Salvage allogeneic hematopoietic stem cell transplantation in a patient with preexisting refractory maxillofacial mucormycosis and severe aplastic anemia: a case report and nursing care model.

OBJECTIVES

Patients with severe aplastic anemia (SAA) complicated by mucormycosis face a significantly elevated risk of mortality and present considerable therapeutic challenges. This study aimed to delineate nursing management and propose a structured care model for a case of SAA complicated by mucormycosis undergoing allogeneic hematopoietic stem cell transplantation (HSCT).

METHODS

The case involved an 18-years-old female with SAA and a progressive right oromaxillofacial mucormycosis ulcer. During salvage allogeneic HSCT, a nurse-led multidisciplinary team implemented care informed by a structured model. Core interventions were structured around four pillars: (1) a multi-tiered infection control strategy; (2) an innovative wound management protocol combining systemic antifungals with local amphotericin B wet dressings; (3) predictive management of complications; and (4) staged and individualized psychological support. The entire nursing process was guided by the Omaha System as the theoretical framework for problem assessment and intervention.

RESULTS

The patient successfully achieved hematopoietic engraftment. The mucormycosis infection was effectively controlled without further dissemination, and the facial wound decreased significantly in size. A critical Grade 3 cytokine release syndrome was successfully managed. The patient maintained a favorable prognosis at the 1-year follow-up.

CONCLUSION

This study demonstrates that a structured and nurse-led model of care is pivotal for successfully managing highly complex HSCT patients with life-threatening co-infections. The Omaha System provided a robust and effective framework for delivering systematic and holistic care in this challenging clinical scenario.