Clinical Approach to the Compromised Host with Fever and Pulmonary Infiltrates

  • Robert H. Rubin
  • Reginald Greene


The immunocompromised patient in whom fever and pneumonitis develop presents a formidable challenge to the clinician. On one hand, a legion of microbial invaders, ranging from common viral and bacterial pathogens to exotic fungal and protozoan agents, have been reported to cause pulmonary infection in these patients. 1-8 On the other hand, noninfectious causes of pulmonary inflammation—radiation lung injury, drug reactions, the underlying neoplasm, pulmonary embolic disease, leukoagglutinin transfusion reactions, pulmonary hemorrhage, atypical pulmonary edema, and alveolar proteinosis— may present a clinical picture similar to that produced by infection (i.e., the febrile pneumonitis syndrome).2,3,5,9-11


Immunocompromised Patient Renal Transplant Patient Pulmonary Infiltrate Invasive Pulmonary Aspergillosis Radiation Pneumonitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Williams DM, Krick JA, Remington JS: Pulmonary infection in the compromised host. Am Rev Respir Dis 114: 359–394. 593-627, 1976.PubMedGoogle Scholar
  2. 2.
    Ramsey PG, Rubin RH, Tolkoff-Rubin NE, et al: The renal transplant patient with fever and pulmonary infiltrates: Etiology, clinical manifestations, and management. Medicine (Baltimore) 59: 206–222, 1980.Google Scholar
  3. 3.
    Rubin RH: The cancer patient with fever and pulmonary infiltrates: Etiology and diagnostic approach. In Remington JS, Swartz MN (eds): Current Clinical Topics in Infectious Disease, Vol. I. McGraw-Hill, New York, 1980, pp. 288–303.Google Scholar
  4. 4.
    Bishop JF, Schimpff SC, Diggs CH, et al: Infections during intensive chemotherapy for non-Hodgkin’s lymphoma. Ann Intern Med 95: 549–555, 1981.PubMedGoogle Scholar
  5. 5.
    Rosenow EC IE, Wilson WR, Cockerill FR IE: Pulmonary disease in the immunocompromised host. Mayo Clin Proc 60: 473–487, 610-631, 1985.PubMedGoogle Scholar
  6. 6.
    Pennington JE, Feldman NT: Pulmonary infiltrates and fever in patients with hematologic malignancy: Assessment of transbronchial biopsy. Am J Med 62: 581–587, 1977.PubMedGoogle Scholar
  7. 7.
    Murray JF, Mills J: Pulmonary infectious complications of human immunodeficiency virus infection: Parts I and II. Am Rev Resp Dis 141: 1356–1372, 1990.PubMedGoogle Scholar
  8. 8.
    Ettinger NA, Trulock EP: Pulmonary considerations of organ transplantation: Parts I-III, Amer Rev Resp Dis 143: 1386–1405, 1991; 144: 213-223, 433-451, 1991.PubMedGoogle Scholar
  9. 9.
    Singer C, Armstrong D, Rosen PP, et al: Diffuse pulmonary infiltrates in immunosuppressed patients: Prospective study of 80 cases. Am J Med 66: 115–120, 1979.Google Scholar
  10. 10.
    Rosenow EC III: Diffuse pulmonary infiltrates in the immunocompromised host. Clin Chest Medicine 11: 55–64, 1990.Google Scholar
  11. 11.
    White DA, Matthay RA: Noninfectious pulmonary complications of infection with the human immunodeficiency virus. Am Rev Resp Dis 140: 1763–1787, 1989.PubMedGoogle Scholar
  12. 12.
    Sickles EA, Greene WH, Wiernik PH: Unusual presentation of infection in granulocytopenic patients. Arch Intern Med 135: 715–719, 1975.PubMedGoogle Scholar
  13. 13.
    Zornoza J, Goldman AM, Wallace S, et al: Radiologic features of gram-negative pneumonias in the neutropenic patient. Am J Roentgenol 127: 989–996, 1976.Google Scholar
  14. 14.
    Bodey GP, Buckley M. Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Am J Roentgenol 64: 328–340, 1966.Google Scholar
  15. 15.
    Poe RH, Wahl GW, Qazi R, et al: Predictors of mortality in the immunocompromised patient with pulmonary infiltrates. Arch Intern Med 146: 1304–1308, 1986.PubMedGoogle Scholar
  16. 16.
    Singer C, Kaplan MH, Armstrong D: Bacteremia and fungemia complicating neoplastic disease. Am J Med 62: 731–742, 1977.PubMedGoogle Scholar
  17. 17.
    Rubin RH, Wolfson JS, Cosimi AB, et al: Infection in the renal transplant patient. Am J Med 70: 405–411, 1981.PubMedGoogle Scholar
  18. 18.
    Reynolds HY: Pulmonary host defenses: State of the art. Chest 95 (Suppl): 223S–230S, 1989.Google Scholar
  19. 19.
    Weitzman SA, Aisenberg AC: Fulminant sepsis after the successful treatment of Hodgkin’s disease. Am J Med 62: 47–50, 1977.PubMedGoogle Scholar
  20. 20.
    Weitzman SA, Aisenberg AC, Siber GR, et al: Impaired humoral immunity in treated Hodgkin’s disease. N Engl J Med 297: 245–248, 1977.PubMedGoogle Scholar
  21. 21.
    Siber GR, Weitzman SA, Aisenberg AC, et al: Impaired antibody response to pneumococcal vaccines after treatment for Hodgkin’s disease. N Engl J Med 299: 442–446, 1978.PubMedGoogle Scholar
  22. 22.
    Rubin RH: Infectious disease complications of renal transplantation. Kidney Int 44: 221–236, 1993.PubMedGoogle Scholar
  23. 23.
    Rubin RH: Impact of cytomegalovirus infection on organ transplant recipients. Rev. Infect Dis (Supplement) 17: S754–S766, 1990.Google Scholar
  24. 24.
    Hibberd PL, Tolkoff-Rubin NE, Cosimi AB, et al: Symptomatic cytomegalovirus disease in the cytomegalovirus antibody seropositive renal transplant recipient treated with OKT3. Transplantation 53: 68–72, 1992.PubMedGoogle Scholar
  25. 25.
    Preiksaitis JK, Diaz-Mitoma F, Mirzayans F, et al: Quantitative oropharyngeal Epstein—Barr virus shedding in renal and cardiac transplant recipients: Relationship to immunosuppressive therapy, serological responses, and the risk of post-transplant lymphoproliferative disorder. J Infect Dis 166: 986–994, 1992.PubMedGoogle Scholar
  26. 26.
    Johnson WG Jr, Pierce AK, Sanford JP: Changing pharyngeal bacterial flora of hospitalized patients. N Engl J Med 281: 1137–1140, 1969.Google Scholar
  27. 27.
    Johanson WG Jr, Higuchi JJ, Chadhuri TR, et al: Bacterial adherence to epithelial cells in bacterial colonization of the respiratory tract. Am Rev Respir Dis 121: 55–63, 1980.PubMedGoogle Scholar
  28. 28.
    Aisner J, Schimpff SC, Bennett JE, et al: Aspergillus infections in cancer patients: Association with fireproofing materials in a new hospital. JAMA 235: 411–413, 1976.PubMedGoogle Scholar
  29. 29.
    Sarubbi FA Jr, Kopf HB, Wilson MB, et al: Increased recovery of Aspergillus flavius from respiratory secretions during hospital construction. Am Rev Resp Dis 125: 33–38, 1982.PubMedGoogle Scholar
  30. 30.
    Atherton ST, White DJ: Stomach as source of bacteria colonizing respiratory tract during artificial ventilation. Lancet 2: 968–969, 1978.PubMedGoogle Scholar
  31. 31.
    du Moulin GC, Hedley-Whyte J, Paterson DG, et al: Aspiration of gastric bacteria in antacid-treated patients: A frequent cause of postoperative colonization of the airways. Lancet 1: 242–245, 1982.PubMedGoogle Scholar
  32. 32.
    Donowitz LG, Page MC, Mileur GL, et al: Alterations of normal gastric flora in critical care patients receiving antacid and cimetidine therapy. Infect Control 7: 23–26, 1986.PubMedGoogle Scholar
  33. 33.
    Ruddell WSJ, Axon ATR, Finlay JM, et al: Effect of cimetidine on gastric bacterial flora. Lancet 1: 672–674, 1990.Google Scholar
  34. 34.
    Driks MR, Craven DE, Celli BR, et al: Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med 317: 1376–1382, 1987.PubMedGoogle Scholar
  35. 35.
    LaForce FM: Lower respiratory tract infections. In Bennett JV, Brachman PS (eds): Hospital Infections, 3rd ed. Little, Brown, Boston, 1992, pp. 611–639.Google Scholar
  36. 36.
    Pingleton SK, Hinthorn DR, Liu C: Enterai nutrition in patients receiving mechanical ventilation: Multiple sources of tracheal colonization include the stomach. Am J Med 80: 827–832, 1986.PubMedGoogle Scholar
  37. 37.
