title: Pneumonia in the neutropenic cancer patient.
abstract: OBJECTIVE
  Pneumonia is the leading cause of death among neutropenic cancer patients, particularly those with acute leukaemia. Even with empiric therapy, case fatality rates of neutropenic pneumonias remain unacceptably high. However, recent advances in the management of neutropenic pneumonia offer hope for improved outcomes in the cancer setting. This review summarizes recent literature regarding the clinical presentation, microbiologic trends, diagnostic advances and therapeutic recommendations for cancer-related neutropenic pneumonia.
  
  
  RESULTS
  Although neutropenic patients acquire pathogens both in community and nosocomial settings, patients' obligate healthcare exposures result in the frequent identification of multidrug-resistant bacterial organisms on conventional culture-based assessment of respiratory secretions. Modern molecular techniques, including expanded use of galactomannan testing, have further facilitated identification of fungal pathogens, allowing for aggressive interventions that appear to improve patient outcomes. Multiple interested societies have issued updated guidelines for antibiotic therapy of suspected neutropenic pneumonia. The benefit of antibiotic medications may be further enhanced by agents that promote host responses to infection.
  
  
  CONCLUSIONS
  Neutropenic cancer patients have numerous potential causes for pulmonary infiltrates and clinical deterioration, with lower respiratory tract infections among the most deadly. Early clinical suspicion, diagnosis and intervention for neutropenic pneumonia provide cancer patients' best hope for survival.
authors.affiliation: Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Evans
authors.forename: David E
authors.initials: DE
authors.lastname: Ost
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000097:blood* / Q000382:microbiology*; D009503:Neutropenia / Q000209:etiology* / Q000382:microbiology*; D018410:Pneumonia, Bacterial / Q000097:blood* / Q000209:etiology*