation (FMT) (being the most effective method of gut microbiota replacement), which we recently assessed in a prospective, multicenter study regarding antibiotic-resistant bacteria decolonization in which sr/d aGvHD patients reached 57% of overall response rate. 4 CORRESPONDENCE E461 CORRESPONDENCE E463
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