    Inglis TJJ, Sherratt MJ, Sproat LJ, et al: Gastroduodenal dysfunction and bacterial colonization of the ventilated lung. Lancet 1: 911–913, 1993.Google Scholar
  38. 38.
    LaForce FM, Hopkins J, Trow R, et al: Human oral defenses against gram-negative rods. Am Rev Resp Dis 114: 929–935, 1976.PubMedGoogle Scholar
  39. 39.
    Reynolds HY: Bacterial adherence to respiratory tract mucosa: A dynamic interaction leading to colonization. Semin Respir Infect 2: 8–19, 1987.PubMedGoogle Scholar
  40. 40.
    Faling LJ: Advances in preventing nosocomial pneumonia. Am Rev Resp Dis 137: 256–258, 1988.PubMedGoogle Scholar
  41. 41.
    Woods DE: Role of fibronectin in the pathogenesis of gramnegative bacillary pneumonia. Rev Infect Dis 9: S386–S390, 1987.PubMedGoogle Scholar
  42. 42.
    Proctor RA: Fibronectin: A brief overview of its structure, function, and physiology. Rev Infect Dis 9: S317–S321, 1987.PubMedGoogle Scholar
  43. 43.
    Proctor RA: Fibronectin: An enhancer of phagocyte function. Rev Infect Dis 9: S412–S419, 1987.PubMedGoogle Scholar
  44. 44.
    Dal Nogare AR, Toews GB, Pierce AK: Increased salivary elastase precedes gram-negative bacillary colonization in postoperative patients. Am Rev Respir Dis 135: 671–675, 1987.Google Scholar
  45. 45.
    Niederman MS, Merrill WW, Ferranti RD, et al: Nutritional status and bacterial binding in the lower respiratory tract in patients with chronic tracheostomy. Ann Intern Med 100: 795–800, 1984.PubMedGoogle Scholar
  46. 46.
    Martin TR: The relationship between malnutrition and lung infections. Clin Chest Med 8: 359–372, 1987.PubMedGoogle Scholar
  47. 47.
    Woods DE, Straus DC, Johanson WG, et al: Role of fibronectin in prevention of adherence of Pseudomonas aeurginosa to buccal cells. J Infect Dis 143: 784–790, 1981.PubMedGoogle Scholar
  48. 48.
    Johanson WG Jr, Pierce AK, Sanford JP, et al: Nosocomial respiratory infections with gram-negative bacilli. Ann Intern Med 77: 701–706, 1972.PubMedGoogle Scholar
  49. 49.
    Hall KA, Copeland JG, Zukoski CF, et al: Markers of coccidioidomycosis prior to cardiac or renal transplantation and risk of recurrence. Abstract 35, 32nd ICAAC, Anaheim, California, 1992.Google Scholar
  50. 50.
    Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons—Florida and New York, 1988-1991. Morb Mortal Wkly Rep 40: 585-591, 1991.Google Scholar
  51. 51.
    Dooley SW, Villarino ME, Lawrence M, et al: Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients. JAMA 257: 2632–2634, 1992.Google Scholar
  52. 52.
    Edlin BR, Tokars JL, Grieco MH, et al: An outbreak of multidrug-resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. N Engl J Med 326: 1514–1521, 1992.PubMedGoogle Scholar
  53. 53.
    Fischl MA, Uttamchandani RB, Daikos GL, et al: An outbreak of tuberculosis caused by multiple drug resistant tubercle bacilli among patients with HIV infection. Ann Intern Med 117: 177–183, 1992.PubMedGoogle Scholar
  54. 54.
    Small PM, Shafer RW, Hopewell PC, et al: Exogenous reinfection with multidrug-resistant Mycobacterium tuberculosis in patients with advanced HIV infection. N Engl J Med 328: 1137–1144, 1993.PubMedGoogle Scholar
  55. 55.
    Scowden EB, Schaffner W, Stone WJ: Overwhelming strongyloidiasis: An unappreciated opportunistic infection. Medicine (Baltimore) 57: 527–544, 1978.Google Scholar
  56. 56.
    Morgan JS, Schaffner, W, Stone WJ: Opportunistic strongyloidiasis in renal transplant recipients. Transplantation 42: 518–524, 1986.PubMedGoogle Scholar
  57. 57.
    Whimbey E, Vartivarian S, Champlin R, et al: Parainfluenza virus infection among adult bone marrow transplant patients, Abstract 27, 32nd ICAAC, Anaheim, California, 1992.Google Scholar
  58. 58.
    Apalsch AM, Green M, Wald ER: Influenza and parinfluenza virus infections in pediatric organ transplant recipients. Abstract 28, 32nd ICAAC, Anaheim, California, 1992.Google Scholar
  59. 59.
    Elting L, Whimbey E, Couch R, et al: Influenza A infection in adult leukemia patients. Abstract 29, 32nd ICAAC, Anaheim, California, 1992.Google Scholar
  60. 60.
    Rubin RH, Tolkoff-Rubin NE: Opportunistic infections in renal allograft recipients. Transplant Proc 20: 1112–1117, 1988.PubMedGoogle Scholar
  61. 61.
    Rubin RH, Tolkoff-Rubin NE: Infection: The new problems. Transplant Proc 21: 1440–1445, 1989.PubMedGoogle Scholar
  62. 62.
    Beatty HN, Miller AA, Broome CV, et al: Legionnaires’ disease in Vermont: May to October 1978. JAMA 240: 127–131, 1978.Google Scholar
  63. 63.
    Bock BV, Kirby BD, Edelstein PH, et al: Legionnaires’ disease in renal transplant recipients. Lancet 1: 410–413, 1978.PubMedGoogle Scholar
  64. 64.
    Gump DW, Frank RO, Winn WC Jr, et al: Legionnaires’ disease in patients with associated serious disease. Ann Intern Med 90: 538–542, 1979.PubMedGoogle Scholar
  65. 65.
    Haley CE, Cohen ML, Halter J, et al: Nosocomial Legionnaires’ disease: A continuing common-source epidemic at Wadsworth Medical Center. Ann Intern Med 90: 583–586, 1979.PubMedGoogle Scholar
  66. 66.
    England AC III, Fraser DW, Plikaytris BD, et al: Sporadic legionellosis in the United States: The first thousand cases. Ann Intern Med 94: 164–170, 1981.PubMedGoogle Scholar
  67. 67.
    Arnow PM, Chou T, Weil D, et al: Nosocomial Legionnaires’ disease caused by aerosolized tap water from respiratory devices. J Infect Dis 146: 460–467, 1982.PubMedGoogle Scholar
  68. 68.
    Pasculle AW, Myerowitz RL, Rinaldo CR: New bacterial agent of pneumonia isolated from renal transplant recipients. Lancet 2: 58–161, 1979.PubMedGoogle Scholar
  69. 69.
    Myerowitz RL, Pasculle AW, Dowling JN, et al: Opportunistic lung infection due to “Pittsburgh pneumonia agent.” N Engl J Med 301: 953–958, 1979.PubMedGoogle Scholar
  70. 70.
    Rogers BH, Donowitz GR, Walker GK, et al: Opportunistic pneumonia: A clinicopathogenic study of cases caused by an unidentified acid-fast bacterium. N Engl J Med 301: 495–961, 1979.Google Scholar
  71. 71.
    Muder RR, Yu VL, Zuravleff JJ: Pneumonia due to the Pittsburgh Pneumonia Agent: New clinical perspective with a review of the literature. Medicine (Baltimore) 62: 120–128, 1983.Google Scholar
  72. 72.
    Rudin JE, Wing EJ: A comparative study of Legionella micdadei and other nosocomial acquired pneumonias. Chest 86: 675–680, 1984.PubMedGoogle Scholar
  73. 73.
    Arnow PM, Andersen P, Mainous PD, et al: Pulmonary aspergillosis during hospital renovation. Am Rev Respir Dis 118: 49–53, 1978.PubMedGoogle Scholar
  74. 74.
    Burton JR, Sachery JB, Bessin R, et al: Aspergillosis in four renal transplant patients: Diagnosis and effective treatment with amphoterocin B. Ann Intern Med 77: 383–388, 1972.PubMedGoogle Scholar
  75. 75.
    Rose HD: Mechanical control of hospital ventilation and aspergillus infections. Am Rev Respir Dis 105: 306–307, 1972.PubMedGoogle Scholar
  76. 76.
    Rhame FS, Streifel AJ, Kersey JH Jr, et al: Extrinsic risk factors for pneumonia in the patient at high risk of infection. Am J Med 75(5A): 42–52, 1984.Google Scholar
  77. 77.
    Opal SM, Asp AA, Cannady PB Jr, et al: Efficacy of infection control measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction. J Infect Dis 153: 634–637, 1986.PubMedGoogle Scholar
  78. 78.
