Parasitic Infections in the Immunocompromised Host: Prevention, Diagnosis, and Management

Parasitic infections in hematopoietic stem cell transplant recipients

“…Exchange transfusion can also be utilized to remove infected blood. 52 In all the reported cases, symptoms resolved with the aforementioned medications. For prevention, transplant recipients should avoid tick exposure by wearing general protective clothing and using repellants.…”

“…In HSCT patients particularly, it is important to take into consideration the interaction between anti-malarial drugs and immunosuppressive therapy, especially between quinine and calcineurin inhibitors. 52,68 Uncomplicated P. falciparum can be treated with artemisinin combinations or atovaquone-proguanil. Severe P. falciparum requires intravenous artesunate or quinidine.…”

“…Other strains of can be treated with chloroquine. 52,67 Although there is no routine screening of donors or recipients, there should still be increased suspicion in patients from endemic areas. Routine malaria prophylaxis post-HSCT is not advocated, and usual avoidance of endemic areas and general care including insecticides and mosquito nets are recommended.…”

“…[69][70][71]73 Diagnosis of babesiosis can be made by direct microscopic visualization of the parasite by peripheral blood smear or by PCR/NAAT of blood. 52 In all reported cases seen in HSCT patients, a peripheral blood smear was done initially and after the classic intraerythrocytic ring forms were seen, PCR was done to confirm the diagnosis. Treatment consists of dual therapy.…”

“…Further specification of species can be made through PCR or immunoassay assessment. 52,108 The acute phase of infection is characterized by high parasitemia, allowing for diagnosis using direct methods such as the Strout method.…”