title: Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania.
abstract: In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients' bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.
authors.affiliation: Department of Hematology, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.|Department of Hematology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Ioana
authors.initials: I
authors.lastname: Frinc
authors.affiliation: Department of Internal Medicine, 5th Medical Clinic, Cluj-Napoca, Romania.
authors.forename: Petru
authors.initials: P
authors.lastname: Ilies
authors.affiliation: Department of Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Florin
authors.initials: F
authors.lastname: Zaharie
authors.affiliation: Department of Hematology, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.
authors.forename: Delia
authors.initials: D
authors.lastname: Dima
authors.affiliation: Department of Stem Cell Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Tanase
authors.affiliation: Department of Hematology, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.
authors.forename: Ljubomir
authors.initials: L
authors.lastname: Petrov
authors.affiliation: Department of Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Irimie
authors.affiliation: Department of Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Berce
authors.affiliation: Department of Surgery, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Cosmin
authors.initials: C
authors.lastname: Lisencu
authors.affiliation: Department of Genetics, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.
authors.forename: Ioana
authors.initials: I
authors.lastname: Berindan-Neagoe
authors.affiliation: Department of Hematology, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.|Department of Hematology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Ciprian
authors.initials: C
authors.lastname: Tomuleasa
authors.affiliation: Department of Hematology, "Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania.|Department of Hematology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Bojan
mesh_terms: D005260:Female; D019337:Hematologic Neoplasms / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology*; D008875:Middle Aged; D010865:Pilot Projects; D012383:Romania; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000379:methods*
keywords: antibiotics; antifungal treatment; hematological malignancies; immunosuppression; transthoracic ultrasound