A 17-year-old boy undergoes chemotherapy for acute lymphoblastic leukemia. As a part of the treatment attempts, he undergoes bone marrow transplant. The patient is prepared and screened adequately for the transplant with antibiotics and immunosuppresants . HLA non identical donor was screened for CMV and other infective etiologies before the transplant and was found negative. 3 weeks after the transplant, the patients lymphocyte and granulocyte numbers increase. Engraftment of the bone marrow cells is confirmed.
One month after the transplant the patient develops severe diarrhea with green watery stools. A pruritic maculo popular rash covers the entire body of the patient. Examination of respiratory system reveals bilateral wheezing and he is jaundiced. Abdominal examination reveals hepatomegaly. His bilirubin levels and liver enzymes are elevated. Serology for viral pathogens is…
