Does norovirus infection affect bone marrow transplant?

Question

Hello doctor,

I got a norovirus infection the day after my bone marrow transplant. I cannot keep my anti-rejection medicines down, and I am throwing up blood should I be worried? My Cyclosporine level dropped to 98, is that a problem? My neutrophils are only at 50, and I have a fever of 102.3 am I at risk for sepsis? How long could this affect my engraftment? Should they consider a feeding tube?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern

This is a serious medical emergency, especially after your recent bone marrow transplant.

Cyclosporine levels usually need to be between 100 to 400 ng/mL. A level of 98 puts you at risk for graft rejection.

Vomiting blood could mean there is injury or damage to your stomach or esophagus, like ulcers.

Your neutrophil count should be between 1,500 to 8,000/µL. At only 50, you have severe neutropenia, which puts you at a high risk of sepsis.

A fever of 102.3°F combined with low neutrophils is an emergency, and you must get intravenous antibiotics immediately. .

Norovirus can lead to dehydration and poor nutrition, which can delay or harm your engraftment because your new marrow needs proper hydration and nutrients to grow.

A feeding tube is often needed when you cannot eat enough, especially for vital medications like Cyclosporine, and to keep your nutrition up. You will also need to monitor your kidney function while on Cyclosporine.

IV fluids and total parenteral nutrition (TPN) may be needed to address dehydration and malnutrition.

You need to be hospitalized immediately for IV antibiotics, fluids, and close monitoring.

Start broad-spectrum IV antibiotics to prevent sepsis and infections, and take IV proton pump inhibitors (PPIs) to help stop more bleeding in your stomach. This is urgent and requires immediate medical attention.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.