Nursing care and infection management of a patient with sinusiodal obstruction syndrome after allogeneic hematopoietic stem cell transplantation under immunosuppression:a case report

Li Wang^{1,2 †} , Li Zhang^{1,2 †} , Qian Li^{1,2 †} , Zhenjun Xi^1,2, Qianqian Liu^1,2, Chang Liu^1,2, Jiemei Jiang^1,2, Yueming Wu^1,2, Mei Yu^1,2, Yongsheng Liu^1,2#, Xiaobing Li^1,2,3#

¹Science and Technology Industry Development Center, Chongqing Medical and Pharmaceutical College, Chongqing 401331, China

²Department of Occupational Disease and Poisoning Medicine, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China

³College of Public Health, Chongqing Medical University, Chongqing 400016, China

† L.W., L.Z. and Q.L. contributed equally to the study.

#Y.L.and X.L. were co-corresponding authors.

*Correspondence: Yongsheng Liu; Email: 241002@cqmpc.edu.cnXiaobing Li; Email: xiaobing.li@cqmpc.edu.cn

Abstract

This report summarizes the nursing and infection management process for a patient who developed severe late-on-set sinusoidal obstruction syndrome while in a state of deep immunosuppression after allogeneic hematopoietic stem cell transplantation. Key nursing measures included: strict adherence to infection control protocols in the laminar airflow ward during potent immunosuppressive therapy; rigorous aseptic techniques for invasive procedures such as abdominal paracentesis and drainage to prevent catheter-related infections; and enhanced monitoring and differentiation of symptoms like fever and diarrhea to guard against opportunistic infections. Symptom management for sinusoidal obstruction syndrome, nutritional support, and psychological care were implemented concurrently. Through these comprehensive nursing interventions, the patient recovered without developing any severe infections while immunocompromised. This case offers valuable insights into infection prevention and comprehensive care for similar high-risk patients.

Keywords: hematopoietic stem cell transplantation, sinusoidal obstruction syndrome, infection control, immuno-suppression, nursing care