Respiratory Infections

  • Olga KlinkovaEmail author


Pneumonia is defined as the presence of a new pulmonary infiltrate on radiologic imaging in the patient with appropriate clinical symptoms such as fever, cough, production of purulent sputum, shortness of breath and/or hypoxia, in the absence of pulmonary edema [1, 2].


Pneumonia in neutropenic cancer patients Community acquired viruses Invasive fungal infection Diffuse alveolar hemorrhage (DAH) Cryptogenic organizing pneumonia (COP) Consolidation pneumonia Nodular and/or cavitary infiltrates “Halo” sign Reverse “halo” sign Scattered nodules Viral pneumonia Rhinosinusitis 


  1. 1.
    Kalil AC, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61–e111.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Vehreschild JJ. Pneumonia and lung infiltrates in neutropenic patients: many stones unturned. Ann Am Thorac Soc. 2013;10(5):493–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Evans SE, Ost DE. Pneumonia in the neutropenic cancer patient. Curr Opin Pulm Med. 2015;21(3):260–71.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Sousa D, et al. Community-acquired pneumonia in immunocompromised older patients: incidence, causative organisms and outcome. Clin Microbiol Infect. 2013;19(2):187–92.PubMedCrossRefGoogle Scholar
  5. 5.
    American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171(4):388–416.CrossRefGoogle Scholar
  6. 6.
    Lossos IS, et al. Bacterial pneumonia in recipients of bone marrow transplantation. A five-year prospective study. Transplantation. 1995;60(7):672–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Rolston KV. The spectrum of pulmonary infections in cancer patients. Curr Opin Oncol. 2001;13(4):218–23.PubMedCrossRefGoogle Scholar
  8. 8.
    Perez F, Adachi J, Bonomo RA. Antibiotic-resistant gram-negative bacterial infections in patients with cancer. Clin Infect Dis. 2014;59(Suppl 5):S335–9.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Rapoport B, et al. The emerging problem of bacterial resistance in cancer patients; proceedings of a workshop held by MASCC “Neutropenia, Infection and Myelosuppression” Study Group during the MASCC annual meeting held in Berlin on 27–29 June 2013. Support Care Cancer. 2016;24(7):2819–26.PubMedGoogle Scholar
  10. 10.
    Satlin MJ, et al. Emergence of carbapenem-resistant Enterobacteriaceae as causes of bloodstream infections in patients with hematologic malignancies. Leuk Lymphoma. 2013;54(4):799–806.PubMedCrossRefGoogle Scholar
  11. 11.
    Konoplev S, et al. Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients. Bone Marrow Transplant. 2001;27(8):877–81.PubMedCrossRefGoogle Scholar
  12. 12.
    Young AY, Leiva Juarez MM, Evans SE. Fungal pneumonia in patients with hematologic malignancy and hematopoietic stem cell transplantation. Clin Chest Med. 2017;38(3):479–91.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Mulanovich VE, Kontoyiannis DP. Fungal pneumonia in patients with hematologic malignancies: current approach and management. Curr Opin Infect Dis. 2011;24(4):323–32.PubMedCrossRefGoogle Scholar
  14. 14.
    Souza JP, et al. High rates of pneumocystis carinii pneumonia in allogeneic blood and marrow transplant recipients receiving dapsone prophylaxis. Clin Infect Dis. 1999;29(6):1467–71.PubMedCrossRefGoogle Scholar
  15. 15.
    Yale SH, Limper AH. Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin Proc. 1996;71(1):5–13.PubMedCrossRefGoogle Scholar
  16. 16.
    Henkle E, Winthrop KL. Nontuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 2015;36(1):91–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Maschmeyer G. Pneumonia in febrile neutropenic patients: radiologic diagnosis. Curr Opin Oncol. 2001;13(4):229–35.PubMedCrossRefGoogle Scholar
  18. 18.
    Maschmeyer G, et al. Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): updated guidelines of the infectious diseases working party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol. 2015;26(1):21–33.PubMedCrossRefGoogle Scholar
