Alex’s fungal infection may take some time to get under control. Once it gets a foothold in a BMT patient it can be a challenge to narrow down the specific strain and to get the right antifungal meds to treat it. Sometimes the body’s own defense system can rise to the occasion and help in the process. But antibiotics won’t wipe out the fungus.

Antibiotics are useful, as in Zocin, for his staff infection and they are used as a prophylactic to help him avoid any other infections.

You might find this article on post BMT fungal infections helpful:
https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/hematology/fungal-infections-after-bone-marrow-transplant/
Basically, a new BMT patient is given a “temporary” immune system until their new system is robust enough to take over. That can take up to 18 months or longer to mature until the patient is completely off the anti-rejection drug and have all their vaccinations. The usual course of meds for a new patient to be taking are an antifungal, antiviral, 2 antibiotics such as penicillin and bactrim, anti-rejection meds such as Tacrolimus, Protonix to protect the stomach, an usually Ursodial for the liver…plus whatever else they may need.

So don’t be frustrated for Alex if he is taking copious amounts of medications for a long time. It’s what we have to do to survive until we’re churning out healthy, functioning blood products again. His doctor is right, His bowel inflammation isn’t at all unusual after a BMT. Gut, mouth, intestinal inflammation is very common until his WBC can rush to the rescue. He’s still very early in the transplant. The old axiom, “This is a marathon, not a race.”, holds true.

Was he given a prophylactic antifungal immediately after transplant such as fluconazole? I’m just curious to know what his regimen was right after transplant. I was on antifungal meds for 2.5 years to avoid any potential fungal infection. First the fluconazole until I could handle oral meds, then switched to pozaconozole for the remainder of the time, until I was completely off the Tacrolimus (anti rejection med).

There can be many setbacks in the first 3 months of transplant. That’s why it’s critical to generally stay near the clinic for the first 100 days. During that time, things such as gut issues, lung issues, yeast infections, etc., which arise can be come acute, developing rapidly.
So it’s important for hyper vigilance with the patient. Temperature should be taken daily and any health changes, no matter how small need to be noted. My BMT team teased about “Even if you get a new hangnail we want to know about it.”
Though not a magic number, after the 100 day period health situations that arise are often slower to develop and don’t mushroom out of control as quickly.

As a mom, I know you’re feeling pretty helpless and frustrated. How is Alex doing with all of this?