Nov 7, 2019

ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients

Journal of the American College of Radiology : JACR
Expert Panel on Thoracic ImagingJeffrey P Kanne

Abstract

The immunocompromised patient with an acute respiratory illness (ARI) may present with fever, chills, weight loss, cough, shortness of breath, or chest pain. The number of immunocompromised patients continues to rise with medical advances including solid organ and stem cell transplantation, chemotherapy, and immunomodulatory therapy, along with the continued presence of human immunodeficiency virus and acquired immunodeficiency syndrome. Given the myriad of pathogens that can infect immunocompromised individuals, identifying the specific organism or organisms causing the lung disease can be elusive. Moreover, immunocompromised patients often receive prophylactic or empiric antimicrobial therapy, further complicating diagnostic evaluation. Noninfectious causes for ARI should also be considered, including pulmonary edema, drug-induced lung disease, atelectasis, malignancy, radiation-induced lung disease, pulmonary hemorrhage, diffuse alveolar damage, organizing pneumonia, lung transplant rejection, and pulmonary thromboembolic disease. As many immunocompromised patients with ARI progress along a rapid and potentially fatal course, timely selection of appropriate imaging is of great importance in this setting. The American College...Continue Reading

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Mentioned in this Paper

Pulmonary Edema
Immunologic Deficiency Syndromes
Acute Respiratory Disease
Stem Cell Transplant
Lung Transplantation
Organ
Evaluation
Administration of Antineoplastic Agent
Pulmonary Hemorrhage
Grade

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