Parasitic infections have a significant impact on recipients of hematopoietic stem cell transplantation (HSCT),
posing considerable risks of morbidity and mortality. They cause a diverse array of clinical syndromes,
ranging from asymptomatic to severe disseminated disease. The incidence and range of parasitic infections
vary according to geographic region, transplant type, conditioning regimen (the high dose of chemotherapy
and radiotherapy to suppressive bone marrow), and immunosuppressive therapy. Early recognition of
parasitic infections in HSCT recipients is challenging due to possible nonspecific clinical manifestations
and overlapping symptoms with other infectious, and non-infectious complications. This calls for a high
index of suspicion and a systematic diagnostic approach for timely diagnosis and appropriate management.
Current diagnostic methods, such as microscopy, serological assays, molecular tests, and imaging studies,
have limitations in sensitivity and specificity, highlighting the need for improved diagnostic tools. Treatment
requires a specific approach based on the pathogen, clinical syndrome, immune status and transplant-related
factors, often involving antiparasitic agents combined with supportive care. Despite advances, gaps remain
in optimizing management, necessitating further research into diagnostic technologies, host-pathogen
interactions, treatment strategies, and preventive measures. A multidisciplinary approach leveraging
emerging technologies is essential for improving outcomes in HSCT recipients with parasitic infections.
This review discusses broadly the clinical presentations, diagnostic approaches, treatment strategies, and
preventive measures for parasitic infections in HSCT recipients.