Immunocompromised Host
Hematology/Oncology
Kotloff RM, Ahya VN, Crawford SW et al. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med 2004; 170:22-48. A State of Art article that provides an excellent overview of the complications of solid organ and hematopoietic stem cell transplantation.
PMID: 15070821
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Segal BH, Walsh TJ, Current approaches to diagnosis and treatment of invasive aspergillosis. Am J Respir Crit Care Med. 2006; 173:707-17. Excellent review of aspergillosis in bone marrow transplant patients and other immune-compromised patients, including diagnosis, antifungal therapy, and immune augmentation strategies.
PMID: 16387806
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Patel NR, Lee PS, Kim JH, et al. The influence of diagnostic bronchoscopy on clinical outcomes comparing adult autologous and allogeneic bone marrow transplant patients. Chest. 2005; 127:1388-96. This review of bronchoscopies performed between 1997 and 2001 found that bronchoscopy revealed a specific diagnosis more often in allogeneic (50%) than autologous (34%) recipients. A subset of 27 patients underwent surgical biopsy after bronchoscopy, which yielded a diagnosis half the time.
PMID: 15821221
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Azoulay E, Mokart D, Lambert J, et al. Diagnostic strategy for hematology and oncology patients with acute respiratory failure: randomized controlled trial. Am J Respir Crit Care Med 2010;182:1038-46. In this prospective, randomized study of 216 cancer patients with acute respiratory failure, most of whom had hematologic malignancies and one-fourth of whom had undergone hematopoietic stem cell transplantation, early bronchoscopy with BAL did not lead to an increased risk of intubation, but was not diagnostically superior to an initial noninvasive diagnostic approach, with the exception of diagnosis of Pneumocystis.
PMID: 20581167
HIV and Pulmonary Disease
Gagnon S, Boota AM, Fischl MA, et al. Corticosteroids as adjunctive therapy for severe PCP in AIDS. N Engl J Med 1990;323:1444-50. One of three studies published in the same year establishing the efficacy of steroids in severe PCP in patients with AIDS.
PMID: 2233916
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Huang L, Quartin A, Jones D, et al. Intensive care of patients with HIV infection. N Engl J Med 2006:355;173-181. This review provides a particularly nice discussion of the risks and benefits of antiretroviral medications in critically-ill patients.
PMID: 16837681
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**See also Procedures (bronchoscopy)
