Protocolo diagnóstico y tratamiento de la neumonía en el paciente inmunocomprometido

  1. Pérez García, A. 1
  2. Falcón Abad, R. 1
  3. Íñigo Pestaña, M. 1
  1. 1 Servicio de Microbiología Clínica y Parasitología, Clínica Universidad de Navarra, Madrid, España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2022

Issue Title: Enfermedades infecciosas (VIII)

Series: 13

Issue: 56

Pages: 3317-3321

Type: Article

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Advances in oncological treatment, immunosuppressive therapies for preventing graft versus host disease, and the widespread use of therapies with biological or immunomodulating drugs has led to an increase in the immunocompromised population in recent years. Severe respiratory infections are the main cause of ICU admission in immunocompromised patients. In regard to the diagnostic approach, the time since onset of the lung disease, the extension of immunosuppression, and radiological patterns will be considered. The development of nucleic acid detection techniques and their application in these patients improves diagnostic sensitivity. It is very important to start empirical treatment as soon as possible in these patients, provided that it is possible after collecting samples.

Bibliographic References

  • Carroll KC, Adams LL. Lower respiratory tract infections. Microbiol Spectr [Internet]. 2016;4(4).
  • Azoulay E, Russell L, Van de Louw A, Metaxa V, Bauer P, Povoa P. Diagnosis of severe respiratory infections in immunocom- promised patients. Intensive Care Med. 2020;46(2):298-314.
  • Van de Louw A, Mirouse A, Peyrony O, Lemiale V, Azoulay E. Bacterial pneumonias in immunocompromised patients. Semin Respir Crit Care Med. 2019;40(4):498-507.
  • Gudiol C, Sabé N, Carratalà J. Is hospital-acquired pneumonia different in transplant recipients? Clin Microbiol Infect. 2019;25(10):1186-94.
  • Mohammed AH, Blebil A, Dujaili J, Rasool Hassan BA. The risk and impact of COVID-19 pandemic on immunosuppressed patients: Cancer, HIV, and solid organ transplant recipients. AIDS Rev. 2020;22(3):151-7.
  • Azzi Y, Bartash R, Scalea J, Loarte Campos P, Akalin E. COVID-19 and solid organ transplantation: A review article. Transplantation. 2021;105(1): 37-55.
  • Altmayer S, Zanon M, Pacini GS, Watte G, Barros MC, Mohammed TL. Comparison of the computed tomography findings in COVID-19 and other viral pneumonia in immunocompetent adults: a systematic review and meta-analysis. Eur Radiol. 2020;30(12):6485-96.
  • Ramos Martínez A, Pintos Pascual I, Múñez Rubio E. Protocolo diagnóstico y tratamiento empírico de la neumonía en el paciente inmunocomprometido. Medicine. 2018;12(55):3281-4