ATS Reading List

Immunocompromised Host

Diagnostic Strategies

Harris B, Lowy FD, Stover DE, et al. Diagnostic bronchoscopy in solid-organ and hematopoietic stem cell transplantation. Ann Am Thorac Soc. 2013; 10:39-49. This review nicely outlines infectious and non-infectious complications of solid organ and hematopoietic stem cell transplantation. The authors advocate for early bronchoscopy in these populations, although the study by Azoulay et al. below suggests the yield may be lower in hematology and oncology patients.
PMID: 23509331
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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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Last Reviewed: June 2017