Introduction and Importance:
PNH is a rare disorder caused by a somatic mutation of PIGA gene that leads to the destruction of blood cells. Allogeneic HSCT is a treatment option for PHN, but it can cause GVHD .Long term immunosuppression as a treatment of GVHD increases the risk for IFIs such as Candida krusei pneumonia.
Case Presentation:
We present the case of a 22 year old male with Candida krusei pneumonia in a known case of chronic GVHD following HSCT for PNH undergoing long term immunosuppressive therapy. The patient presented with progressive shortness of breath, productive cough, palpitations, and difficulty swallowing. On examination, he had skin rashes and oral lesions, along with signs of severe malnutrition. Diagnosis was made on the basis of radiological imaging and fungal culture.
Discussion:
The combination of PNH, GVHD, and HSCT created an immunocompromised state, making the patient susceptible to opportunistic infections, including fungal pneumonia. Early recognition of this condition is challenging due to its non-specific symptoms and potential overlap with other post-transplant complications. Timely diagnosis and appropriate treatment, including antifungal therapy and immunosuppression management, are crucial for optimising patient outcomes.
Conclusion:
This case highlights the importance of early recognition and timely treatment of fungal infections in patients with severe conditions such as GVHD following HSCT for PNH. Timely treatment with appropriate anti-fungals is necessary for optimal outcome. Additionally, more research with long term follow-up and monitoring is necessary to address the necessary knowledge gaps in this field.