Clinical Approach to the Compromised Host with Fever and Pulmonary Infiltrates

Abstract

114CHAPTER 4isms. [30][31][32] Thus, in the majority of immunocompromised patients, the concern is the "net state of immunosuppression," rather than a single defect.

Parainfluenza Virus Type 3 Pneumonia in Bone Marrow Transplant Recipients: Multiple Small Nodules in High‐Resolution Lung Computed Tomography Scans Provide a Radiological Clue to Diagnosis

“…However, during a nosocomial outbreak at Westmead Hospital (Westmead, Australia) in late 2003 that involved 7 allogeneic HSCT recipients and 1 autologous HSCT recipient, 3 patients presented with lower respiratory tract infection, 3 with upper respiratory tract infection that progressed within 19 days to lower respiratory tract infection, and 1 with an upper respiratory tract infection alone [6]. Radiological results indicate that areas of consolidation are typical of bacterial pneumonia, that peribronchovascular lesions are more likely due to viral or Pneumocystis pneumonitis, and that nodular (size, 11 cm) infiltrates are associated with fungal, nocardial, and tuberculous infections [7].High-resolution computed tomography (CT) of the lungs is more sensitive than chest radiography for identifying pulmonary abnormalities and is particularly useful in the diagnosis of filamentous fungal infection in HSCT recipients. On the basis of a study of a heterogeneous group of 78 immunocompromised patients, 12 of whom had viral pneumonitis, it was suggested that the presence of multiple, small (size, !10 mm), noncavitating nodules with irregular margins was predictive of viral pneumonitis [8].…”

“…However, during a nosocomial outbreak at Westmead Hospital (Westmead, Australia) in late 2003 that involved 7 allogeneic HSCT recipients and 1 autologous HSCT recipient, 3 patients presented with lower respiratory tract infection, 3 with upper respiratory tract infection that progressed within 19 days to lower respiratory tract infection, and 1 with an upper respiratory tract infection alone [6]. Radiological results indicate that areas of consolidation are typical of bacterial pneumonia, that peribronchovascular lesions are more likely due to viral or Pneumocystis pneumonitis, and that nodular (size, 11 cm) infiltrates are associated with fungal, nocardial, and tuberculous infections [7].…”