    Singer C, Armstrong D, Rosen PP, et al: Pneumocystis carinii pneumonia: A cluster of 11 cases. Am J Med 82: 772–777, 1975.Google Scholar
  79. 79.
    Hopkins C, Weber DJ, Rubin RH: Invasive aspergillus infection: Possible non-ward common source within the hospital environment. J Hosp Infect 12: 19–25, 1989.Google Scholar
  80. 80.
    Kacmarek RM, Kratohuil J, Dashevsky Y, et al: Performance of prototype portable HEPA-filtered positive pressure enclosures. Respir Care 37: 1368, 1992.Google Scholar
  81. 81.
    Rubin RH: The compromised host as sentinel chicken. N Engl J Med 317: 1151–1153, 1987.PubMedGoogle Scholar
  82. 82.
    Nash G: Pathology of pulmonary infections: Immune compromised vs. normal host. Chest 95 (Suppl): 176S–180S, 1989.Google Scholar
  83. 83.
    Myerowitz RL: The pathology of opportunistic infections with pathogenetic, diagnostic, and clinical correlations. New York, Raven Press, 1983, pp. 83–94.Google Scholar
  84. 84.
    Nash G: Pathologic features of the lung in the immunocompromised host. Human Pathol 13: 841–858, 1982.Google Scholar
  85. 85.
    Weber WR, Askin FB, Dehner LP: Lung biopsy in Pneumocystis carinii pneumonia: A histopathologic study of typical and atypical features. Am J Clin Pathol 67: 11–19, 1977.PubMedGoogle Scholar
  86. 86.
    Epler GR, Colby TV, McLoud TC, et al: Bronchiolitis obliterans organizing pneumonia. N Engl J Med 312: 152–158, 1985.PubMedGoogle Scholar
  87. 87.
    Gross NJ: Pulmonary effects of radiation therapy. Ann Intern Med 86: 81–92, 1977.PubMedGoogle Scholar
  88. 88.
    Jennings FL, Arden A: Development of radiation pneumonitis: Time and dose factors. Arch Pathol Lab Med 74: 351–360, 1962.Google Scholar
  89. 89.
    Teates CD: The effects of unilateral thoracic irradiation on pulmonary blood flow. Am J Roentgenol 102: 875–882, 1968.Google Scholar
  90. 90.
    Margolis LW, Phillips TL: Whole-lung irradiation for metastatic tumor. Radiology 93: 1173–1179, 1969.PubMedGoogle Scholar
  91. 91.
    Deeley TJ: The effects of radiation on the lungs in the treatment of carcinoma of the bronchus. Clin Radiol 11: 33–39, 1960.PubMedGoogle Scholar
  92. 92.
    Gross NJ: Surfactant subtypes in experimental lung damage: Radiation pneumonitis. Am J Physiol 260(4 Pt l): L302–310, 1991.PubMedGoogle Scholar
  93. 93.
    Hallman M, Maasilta P, Kivisaari L, et al: Changes in surfactant in bronchoalveolar lavage fluid after hemithorax irradiation in patients with mesothelioma. Am Rev Respir Dis 141: 998–1005, 1990.PubMedGoogle Scholar
  94. 94.
    Libshitz HI, Brosof AB, Southard ME: Radiographic appearance of the chest following extended field radiation therapy for Hodg-kin’s disease: A consideration of time-dose relationships. Cancer 32: 206–215, 1973.PubMedGoogle Scholar
  95. 95.
    Ikezoe J, Takashima S, Morimoto S, et al: CT appearance of acute radiation-induced injury in the lung. Am J Roentgenol 150: 765f–770, 1988.Google Scholar
  96. 96.
    Poussin-Rosillo H, Nisce LZ, Lee BJ, et al: Complications of total nodal irradiation of Hodgkin’s disease stages III and IV. Cancer 42: 437–441, 1978.PubMedGoogle Scholar
  97. 97.
    Goldman AL, Enquist R: Hyperacute radiation pneumonitis. Chest 67: 613–615, 1975.PubMedGoogle Scholar
  98. 98.
    Roswit B, White DC: Severe radiation injuries of the lung. Am J Roentgenol 129: 127–136, 1977.Google Scholar
  99. 99.
    Lingos TI, Recht A, Vicini F, et al: Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy. Int J Radiat Oncol Biol Phys 21: 355–360, 1991.PubMedGoogle Scholar
  100. 100.
    Tarbell NJ, Thompson L, Mauch P: Thoracic irradiation in Hodgkin’s disease: Disease control and long-term complications. Int J Radiat Oncol Biol Phys 18: 275–281, 1990.PubMedGoogle Scholar
  101. 101.
    Phillips TL, Wharam MD, Margolis LW: Modification of radiation injury to normal tissues by chemotherapeutic agents. Cancer 35: 1678–1684, 1975.PubMedGoogle Scholar
  102. 102.
    Castellino RA, Glatstein E, Turbow MM, et al: Latent radiation injury of lung or heart activated by steroid withdrawal. Ann Intern Med 80: 593–599, 1974.PubMedGoogle Scholar
  103. 103.
    Kun LE, DeVita VT, Young RC, et al: Treatment of Hodgkin’s disease using intensive chemotherapy followed by irradiation. Int J Radiat Oncol Biol Phys 1: 619–626, 1976.PubMedGoogle Scholar
  104. 104.
    Cohen IJ, Loven D, Schoenfeld T, et al: Dactinomycin potentiation of radiation pneumonitis: A forgotten interaction. Pediatr Hematol Oncol 8: 187–192, 1991.PubMedGoogle Scholar
  105. 105.
    Blomgrist C, Tiusaneu K, Elomaa I, et al: The combination of radiotherapy, adjuvant chemotherapy (Cyclophosphamide-doxorubicin—ftorafin) and tamoxifen in Stage II breast cancer: Long term follow-up results of a randomized trial. Br J Cancer 66: 1171–1176, 1992.Google Scholar
  106. 106.
    Roswit B, White DC: Severe radiation injuries of the lung. Am J Roentgenol 129: 127–136, 1977.Google Scholar
  107. 107.
    Gibson PG, Bryant DH, Morgan GW, et al: Radiation-induced lung injury: A hypersensitivity pneumonitis?. Ann Intern Med 109: 288–291, 1988.PubMedGoogle Scholar
  108. 108.
    Gross NJ, Holloway NO, Narine KR: Effects of some nonsteroi-dal anti-inflammatory agents on experimental radiation pneumonitis. Radiat Res 127: 317–324, 1991.PubMedGoogle Scholar
  109. 109.
    Kataoka M, Kawamura M, Itoh H, et al: Ga-67 citrate scintigraphy for the early detection of radiation pneumonitis. Clin Nucl Med 17: 27–31, 1992.PubMedGoogle Scholar
  110. 110.
    Kataoka M, Kawamura M, Ueda N, et al: Diffuse gallium-67 uptake in radiation pneumonitis. Clin Nucl Med 15: 707–711, 1990.PubMedGoogle Scholar
  111. 111.
    Kataoka M: Gallium-67 citrate imaging for the assessment of radiation pneumonitis. Ann Nucl Med 3: 73–81, 1989.PubMedGoogle Scholar
  112. 112.
    Rosenow EC III: The spectrum of drug-induced pulmonary disease. Ann Intern Med 77: 977–991, 1972.PubMedGoogle Scholar
  113. 113.
    Brettner A, Heitzman ER, Woodin WG: Pulmonary complications of drug therapy. Radiology 96: 31–38, 1970.PubMedGoogle Scholar
  114. 114.
    Whitcomb ME: Drug-induced lung disease. Chest 63: 418–422, 1973.PubMedGoogle Scholar
  115. 115.
    Goldiner PL, Schweizer O: The hazards of anesthesia and surgery in bleomycin-treated patients. Semin Oncol 6: 121–124, 1979.PubMedGoogle Scholar
  116. 116.
    Tryka AF, Skornik WA, Godleski JJ, et al: Potentiation of bleomycin-induced lung injury by exposure to 70% oxygen: Morphologic assessment. Am Rev Respir Dis 126: 1074–1079, 1982.PubMedGoogle Scholar
  117. 117.
    Einhorn L, Krause M, Hornback N, et al: Enhanced pulmonary toxicity with bleomycin and radiotherapy in oat cell lung cancer. Cancer 37: 2414–2416, 1976.PubMedGoogle Scholar
  118. 118.
    Nakamura H, Sato S, Takahashi K: Effects of vitamin E deficiency on bleomycin-induced pulmonary fibrosis in the hamster. Lung 166: 161–176, 1988.PubMedGoogle Scholar
  119. 119.
    Littler WA, Ogilvie C: Lung function in patients receiving busulphan. Br Med J 4: 530–532, 1970.PubMedGoogle Scholar
  120. 120.
    Rodman T, Karr S, Close HP: Radiation reaction in the lung: Report of a fatal case in a patient with carcinoma of the lung, with studies of pulmonary function before and during prednisone therapy. N Engl J Med 262: 431–434, 1960.PubMedGoogle Scholar
  121. 121.
