Interstitial pneumonitis in the immunologically suppressed child: an urgent surgical condition.
Thirty-eight children were evaluated for interstitial pneumonia by open lung biopsy. In most instances the patients were immunosuppressed as a result of cancer chemotherapy and irradiation. Pneumocystis carinii infection was the most common cause of pneumonitis (60.4%), especially in children with leukemia (78.3%). The clinical triad of hypoxemia, tachypnea, and a diffuse interstitial infiltrate on chest x-ray, is an indication for early open lung biopsy. Survival was 91.7% in cases of acute pneumocystis pneumonia, a significant improvement over previous reports. These observations strongly support the concept of early open lung biopsy in the management of diffuse interstitial pneumonitis in patients who are immunosuppressed.
D000208:Acute Disease; D000293:Adolescent; D001706:Biopsy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007223:Infant; D007938:Leukemia / Q000628:therapy; D008168:Lung / Q000473:pathology; D008297:Male; D009369:Neoplasms / Q000628:therapy; D011010:Pneumocystis / Q000302:isolation & purification; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000276:immunology / Q000601:surgery*