Pulmonary Infiltrates in Leukemia

Tenholder, MAJ Michael F.; Hooper, Ltc Robert G.

doi:10.1378/chest.78.3.468

Cited by 110 publications

(60 citation statements)

References 17 publications

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“…The incidence of pulmonary infection in patients with underlying malignancy and new pulmonary symptoms is high (1,2). The development of effective new antimicrobial agents, particularly antiviral agents, underscores the need for quick and noninvasive means of making a specific diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Illnesses include recurrence of tumour, pulmonary infection, adverse reaction from chemotherapy or radiation therapy, cardiogenic or noncardiogenic pulmonary edema and, in patients with allogeneic bone marrow transplants (BMT), graft-versushost disease. Previous reports have found that over 50% of these symptoms are infectious in etiology (1,2). In the majority of cases, the pathogens implicated were opportunistic organisms such as cytomegalovirus (CMV) and Pneumocystis carinii pneumonia (PCP) (1-3), which if left untreated are associated with significant and high mortality and morbidity.…”

mentioning

confidence: 99%

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Utility of Bronchoscopy with Bronchoalveolar Lavage in Diagnosing Pulmonary Infection in Hospitalized Patients with Underlying Malignancy

Chow

McGeer

Kasupski

et al. 1997

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Objectives: To evaluate the clinical utility of bronchoscopy with bronchoalveolar lavage (BAL) for diagnosing pulmonary infection in patients with underlying malignancy and to evaluate the impact of positive microbiology results on antimicrobial therapy. Design: Retrospective chart review. Setting: University-affiliated downtown teaching hospital in Toronto. Patient population: All patients who underwent bronchoscopy with BAL from November 1990 to September 1992. Results: One hundred and thirty-nine BALs were performed, of which 82 (59%) were positive for microorganisms. These 82 charts were reviewed. The main underlying diagnosis was hemotogenous malignancy (70 of 82). Primary indiction for bronchoscopy was the presence of pulmonary symptoms with or without radiographic abnormality. Common organisms identified were fungi (n=50), primarily Candida albicans and cytomegalovirus (CMV) (27), and 16 'usual' pathogens. Less common were herpes simplex virus (six), Pneumoncystis carinii pneumonia (PCP) (four), Legionella pneumoniae and Mycoplasma pneumoniae (one each). Eighty-seven per cent of patients were on broad spectrum antibiotics at the time of bronchoscopy. Although antiibiotic therapy was altered postbronchoscopy in 47 of the 82 cases, only 26 instances could be directly attributed to the results of BAL. Pathogens that commonly initiated specific therapy were CMV (16 of 27) and PCP (three of four). Diagnostic yield was highest in allogenic bone marrow transplant recipients (BMT). They comprised only 49% (40 of 82) of the cases but accounted for 85% (22 of 26) of those whose therapy was directly altered by the results of BAL. Of these 22 cases, 20 were attributed to the isolation of CMV. Conclusions: The overall raw diagnostic yield from bronchoscopy with BAL was high at 59%. Of those with positive BAL cultures, a change in antimicrobial management occurred in 32% of cases. In a patient poulation with underlying hematogenous malignancy, particularly BMT recipients, bronchoscopy with BAL is useful for a specfic diagnosis of pulmonary infection.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Utility of Bronchoscopy with Bronchoalveolar Lavage in Diagnosing Pulmonary Infection in Hospitalized Patients with Underlying Malignancy

Chow

McGeer

Kasupski

et al. 1997

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Localized infiltrates are those limited to focal areas of the lung, in a segmental or lobar distribution or presenting as masses (>2 cm) or nodules (<2 cm). ICH with segmental or lobar infiltrates and compatible histories often have bacterial pneumonia which responds to antibacterial therapy [44]. When FOB is performed, the yield is often less than 50% because patients may have a partially treated bacterial process, fungal pneumonia or malignancy.…”

Section: Fiber-optic Bronchoscopymentioning

confidence: 99%

The Lung in the Immunocompromised Host: Diagnostic Methods

Santamauro

Mangino²,

Stover³

1999

Respiration

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“…3 The incidence among patients with transplants is lower, reported at 12% in one series of renal transplant recipients, probably because oftheir lower degree of immunosuppression.5 Running Pneumocystis a close second are fungal infections, especially with Candida spp and Aspergillus fumigatus, and viruses such as cytomegalovirus and herpes simplex. With improved diagnostic techniques an increasing number of exotic and unusual diseases are being unearthed.…”

Section: Pulmonary Problems Of the Immunocompromised Patientmentioning

confidence: 99%

Pulmonary problems of the immunocompromised patient.

Burnie¹

1981

BMJ

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Pulmonary Infiltrates in Leukemia

Cited by 110 publications

References 17 publications

Utility of Bronchoscopy with Bronchoalveolar Lavage in Diagnosing Pulmonary Infection in Hospitalized Patients with Underlying Malignancy

Utility of Bronchoscopy with Bronchoalveolar Lavage in Diagnosing Pulmonary Infection in Hospitalized Patients with Underlying Malignancy

The Lung in the Immunocompromised Host: Diagnostic Methods

Pulmonary problems of the immunocompromised patient.

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