    Brady LW, Germon PA, Cander L: The effects of radiation therapy on pulmonary function in carcinoma of the lung. Radiology 85: 130–134, 1965.PubMedGoogle Scholar
  122. 122.
    Horiuchi T, Mason RJ, Kuroki Y, et al: Surface and tissue forces, surfactant protein A, and the phospholipid components of pulmonary surfactant in bleomycin-induced pulmonary fibrosis in the rat. Am Rev Respir Dis 141: 1006–1013, 1990.PubMedGoogle Scholar
  123. 123.
    Sostman HD, Matthay RA, Putman CE: Cytotoxic drug-induced lung disease. Am J Med 62: 608–615, 1977.PubMedGoogle Scholar
  124. 124.
    Willson JVK: Pulmonary toxicity of antineoplastic drugs. Cancer Treatm Rep 62: 2003–2008, 1978.Google Scholar
  125. 125.
    Holoye PY, Luna MA, MacKay B, et al: Bleomycin hypersensitivity pneumonitis. Ann Intern Med 88: 47–49, 1978.PubMedGoogle Scholar
  126. 126.
    Rosenow EC III: Chemotherapeutic drug-induced pulmonary disease. Semin Respir Med 2: 89–96, 1980.Google Scholar
  127. 127.
    Collis CH: Lung damage from cytotoxic drugs. Cancer Chemother Pharmacol 4: 17–27, 1980.PubMedGoogle Scholar
  128. 128.
    Weiss RB, Muggia FM: Cytotoxic drug-induced pulmonary disease. Am J Med 68: 259–266, 1980.PubMedGoogle Scholar
  129. 129.
    Batist G, Andrews JL Jr: Pulmonary toxicity of antineoplastic drugs. JAMA 246: 1449–1453, 1981.PubMedGoogle Scholar
  130. 130.
    Ginsberg SJ, Comis RL: The pulmonary toxicity of antineoplastic agents. Semin Oncol 9: 34–51, 1982.PubMedGoogle Scholar
  131. 131.
    Oliner H, Schwartz R, Rubio F Jr, et al: Interstitial pulmonary fibrosis following busulfan therapy. Am J Med 31: 134–139, 1961.PubMedGoogle Scholar
  132. 132.
    Leake E, Smith WG, Woodiff HK: Diffuse interstitial pulmonary fibrosis after busulphan therapy. Lancet 2: 432–434, 1963.PubMedGoogle Scholar
  133. 133.
    Heard BE, Cooke RA: Busulphan lung. Thorax 23: 187–193, 1968.PubMedGoogle Scholar
  134. 134.
    Kirschner RH, Esterly JR: Pulmonary lesions associated with busulfan therapy of chronic myelogenous leukemia. Cancer 27: 1074–1080, 1971.PubMedGoogle Scholar
  135. 135.
    Manning DM, Strimlan CV, Turbiner EH: Early detection of busulfan lung: Report of a case. Clin Nucl Med 5: 412–414, 1980.PubMedGoogle Scholar
  136. 136.
    Hankins DG, Sanders S, MacDonald FM, et al: Pulmonary toxicity recurring after a six week course of busulfan therapy and after subsequent therapy with uracil mustard. Chest 73: 413–416, 1978.Google Scholar
  137. 137.
    Horowitz AL, Friedman M, Smither J, et al: The pulmonary changes of bleomycin toxicity. Radiology 106: 65–68, 1973.PubMedGoogle Scholar
  138. 138.
    Blum RH, Carter SK, Agre K: A clinical review of bleomycin— A new antineoplastic agent. Cancer 31: 903–914, 1973.PubMedGoogle Scholar
  139. 139.
    Pascual RS, Mosher MB, Sikand RS, et al: Effects of bleomycin on pulmonary function in man. Am Rev Respir Dis 108: 211–217, 1973.PubMedGoogle Scholar
  140. 140.
    Samuels ML, Johnson DE, Itoloye PY, et al: Large-dose bleomycin therapy and pulmonary toxicity: A possible role of prior radiotherapy. JAMA 235: 1117–1120, 1976.PubMedGoogle Scholar
  141. 141.
    Iacovino JR, Leitner J, Abbas AK, et al: Fatal pulmonary reaction from low doses of bleomycin: An idiosyncratic tissue response. JAMA 235: 1253–1255, 1976.PubMedGoogle Scholar
  142. 142.
    Dearnaley DP, Horwich A, Ahern R, et al: Combination chemotherapy with bleomycin, etoposide, and cisplatin (BEP) for metastatic testicular teratoma: Long-term follow-up. Eur J Cancer 27: 684–691, 1991.PubMedGoogle Scholar
  143. 143.
    Perez-Guerra F, Harkleroad LE, Walsh RE, et al: Acute bleomycin lung. Am Rev Respir Dis 106: 909–913, 1972.PubMedGoogle Scholar
  144. 144.
    Brown WG, Hasan FM, Barbee RA: Reversibility of severe bleomycin-induced pneumonitis. JAMA 239: 2012–2014, 1978.PubMedGoogle Scholar
  145. 145.
    Aronin PA, Mahaley MS Jr, Rudnick SA, et al: Prediction of BCNU pulmonary toxicity in patients with malignant gliomas: An assessment of risk factors. N Engl J Med 303: 183–188, 1980.PubMedGoogle Scholar
  146. 146.
    Durant JR, Norgard MJ, Murad TM, et al: Pulmonary toxicity associated with bischloroethyl nitrosourea (BCNU). Ann Intern Med 90: 191–194, 1979.PubMedGoogle Scholar
  147. 147.
    Rodin AE, Haggard ME, Travis LB: Lung changes and chemotherapeutic agents in childhood: Report of a case associated with cyclophosphamide therapy. Am J Dis Child 120: 337–340, 1970.PubMedGoogle Scholar
  148. 148.
    Dohner VA, Ward HP, Standard RE: Alveolitis during procarbazine, vincristine and cyclophosphamide therapy. Chest 62: 636–639, 1972.PubMedGoogle Scholar
  149. 149.
    Patel AR, Shah PC, Rhee HL, et al: Cyclophosphamide therapy and interstitial pulmonary fibrosis. Cancer 38: 1542–1549, 1976.PubMedGoogle Scholar
  150. 150.
    Rubio FA: Possible pulmonary effects of alkylating agents. N Engl J Med 287: 1150–1151, 1972.PubMedGoogle Scholar
  151. 151.
    Rose MS: Busulphan toxicity syndrome caused by chlorambucil. Br Med J 2: 123–127, 1975.PubMedGoogle Scholar
  152. 152.
    Godard P, Marty JP, Michel FB: Interstitial pneumonia and chlorambucil. Chest 76: 471–473, 1979.PubMedGoogle Scholar
  153. 153.
    Twohig KJ, Matthay RA: Pulmonary effects of cytotoxic agents other than bleomycin. Clin Chest Med 11: 31–54, 1990.PubMedGoogle Scholar
  154. 154.
    Sen RP, Walsh TE, Fisher W, et al: Pulmonary complications of combination therapy with cyclophosphamide and prednisone. Chest 99: 143–146, 1991.PubMedGoogle Scholar
  155. 155.
    Clarysse AM, Cathey WJ, Cartwright GE, et al: Pulmonary disease complicating intermittent therapy with methotrexate. JAMA 209: 1861–1864, 1969.PubMedGoogle Scholar
  156. 156.
    Whitcomb ME, Schwartz MI, Tormey DC: Methotrexate pneumonitis: Case report and review of the literature. Thorax 27: 636–639, 1972.PubMedGoogle Scholar
  157. 157.
    Goldman GC, Moschella SL: Severe pneumonitis occurring during methotrexate therapy: Report of two cases. Arch Dermatol 103: 194–197, 1971.PubMedGoogle Scholar
  158. 158.
    Everts CS, Westcott JL, Bragg DG: Methotrexate therapy and pulmonary disease. Radiology 107: 539–543, 1973.PubMedGoogle Scholar
  159. 159.
    Lisbona A, Schwartz J, Lachance C, et al: Methotrexate-induced pulmonary disease. J Can Assoc Radiol 24: 215–220, 1973.PubMedGoogle Scholar
  160. 160.
    Sostman HD, Matthay RA, Putman CE, et al: Methotrexateinduced pneumonitis. Medicine (Baltimore) 55: 371–388, 1976.Google Scholar
  161. 161.
    Gutin PH, Green MR, Bleyer WA, et al: Methotrexate pneumonitis induced by intrathecal methotrexate therapy: A case report with pharmacokinetic data. Cancer 38: 1529–1534, 1976.PubMedGoogle Scholar
  162. 162.
    Lascari AD, Strano AJ, Johnson WW, et al: Methotrexate-induced sudden fatal pulmonary reaction. Cancer 40: 1393–1397, 1977.PubMedGoogle Scholar
  163. 163.
