Infections after hematopoietic stem cell transplantation

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Timeline of Infections

Time Risk factors Bacteria Viruses Fungi Parasites
Pre-engraftment
day 0 to 30
Neutropenia, mucositis, and central lines GPCs and GNBs BK virus, HSV, and resp/enteric viruses Candida and Aspergillus Strongyloides
Early post-engraftment
to day 100
Immunosuppressing meds, acute GVHD, central lines GPCs, encapsulated bacteria, Listeria, Salmonella, Nocardia HSV, CMV, HHV-6, adenovirus, resp/enteric viruses Aspergillus, other molds, PJP Strongyloides, Toxoplasma
Mid post-engraftment
to 1 year
Immunosuppressing meds, chronic GVHD Encapsulated bacteria, Listeria, Salmonella, Nocardia VZV, EBV (and PTLD), CMV, respiratory/enteric viruses Aspergillus, other molds, PJP
Late post-engraftment
after 1 year
Immunosuppresing meds, chronic GVHD Encapsulated bacteria, Listeria, Salmonella, Nocardia VZV, CMV, respiratory/enteric viruses

Further Reading