Infectious Diseases

Answer 3 Candida species. Candidemia can occur in patients receiving cytotoxic chemotherapy with prolonged neutropenia. Disseminated candidiasis, as with other infections, may go undetected owing to the muted inflammatory reaction in the absence of neutrophils. These infections become clinically apparent only after recovery from neutropenia. Hepatosplenic infection and retinitis are some of the manifestations of disseminated candidiasis. Cytomegalovirus disease in stem cell transplant recipients generally causes viremia, pneumonia, and gastrointestinal disease; often, this occurs in the setting of graft-versus-host disease. Acute retinal necrosis caused by HSV generally has been described in immunocompetent persons. Left-sided endocarditis caused by Staphylococcus aureus can result in retinal emboli but is unlikely in this patient who has no features of endocarditis and negative blood cultures. Reactivation of toxoplasma infection is rare in stem cell transplantation recipients and occurs in patients with graft-versus-host disease. It can be disseminated and generally affects the brain, heart, and lungs. Click here to return to the questions

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