    Rosenow EC III, Unni KK: Drug-induced pulmonary granu-lomas. Lung Biol Health Dis 20: 469–484, 1983.Google Scholar
  164. 164.
    Cooperative study: Acute lymphocytic leukemia in children— Maintenance therapy with methotrexate administered intermittently: Acute leukemia group B. JAMA 207: 923–928, 1969.Google Scholar
  165. 165.
    Green L, Schattner A, Berkenstadt H: Severe reversible interstitial pneumonitis induced by low dose methotrexate: Report of a case and review of the literature. J Rheumatol 16: 1007–1008, 1989.Google Scholar
  166. 166.
    Ridley MG, Wolfe CS, Mathews JA: Life-threatening acute pneumonitis during low dose methotrexate treatment for rheumatoid arthritis: A case report and review of the literature. Ann Rheum Dis 47: 784–788, 1988.PubMedGoogle Scholar
  167. 167.
    Shapiro CL, Yeap BY, Godleski J, et al: Drug-related pulmonary toxicity in non-Hodgkin’s lymphoma: Comparative results with three different treatment regimens. Cancer 68: 699–705, 1991.PubMedGoogle Scholar
  168. 168.
    Cook NJ, Carroll GJ: Successful reintroduction of methotrexate after pneumonitis in two patients with rheumatoid arthritis. Ann Rheum Dis 51: 272–274, 1992.PubMedGoogle Scholar
  169. 169.
    Hargreaves MR, Mowat AG, Benson MK: Acute pneumonitis associated with low dose methotrexate treatment for rheumatoid arthritis: Report of five cases and review of published reports. Thorax 47: 628–633, 1992.PubMedGoogle Scholar
  170. 170.
    Kremer JM, Phelps CT: Long term prospective study of the use of methotrexate in the treatment of rheumatoid arthritis: Update after a mean of 90 months. Arthritis Rheum 35: 138–145, 1992.PubMedGoogle Scholar
  171. 171.
    Elsasser S, Dalquen P, Soler M, et al: Methotrexate-induced pneumonitis: Appearance four weeks after discontinuation of treatment. Am Rev Resp Dis 140: 1089–1092, 1989.PubMedGoogle Scholar
  172. 172.
    White DA, Rankin JA, Stover DE, et al: Methotrexate pneumonitis: Bronchoalveolar lavage findings suggest an immunologic disorder. Am Rev Resp Dis 139: 18–21, 1989.PubMedGoogle Scholar
  173. 173.
    Codling BW, Chakera TM: Pulmonary fibrosis following therapy with melphalan for multiple myeloma. J Clin Pathol 25: 668–673, 1972.PubMedGoogle Scholar
  174. 174.
    Rubin G, Baume P, Vandenberg R: Azathioprine and acute restrictive lung disease. Aust NZ J Med 2: 272–274, 1972.Google Scholar
  175. 175.
    Hazlett DR, Ward GW, Madison DS: Pulmonary function loss in diphenylhydantoin therapy. Chest 66: 660–664, 1974.PubMedGoogle Scholar
  176. 176.
    Marshall A, Moore K: Pulmonary disease after amitriptyline overdosage. Br Med J 1: 716–717, 1973.PubMedGoogle Scholar
  177. 177.
    Winterbauer RH, Wikske KR, Wheelis RF: Diffuse pulmonary injury associated with gold treatment. N Engl J Med 294: 919–921, 1976.PubMedGoogle Scholar
  178. 178.
    Zitnik RJ, Cooper JA Jr: Pulmonary disease due to antirheumatic agents. Clin Chest Med 11: 139–150, 1990.PubMedGoogle Scholar
  179. 179.
    Jick SS, Jick H, Walker AM, et al: Hospitalizations for pulmonary reactions following nitrofurantoin use. Chest 96: 512–515, 1989.PubMedGoogle Scholar
  180. 180.
    Wilson BD, Clarkson CE, Lippmann ML: Amiodarone-induced pulmonary inflammation: Correlation with drug dose and lung levels of drug, metabolite, and phospholipid. Am Rev Resp Dis 143: 1110–1114, 1991.PubMedGoogle Scholar
  181. 181.
    Whitcomb ME, Schwartz MI, Keller AR, et al: Hodgkin’s disease of the lung. Am Rev Respir Dis 106: 79–85, 1972.PubMedGoogle Scholar
  182. 182.
    Martin JJ: The Nisbet Symposium: Hodgkin’s disease— Radiological aspects of the disease. Australas Radiol 11: 206–218, 1967.Google Scholar
  183. 183.
    Strickland B: Intra-thoracic Hodgkin’s disease. Part II. Peripheral manifestations of Hodgkin’s disease in the chest. Br J Radiol 40: 930–938, 1967.PubMedGoogle Scholar
  184. 184.
    Fraser RG, Pare JAP: Neoplastic diseases of the lungs. In Fraser RG, Pare JAP (eds): Diagnosis of Diseases of the Chest, 2nd ed, Vol. II. W. B. Saunders, Philadelphia, 1978, pp. 981–1134.Google Scholar
  185. 185.
    Rosenberg SA, Diamond HD, Jaslowitz B, et al: Lymphosarcoma: A review of 1269 cases. Medicine (Baltimore) 40: 31–84, 1961.Google Scholar
  186. 186.
    Rose HA: Primary lymphosarcoma of the lung. J Thorac Cardiovasc Surg 33: 254–263, 1957.Google Scholar
  187. 187.
    Baron MG, Whitehouse WM: Primary lymphosarcoma of the lung. Am J Roentgenol 85: 294–308, 1961.Google Scholar
  188. 188.
    Vernant JP, Brun B, Mannoni P, et al: Respiratory distress of hyperleukocytic granulocytic leukemias. Cancer 44: 264–268, 1979.PubMedGoogle Scholar
  189. 189.
    McKee LC Jr, Collins RD: Intravascular leukocyte thrombi and aggregates as a cause of morbidity and mortality in leukemia. Medicine (Baltimore) 53: 463–478, 1974.Google Scholar
  190. 190.
    Myers TJ, Cole SR, Klatsky AU, et al: Respiratory failure due to pulmonary leukostasis following chemotherapy of acute nonlymphocytic leukemia. Cancer 51: 1808–1813, 1983.PubMedGoogle Scholar
  191. 191.
    Tryka AF, Godleski JJ, Fanta CH: Leukemic cell lysis pneumonopathy: A complication of treated myeloblastic leukemia. Cancer 50: 2763–2770, 1982.PubMedGoogle Scholar
  192. 192.
    Green RA, Nichlos NJ: Pulmonary involvement in leukemia. Am Rev Respir Dis 80: 833–844, 1959.Google Scholar
  193. 193.
    Blank N, Castellino RA, Shah V: Radiographic aspects of pulmonary infection in patients with altered immunity. Radiol Clin North Am 11: 175–190, 1973.PubMedGoogle Scholar
  194. 194.
    Simmons RL, Uranga VM, LaPlante ES, et al: Pulmonary complications in transplant recipients. Arch Surg 105: 260–268, 1972.PubMedGoogle Scholar
  195. 195.
    Friedman M, Libert R. Michaelson ED: Unilateral pulmonary edema after renal transplantation. N Engl J Med 293: 343–344, 1975.PubMedGoogle Scholar
  196. 196.
    Cosimi AB, Cho SI, Delmonico FL, et al: A randomized clinical trial comparing OKT3 and steroids for treatment of hepatic allograft rejection. Transplantation 43: 91–95, 1987.PubMedGoogle Scholar
  197. 197.
    Ortho Multicenter Transplant Study Group: A randomized clinical trial of OKT3 monoclonal antibody for acute rejection of cadaveric renal transplants. N Engl J Med 313: 337–342, 1985.Google Scholar
  198. 198.
    Ward HN: Pulmonary infiltrates associated with leukoagglutinin transfusion reactions. Ann Intern Med 73: 689–694, 1970.PubMedGoogle Scholar
  199. 199.
    Thompson JSA, Severson CD, Parmely MJ, et al: Pulmonary “hypersensitivity” reactions induced by transfusion of non-HL-A leukoagglutinins. N Engl J Med 284: 1120–1125, 1971.PubMedGoogle Scholar
  200. 200.
    Tenholder MF, Hooper RG: Pulmonary infiltrates in leukemia. Chest 78: 468–473, 1980.PubMedGoogle Scholar
  201. 201.
    Popovsky MA, Abel MD, Moore SB: Transfusion-related acute lung injury associated with passive transfer of antileukocyte antibodies. Am Rev Respir Dis 128: 185–189, 1983.PubMedGoogle Scholar
  202. 202.
    Schiller V, Aberle DR, Aberle AM: Pulmonary alveolar proteinosis: Occurrence with metastatic melanoma to lung. Chest 96: 466–467, 1989.Google Scholar
  203. 203.
    Honda Y, Takahashi H, Shijubo N, et al: Surfactant protein A concentration in bronchoalveolar lavage fluids of patients with pulmonary alveolar proteinosis. Chest 103: 496–499, 1993.PubMedGoogle Scholar
  204. 204.
