Wow, very interesting & challenging case. I have had 1 patient with a similar experience quite sometime ago but we had treated him with short term steroids. As I thought about this case, it conjures up results that some of my patients share after seeing a Naturopath or Functional medicine doc. Stools studies are fairly common place within the integrative care setting. We all are aware that so much of our immunity is related to the gut micro biome. An alarming rate of Americans have large quantities of candida in their GI tracts causing all kinds of disruption to body function & regulation, especially over long periods of time. With that said, I wonder if Bri, your patient may have been heavily colonized with candida at baseline and the ICI set them up for an opportunistic infection. Just a thought.
Our center is doing gut micro biome research studies with stool samples in the lab setting, nothing yet moving into the clinical setting, stay tuned.