Evaluation of pulmonary infiltrates in critically ill patients with cancer and marrow transplant.
Pulmonary infiltrates in critically ill patients with cancer or marrow transplant can be evaluated by the differential diagnosis presented at the beginning of this article. The patient's quantitative immune system dysfunction, epidemiologic history and chest radiographic findings (pattern, rapidity, and time of onset) will help focus the differential diagnosis. In this patient population, however, common diagnoses can have atypical presentations, unusual diagnoses do occur, and more than one process may be responsible for a patient's infiltrates. Early bronchoscopy to rule out infection is the focus of diagnostic testing. Surgical lung biopsy in this patient population has a low yield.
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Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, and McClellan Memorial Veterans Hospital, Little Rock, Arkansas, USA. whitepeter@exchange.uams.edu
D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects; D016026:Bone Marrow Transplantation; D016638:Critical Illness; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology; D009369:Neoplasms / Q000150:complications*; D011183:Postoperative Complications / Q000175:diagnosis*; D011654:Pulmonary Edema / Q000150:complications / Q000175:diagnosis*; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000209:etiology
D000970:Antineoplastic Agents