    Crouch E, Persson A, Chang D: Accumulation of surfactant protein D in human pulmonary alveolar proteinosis. Am J Pathol 142: 241–248, 1993.PubMedGoogle Scholar
  205. 205.
    Singh G, Katyal SL, Bedrossian CW, et al: Pulmonary alveolar proteinosis: Staining for surfactant apoprotein in alveolar proteinosis and in conditions simulating it. Chest 83: 82–86, 1983.PubMedGoogle Scholar
  206. 206.
    Ruben FL, Talamo TS: Secondary pulmonary alveolar proteinosis occurring in two patients with acquired immune deficiency syndrome. Am J Med 80: 1187–1190, 1986.PubMedGoogle Scholar
  207. 207.
    Godwin JD, Muller NL, Takasugi JE: Pulmonary alveolar proteinosis: CT findings. Radiology 169: 609–613, 1988.PubMedGoogle Scholar
  208. 208.
    Carre PC, Didier AP, Pipy BR, et al: The lavage fluid from a patient with alveolar proteinosis inhibits the in vitro chemiluminescence response and arachidonic acid metabolism of normal guinea pig alveolar macrophages. Am Rev Respir Dis 142: 1068–1072, 1990.PubMedGoogle Scholar
  209. 209.
    Hoffman RM, Dauber JH, Rogers RM: Improvement in alveolar macrophage migration after therapeutic whole lung lavage in pulmonary alveolar proteinosis. Am Rev Resp Dis 134: 1030–1032, 1989.Google Scholar
  210. 210.
    Sickles EA, Greene WH, Wiernik PH: Unusual presentation of infection in granulocytopenic patients. Arch Intern Med 135: 715–719, 1975.PubMedGoogle Scholar
  211. 211.
    Sickles EA, Young VM, Greene WH, et al: Pneumonia in acute leukemia. Ann Intern Med 79: 528–534, 1973.PubMedGoogle Scholar
  212. 212.
    Levine AS, Schimpff SC, Graw RG, et al: Hematologic malignancies and other marrow failure states: Progress in the management of complicating infections. Semin Hematol 11: 141–202, 1974.PubMedGoogle Scholar
  213. 213.
    Groskin SA, Stadnick ME, DuPont PG: Pneumocystis carinii pneumonia: Effect of corticosteroid treatment on radiographic appearance in a patient with AIDS. Radiology 180: 423–425, 1991.PubMedGoogle Scholar
  214. 214.
    Kuhlman JE, Fishman EK, Hruban RH, et al: Disease of the chest in AIDS: CT diagnosis. RadioGraphics 9(5): 827–857, 1989.PubMedGoogle Scholar
  215. 215.
    Kuhlman JE, Knowles M, Fishman EK, et al: Premature bullous damage in AIDS: CT diagnosis. Radiology 173: 23–26, 1989.PubMedGoogle Scholar
  216. 216.
    Barloon TJ, Galvin JR, Mori M, et al: High-resolution ultrafast chest CT in the clinical management of febrile bone marrow transplant patients with normal or nonspecific chest roentgenograms. Chest 99: 928–933, 1991.PubMedGoogle Scholar
  217. 217.
    Kuhlman JE, Fishman EK, Siegelman SS: Invasive pulmonary aspergillosis in acute leukemia: Characteristic findings on CT, the CT halo sign and the role of CT in early diagnosis. Radiology 157: 611–614, 1985.PubMedGoogle Scholar
  218. 218.
    Graham NJ, Muller NL, Miller RR, et al: Intrathoracic complications following allogeneic bone marrow transplantation: CT findings. Radiology 181: 153–156, 1991.PubMedGoogle Scholar
  219. 219.
    Golden JA, Sollitto RA: The radiology of pulmonary disease: Chest radiography, computed tomography, and gallium scanning. In White DA, Stover DE (eds): Pulmonary Effects of AIDS. Clin Chest Med 9: 481–495, 1988.PubMedGoogle Scholar
  220. 220.
    Barrio JL, Suarez M, Rodriguesz JL, et al: Pneumocystis carinii pneumonia presenting as cavitating and noncavitating solitary pulmonary nodules in patients with the acquired immunodeficiency syndrome. Am Rev Respir Dis 134: 1094–1096, 1986.PubMedGoogle Scholar
  221. 221.
    Plunkett MB, Peterson MS, Landereneau RJ, et al: Peripheral pulmonary nodules: Preoperative percutaneous needle localization with CT guidance. Radiology 185: 274–276, 1992.PubMedGoogle Scholar
  222. 222.
    Naidich DP, Sussman R, Kutcher WL, et al: Solitary pulmonary nodules: CT-bronchoscopic correlation. Chest 3: 595–598, 1988.Google Scholar
  223. 223.
    Janzen DL, Adler BD, Padley SPG, et al: Diagnostic success of bronchoscopic biopsy in immunocompromised patients with acute pulmonary disease: Predictive value of disease distribution as shown on CT. Am J Roentgenol 160: 21–24, 1993.Google Scholar
  224. 224.
    Mann H, Ward JH, Samlowski WE: Vascular leak syndrome associated with interleukin-2: Chest radiographie manifestations. Radiology 176: 191–194, 1990.PubMedGoogle Scholar
  225. 225.
    Srivatsa SS, Burger CD, Douglas WW: Upper lobe pulmonary parenchymal calcification in a patient with AIDS and Pneumocystis carinii pneumonia receiving aerosolized pentamidine. Chest 101: 266–267, 1992.PubMedGoogle Scholar
  226. 226.
    Im JG, Webb WR, Han MC, et al: Apical opacity associated with pulmonary tuberculosis: High-resolution CT findings. Radiology 178: 727–731, 1991.PubMedGoogle Scholar
  227. 227.
    Carson PJ, Goldsmith JC: Atypical pulmonary diseases associated with AIDS. Chest 100: 675–677, 1991.PubMedGoogle Scholar
  228. 228.
    Naidich DP: Pulmonary manifestations of HIV infection. In Greene R, Muhm JR (eds): Syllabus: A Categorical Course in Chest Radiology. Radiological Society of North America, Chicago, 1992, pp. 135–155.Google Scholar
  229. 229.
    Bergin CJ, Wirth RL, Berry GJ, et al: Pneumocystis carinii pneumonia: CT and HRCT observations. J Comput Assist Tomogr 14: 756–759, 1990.PubMedGoogle Scholar
  230. 230.
    Wasser LS, Brown E, Talavera W: Miliary PCP in AIDS. Chest 96: 693–695, 1989.PubMedGoogle Scholar
  231. 231.
    Cohen BA, Pomeranz S, Rabinowitz JG, et al: Pulmonary complications of AIDS: Radiologie features. Am J Roentgenol 143: 115–122, 1984.Google Scholar
  232. 232.
    Jayes RL, Kamerow HN, Hasselquist SM, et al: Disseminated pneumocystosis presenting as a pleural effusion. Chest 103: 306–308, 1993.PubMedGoogle Scholar
  233. 233.
    Radin DR, Baker EL, Klatt EC, et al: Visceral and nodal calcification in patients with AIDS-related Pneumocystis carinii infection. Am J Roentgenol 154: 27–31, 1990.Google Scholar
  234. 234.
    Kuhlman JE, Kavuru M, Fishman EK, et al: Pneumocystis carinii pneumonia: Spectrum of parenchymal CT findings. Radiology 175: 711–714, 1990.PubMedGoogle Scholar
  235. 235.
    Goodman PC, Daley C, Minagi H: Spontaneous pneumothorax in AIDS patients with Pneumocystis carinii pneumonia. Am J Roentgenol 147: 29–31, 1986.Google Scholar
  236. 236.
    Travis WD, Pittaluga S, Lipschik GY, et al: Atypical pathologic manifestations of Pneumocystis carinii pneumonia in acquired immune deficiency syndrome. Am J Surg Pathol 14: 615–625, 1990.PubMedGoogle Scholar
  237. 237.
    Gurney JW, Bates FT: Pulmonary cystic disease: Comparison of Pneumocystis carinii pneumatoceles and bullous emphysema due to intravenous drug abuse. Radiology 173: 27–31, 1989.PubMedGoogle Scholar
  238. 238.
    Smith RL, Berkowitz KA, Aranda CP: Bronchoalveolar lavage neutrophilia seen in Pneumocystis pneumonia presenting pneumothorax. Chest 100: 865–867, 1991.PubMedGoogle Scholar
  239. 239.
    McClellan MD, Miller SB, Parsons PE, et al: Pneumothorax with Pneumocystis carinii pneumonia in AIDS. Chest 100: 1224–1228, 1991.PubMedGoogle Scholar
  240. 240.
    Pinsk R, Rogers LF: Cystic parenchymal changes associated with spontaneous pneumothorax in an HIV-positive patient. Chest 97: 1471–1472, 1990.PubMedGoogle Scholar
  241. 241.
