RT Journal Article
T1 Diagnosis of severe respiratory infections in immunocompromised patients.
A1 Azoulay, Elie
A1 Russell, Lene
A1 Van de Louw, Andry
A1 Metaxa, Victoria
A1 Bauer, Philippe
A1 Povoa, Pedro
A1 Montero, José Garnacho
A1 Loeches, Ignacio Martin
A1 Mehta, Sangeeta
A1 Puxty, Kathryn
A1 Schellongowski, Peter
A1 Rello, Jordi
A1 Mokart, Djamel
A1 Lemiale, Virginie
A1 Mirouse, Adrien
A1 Nine-i Investigators, 
K1 Aspergillosis
K1 Cytomegalovirus
K1 Influenza
K1 Mucormycosis
K1 Pneumocystis pneumonia
K1 Toxoplasmosis
AB An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections (Aspergillus, Mucorales, and Pneumocystis jirovecii) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.
YR 2020
FD 2020-02-07
LK http://hdl.handle.net/10668/15072
UL http://hdl.handle.net/10668/15072
LA en
DS RISalud
RD Apr 12, 2025