Journal
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 27, Issue 3, Pages 297-309Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-2006-945530
Keywords
aspergillosis; bone marrow transplantation; cytomegalovirus infection; diffuse alveolar hemorrhage; idiopathic pneumonia syndrome; periengraftment respiratory distress syndrome; pneumonia; respiratory insufficiency
Categories
Ask authors/readers for more resources
Tens of thousands of patients undergo hematopoietic stem cell transplantation (HSCT) annually, 15 to 40% of whom are admitted to the intensive care unit. Pulmonary complications are the most life threatening, conditions that develop in HSCT recipients. Both infections and noninfectious complications occur more frequently in allogeneic HSCT. The management of HSCT recipients requires knowledge of their immune status appropriate diagnostic evaluation, and early. treatment. During the preengraftment phase (0 to 30 days after transplant), the most prevalent pathogens causing infection are bacteria and Candida species and, if the neutropenia persists, Aspergillus species. The earls postengraftment phase (30 to 100 days) is characterized by cytomegalovirus (CMV Pneumocystis jiroveci, and Aspergillus infections. During the late posttransplant phase (> 100 days), allogeneic HSCT recipients are at risk for CMV, community-acquired respiratory virus, and encapsulated bacterial infections. Antigen and polymerase chain reaction assays are important for the diagnosis of CMV and Aspergillus infections. Diffuse alveolar hemorrhage (DAH) and periengraftment respiratory, distress syndrome occur in both allogeneic and autologous HSCT recipients, usually during, the first 30 days. Bronchiolitis obliterans Occurs exclusively in allogeneic HSCT recipients with graft versus host disease. Idiopathic pneumonia syndrome occurs at any time following transplant. Bronchoscopy is usually helpful for the diagnosis of the infectious pulmonary complications and DAH.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available