    McFadden RG, Carr TJ, Mackie IDF: Thoracic magnetic resonance imaging in the evaluation of HIV-1/AIDS pneumonitis. Chest 101: 371–374, 1992.PubMedGoogle Scholar
  242. 242.
    Hill AR, Premkumar S, Brustein S, et al: Disseminated tuberculosis in the acquired immunodeficiency syndrome era. Am Rev Respir Dis 144: 1164–1170, 1991.PubMedGoogle Scholar
  243. 243.
    Long R, Maycher B, Scalcini M, et al: The chest roentgenogram in pulmonary tuberculosis patients seropositive for human immunodeficiency virus type 1. Chest 99: 123–127, 1991.PubMedGoogle Scholar
  244. 244.
    Flora GS, Modilevsky T, Antoniskis D, et al: Undiagnosed tuberculosis in patients with human immunodeficiency virus infection. Chest 98: 1056–1059, 1990.PubMedGoogle Scholar
  245. 245.
    Barnes PF, Bloch AB, Davidson PT, et al: Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med 324: 1644–1650, 1991.PubMedGoogle Scholar
  246. 246.
    Pastores SM, Naidich DP, Aranda C, et al: Intrathoracic adenopathy associated with pulmonary tuberculosis in patients with human immunodeficiency virus infection. Chest 103: 1433–1437, 1993.PubMedGoogle Scholar
  247. 247.
    Horsburgh CR: Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med 324: 1332–1338, 1991.PubMedGoogle Scholar
  248. 248.
    Magnenat JL, Nicod LP, Auckenthaler R, et al: Mode of presentation and diagnosis of bacterial pneumonia in human immunodeficiency virus-infected patients. Am Rev Respir Dis 144: 917–922, 1991.PubMedGoogle Scholar
  249. 249.
    Sadaghdar H, Eden E: Pulmonary Kaposi’s sarcoma presenting as fulminant respiratory failure. Chest 100: 858–860, 1991.PubMedGoogle Scholar
  250. 250.
    Naidich DP, Tarras M, Garay SM, et al: Kaposi’s sarcoma: CT-radiographic correlation. Chest 96: 723–728, 1989.PubMedGoogle Scholar
  251. 251.
    Garay SM, Belenko M, Fazzine I, et al: Pulmonary manifestations of Kaposi’s sarcoma. Chest 91: 39–43, 1987.PubMedGoogle Scholar
  252. 252.
    Nathan S, Vaghaiwalla R, Mohsenifar Z: Use of Nd: YAG laser in endobronchial Kaposi’s sarcoma. Chest 98: 1299–1300, 1990.PubMedGoogle Scholar
  253. 253.
    Lee VW, Fuller JD, O’Brien MJ, et al: Pulmonary Kaposi sarcoma in patients with AIDS: Scintigraphic diagnosis with sequential thallium and gallium scanning. Radiology 180: 409–412, 1991.PubMedGoogle Scholar
  254. 254.
    Chechani V, Kamholz SL: Pulmonary manifestations of disseminated cryptococcosis in patients with AIDS. Chest 98: 1060–1066, 1990.PubMedGoogle Scholar
  255. 255.
    Zuger A, Louie E, Holzman RS, et al: Cryptococcal disease in patients with the acquired immunodeficiency syndrome. Ann Intern Med 104: 234–240, 1986.PubMedGoogle Scholar
  256. 256.
    Denning DW, Follansbee SE, Scolaro M, et al: Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 324: 654–662, 1991.PubMedGoogle Scholar
  257. 257.
    Sider L, Weiss AJ, Smith MD, et al: Varied appearance of AIDS-related lymphoma in the chest. Radiology 171: 629–632, 1989.PubMedGoogle Scholar
  258. 258.
    Heitzman ER: Pulmonary neoplastic and lymphoproliferative disease in AIDS: A review. Radiology 177: 347–351, 1990.PubMedGoogle Scholar
  259. 259.
    Townsend RR: CT of AIDS-related lymphoma. Am J Roentgenol 156: 969–974, 1991.Google Scholar
  260. 260.
    Vanarthos WJ, Ganz WI, Vanarthos JC, et al: Diagnostic uses of nuclear medicine in AIDS. RadioGraphics 12: 731–749, 1992.PubMedGoogle Scholar
  261. 261.
    Bottles K, McPhaul LW, Volberding P: Fine-needle aspiration biosy of patients with acquired immunodeficiency syndrome (AIDS): Experience in an outpatient clinic. Ann Intern Med 108: 42–45, 1988.PubMedGoogle Scholar
  262. 262.
    Herts BR, Megibow AJ, Birnbaum BA, et al: High-attenuation lymphadenopathy in AIDS patients: Significance of findings at CT. Radiology 185: 777–781, 1992.PubMedGoogle Scholar
  263. 263.
    Aisner J, Schimpff SC, Wiernik PH: Treatment of invasive aspergillosis: Relation of early diagnosis and treatment to response. Ann Intern Med 86: 539–543, 1977.PubMedGoogle Scholar
  264. 264.
    Rubin RH, Tolkoff-Rubin NE: The problem of human immunodeficiency virus (HIV) infection and transplantation. Transplant Int 1: 36–42, 1988.Google Scholar
  265. 265.
    Schaefer JC, Yu B, Armstrong D: An Aspergillus immunodiffusion test in the early diagnosis of aspergillosis in adult leukemia patients. Am Rev Respir Dis 113: 325–329, 1976.PubMedGoogle Scholar
  266. 266.
    Filice G, Yu B, Armstrong D: Immunodiffusion and agglutination tests for Candida in patients with neoplastic disease: Inconsistent correlation of results with invasive disease. J Infect Dis 135: 349–357, 1977.PubMedGoogle Scholar
  267. 267.
    Edwards JE Jr, Lehrer RI, Stiehm ER, et al: Severe candidal infections: Clinical perspective, immune defense mechanisms, and current concepts of therapy. Ann Intern Med 89: 91–106, 1978.PubMedGoogle Scholar
  268. 268.
    Rubin RH: Systemic mycotic infections. In Rubenstein E, Federman DD (eds): Scientific American’s Medicine, Section 7, Subsection IX. Scientific American, New York, 1993, pp. 1–21.Google Scholar
  269. 269.
    Murray PR, Washington JA II: Microscopic and bacteriologic analysis of expectorated sputum. Mayo Clin Proc 50: 339–344, 1975.PubMedGoogle Scholar
  270. 270.
    Bodey GP, Powell RD, Hersh EM, et al: Pulmonary complications of acute leukemia. Cancer 19: 781–793, 1966.PubMedGoogle Scholar
  271. 271.
    Sickles EA, Young VM, Greene WH, et al: Pneumonia in acute leukemia. Ann Intern Med 79: 528–534, 1973.PubMedGoogle Scholar
  272. 272.
    Aisner J, Kuols LK, Sickles EA, et al: Transtracheal selective bronchial brushing for pulmonary infiltrates in patients with cancer. Chest 69: 367–371, 1976.PubMedGoogle Scholar
  273. 273.
    Bigby TD, Margolskee D, Curtis JL, et al: The usefulness of induced sputum in the diagnosis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. Am Rev Resp Dis 133: 515–518, 1986.PubMedGoogle Scholar
  274. 274.
    Pitchenik AE, Ganjei P, Torres A, et al: Sputum examination for the diagnosis of Pneumocystis carinii pneumonia in AIDS. Am Rev Resp Dis 133: 226–229, 1986.PubMedGoogle Scholar
  275. 275.
    Kovacs JA, Ng JL, Masur H, et al: Diagnosis of Pneumocystis carinii pneumonia: Improved detection in sputum with use of monoclonal antibodies. N Engl J Med 318: 589–593, 1988.PubMedGoogle Scholar
  276. 276.
    O’Brien RF, Quinn JL, Miyahara BT, et al: Diagnosis of Pneumocystis carinii pneumonia by induced sputum in a city with moderate incidence of AIDS. Chest 95: 136–138, 1989.PubMedGoogle Scholar
  277. 277.
    Masur H, Shelhamer J, Parrillo JE: The management of pneumonias in immunocompromised patients. JAMA 253: 1769–1773, 1985.PubMedGoogle Scholar
  278. 278.
    Barlett JG: Diagnostic accuracy of transtracheal aspiration: Bacteriologic studies. Am Rev Respir Dis 115: 777–782, 1977.Google Scholar
  279. 279.
    Matthay RA, Moritz ED: Invasive procedures for diagnosing pulmonary infection: A critical review. Clin Chest Med 2: 3–19, 1981.PubMedGoogle Scholar
  280. 280.
    Verra F, Mouda H, Rauss A, et al: Bronchoalveolar lavage in immunocompromised patients: Clinical and functional consequences. Chest 101: 1215–1220, 1992.PubMedGoogle Scholar
  281. 281.
    Thiede WH, Banaszak GF: Selective bronchial catheterization. N Engl J Med 286: 525–528, 1972.Google Scholar
  282. 282.
    Repsher LH, Schröter G, Hammon WS: Diagnosis of Pneumocystis carinii. N Engl J Med 287: 340–341, 1972.PubMedGoogle Scholar
  283. 283.
    Finley R, Kieff E, Thompson S, et al: Bronchial brushing in the diagnosis of pulmonary disease in patients at risk for opportunistic infection. Am Rev Respir Dis 109: 379–386, 1974.PubMedGoogle Scholar
  284. 284.
    Xaubet A, Torres A, Marco F, et al: Pulmonary infiltrates in immunocompromised patients: Diagnostic value of telescopic plugged catheter and bronchoalveolar lavage. Chest 95: 130–135, 1989.PubMedGoogle Scholar
  285. 285.
    Weldon-Linne CM, Rhone DP, Bourassa R: Bronchoscopy specimens in adults with AIDS: Comparative yields of cytology, histology, and cultures for diagnosis of infectious agents. Chest 98: 24–28, 1990.PubMedGoogle Scholar
  286. 286.
    Malabonga VM, Basti J, Kamholz SL: Utility of bronchoscopic sampling techniques for cryptococcal disease in AIDS. Chest 99: 370–372, 1991.PubMedGoogle Scholar
  287. 287.
    Mason GR, Hashimoto CH, Dickman PS, et al: Prognostic implications of bronchoalveolar lavage neutrophilia in patients with Pneumocystis carinii pneumonia and AIDS. Am Rev Respir Dis 139: 1336–1342, 1989.PubMedGoogle Scholar
  288. 288.
    Saito H, Anaissie GE, Morice RC, et al: Bronchoalveolar lavage in the diagnosis of pulmonary infiltrates in patients with acute leukemia. Chest 94: 745–749, 1988.PubMedGoogle Scholar
  289. 289.
    Kovalski R, Hansen-Flaschen J, Lodato RF, et al: Localized pulmonary infiltrates: Diagnosis by bronchoscopy and resolution with therapy. Chest 97: 674–678, 1990.PubMedGoogle Scholar
  290. 290.
    Beyt BE Jr, King DK, Glew RH: Fatal pneumonitis and septicemia after fiberoptic bronchoscopy. Chest 72: 105–107, 1977.PubMedGoogle Scholar
  291. 291.
    Robbins H, Goldman AL: Failure of a “prophylactic” antimicrobial drug to prevent sepsis after fiberoptic bronchoscopy. Am Rev Respir Dis 116: 325–326, 1977.PubMedGoogle Scholar
  292. 292.
    Mehta AC, Kavuru MS, Meeker DP, et al: Transbronchial needle aspiration for histology specimens. Chest 96: 1228–1232, 1989.PubMedGoogle Scholar
  293. 293.
    Dijkman JH, van der Meer JWM, Bakker W, et al: Transpleural lung biopsy by the thoracoscopic route in patients with diffuse interstitial pulmonary disease. Chest 82: 76–83, 1982.PubMedGoogle Scholar
  294. 294.
    Lloyd MS: Thoracoscopy and biopsy in the diagnosis of pleurisy with effusion. Q Bull Sea View Hosp 14: 128–133, 1953.PubMedGoogle Scholar
  295. 295.
    DeCamp PT, Mosley PW, Scott ML, et al: Diagnostic thoracoscopy. Ann Thorac Surg 16: 79–84, 1973.Google Scholar
  296. 296.
    Oldenburg FA, Newhouse MT: Thoracoscopy: A safe, accurate diagnostic procedure using the rigid thoracoscope and local anesthesia. Chest 75: 45–50, 1979.PubMedGoogle Scholar
  297. 297.
    Faling LJ: New advances in diagnosing nosocomial pneumonia in intubated patients. Part I. Am Rev Respir Dis 137: 253–255, 1988.PubMedGoogle Scholar
  298. 298.
    Marquette CH, Ramon P, Courcol R, et al: Bronchoscopic protected catheter brush for the diagnosis of pulmonary infections. Chest 93: 746–750, 1988.PubMedGoogle Scholar
  299. 299.
    Wimberley N, Faling LJ, Bartlett JG: A fiberoptic bronchoscopy technique to obtain uncontaminated lower airway secretions for bacterial culture. Am Rev Respir Dis 119: 337–343, 1979.PubMedGoogle Scholar
  300. 300.
    Westcott JL: Percutaneous transthoracic needle biopsy: State of the art. Radiology 169: 593–601, 1988.PubMedGoogle Scholar
  301. 301.
    Perlmutt LM, Johnston WW, Dunnick NR: Percutaneous transthoracic needle aspiration: A review. Am J Roentgenol 152: 451–455, 1989.Google Scholar
  302. 302.
    Conces DJ Jr, Clark SA, Tarver RD, et al: Transthoracic aspiration needle biopsy: Value in the diagnosis of pulmonary infections. Am J Roentgenol 152: 31–34, 1989.Google Scholar
  303. 303.
    Greene R, Szyfelbein W, Isler RJ, et al: Supplementary tissue core histology from fine needle transthoracic aspiration biopsy. Am J Roentgenol 144: 787–792, 1985.Google Scholar
  304. 304.
    Greene R: Transthoracic needle aspiration biopsy. In Athanasoulis C, Pfister R, Greene R, et al (eds): Interventional Radiology. W. B. Saunders, Philadelphia, 1981, pp. 587–634.Google Scholar
  305. 305.
    Scott WW, Kuhlman JE: Focal pulmonary lesions in patients with AIDS: Percutaneous transthoracic needle biopsy. Radiology 180: 419–421, 1991.PubMedGoogle Scholar
  306. 306.
    Miller KS, Fish GB, Stanley JH, et al: Prediction of pneumothorax rate in percutaneous needle aspiration of the lung. Chest 93: 742–745, 1988.PubMedGoogle Scholar
  307. 307.
    Moore EH, Shepard JO, McCloud TC, et al: Positional precautions in needle aspiration lung biopsy. Radiology 175: 733–735, 1990.PubMedGoogle Scholar
  308. 308.
    Zavala DC, Bedell GN, Rossi NP: Trephine lung biopsy with a high-speed air drill. J Thorac Cardiovasc Surg 64: 220–228, 1972.PubMedGoogle Scholar
  309. 309.
    McCartney RL: Hemorrhage following percutaneous lung biopsy. Radiology 112: 305–307, 1974.PubMedGoogle Scholar
  310. 310.
    Clore F, Virapongse C, Saterfiel J: Low-risk large-needle biopsy of chest lesions. Chest 96: 538–541, 1989.PubMedGoogle Scholar
  311. 311.
    Goralnick CH, O’Connell DM, El Yousef SJ, et al: CT-guided cutting-needle biopsies of selected chest lesions. Am J Roentgenol 151: 903–907, 1988.Google Scholar
  312. 312.
    Toledo-Pereyra LH, DeMeester TR, Kinealey A, et al: The benefit of open lung biopsy in patients with previous non-diagnostic transbronchial lung biopsy: A guide to appropriate therapy. Chest 77: 647–650, 1980.PubMedGoogle Scholar
  313. 313.
    Jaffe JP, Maki DG: Lung biopsy in immunocompromised patients: One institution’s experience and an approach to management of pulmonary disease in the compromised host. Cancer 48: 1144–1153, 1981.PubMedGoogle Scholar
  314. 314.
    Haverkos HW, Dowling JN, Pasculle AW, et al: Diagnosis of pneumonitis in immunocompromised patients by open lung biopsy. Cancer 52: 1093–1097, 1983.PubMedGoogle Scholar
  315. 315.
    McKenna RJ Jr, Mountain CF, McMurtey MJ: Open lung biopsy in immunocompromised patients. Chest 86: 671–674, 1984.PubMedGoogle Scholar
  316. 316.
    Cockerill FR III, Wilson WR, Carpenter HA, et al: Open lung biopsy in immunocompromised patients. Arch Intern Med 145: 1398–1404, 1985.PubMedGoogle Scholar
  317. 317.
    Cheson BD, Samlowski WE, Tang TT, et al: Value of open-lung biopsy in 87 immunocompromised patients with pulmonary infiltrates. Cancer 55: 453–459, 1985.PubMedGoogle Scholar
  318. 318.
    Catterall JR, McCabe RE, Brooks RG, et al: Open lung biopsy in patients with Hodgkin’s disease and pulmonary infiltrates. Am Rev Respir Dis 139: 1274–1279, 1989.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Robert H. Rubin
    • 1
    • 2
  • Reginald Greene
    • 3
    • 4
  1. 1.Infectious Disease and Transplantation Units, Massachusetts General Hospital, and Department of MedicineHarvard Medical SchoolBostonUSA
  2. 2.Center for Experimental Pharmacology and TherapeuticsHarvard-MIT Division of Health Sciences and TechnologyCambridgeUSA
  3. 3.Chest Division, Radiology Service, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of RadiologyHarvard Medical SchoolBostonUSA

Personalised recommendations