  19. 19.
    Maschmeyer G, et al. Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients: guidelines of the infectious diseases working party of the German Society of Haematology and Oncology. Eur J Cancer. 2009;45(14):2462–72.PubMedCrossRefGoogle Scholar
  20. 20.
    Patterson TF, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63(4):e1–e60.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Satish Kumar Bajaj BT. Respiratory infections in immunocompromised patients: lung findings using chest computed tomography. Radiol Infect Dis. 2017;4:29–37.CrossRefGoogle Scholar
  22. 22.
    Wahba H, et al. Reversed halo sign in invasive pulmonary fungal infections. Clin Infect Dis. 2008;46(11):1733–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Farooq A, Alrabaa S, Quilitz R, Yacoub A, Maroon ME, Fulp W, Sandin R, Greene JN. Comparison of clinical and radiological features of aspergillus, zygomycosis, and fusarium pneumonia in neutropenic patients. Infect Dis Clin Pract. 2014;22(5):288–93.CrossRefGoogle Scholar
  24. 24.
    Hohenadel IA, et al. Role of bronchoalveolar lavage in immunocompromised patients with pneumonia treated with a broad spectrum antibiotic and antifungal regimen. Thorax. 2001;56(2):115–20.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Kuehnhardt D, et al. Therapeutic implication of BAL in patients with neutropenia. Ann Hematol. 2009;88(12):1249–56.PubMedCrossRefGoogle Scholar
  26. 26.
    Freifeld AG, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):e56–93.PubMedCrossRefGoogle Scholar
  27. 27.
    Carcas AJ, et al. Tobramycin penetration into epithelial lining fluid of patients with pneumonia. Clin Pharmacol Ther. 1999;65(3):245–50.PubMedCrossRefGoogle Scholar
  28. 28.
    Mandell LA, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27–72.PubMedCrossRefGoogle Scholar
  29. 29.
    Maschmeyer G, et al. ECIL guidelines for treatment of pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients. J Antimicrob Chemother. 2016;71(9):2405–13.PubMedCrossRefGoogle Scholar
  30. 30.
    Lemiale V, et al. Adjunctive steroid in HIV-negative patients with severe pneumocystis pneumonia. Respir Res. 2013;14:87.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Vakil E, Evans SE. Viral pneumonia in patients with hematologic malignancy or hematopoietic stem cell transplantation. Clin Chest Med. 2017;38(1):97–111.PubMedCrossRefGoogle Scholar
  32. 32.
    Marchesi F, et al. Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant. Hematol Oncol. 2018;36(2):381–91.PubMedCrossRefGoogle Scholar
  33. 33.
    Khanna N, et al. Respiratory syncytial virus infection in patients with hematological diseases: single-center study and review of the literature. Clin Infect Dis. 2008;46(3):402–12.PubMedCrossRefGoogle Scholar
  34. 34.
    Weigt SS, et al. Respiratory viral infections in hematopoietic stem cell and solid organ transplant recipients. Semin Respir Crit Care Med. 2011;32(4):471–93.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Torres HA, et al. Characteristics and outcome of respiratory syncytial virus infection in patients with leukemia. Haematologica. 2007;92(9):1216–23.PubMedCrossRefGoogle Scholar
  36. 36.
    Waghmare A, Englund JA, Boeckh M. How I treat respiratory viral infections in the setting of intensive chemotherapy or hematopoietic cell transplantation. Blood. 2016;127(22):2682–92.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Chemaly RF, et al. The characteristics and outcomes of parainfluenza virus infections in 200 patients with leukemia or recipients of hematopoietic stem cell transplantation. Blood. 2012;119(12):2738–45; quiz 2969.PubMedCrossRefGoogle Scholar
  38. 38.
    Marinez J, Vincent AL, Sandin RL, Greene JN. Interferon Alfa-2b as a successful treatment for parainfluenza virus pneumonia in a non-hodgkin lymphoma patient. Infect Dis Clin Pract. 2008;16(3):187–9.CrossRefGoogle Scholar
  39. 39.
    Rosenfeld RM. CLINICAL PRACTICE. Acute sinusitis in adults. N Engl J Med. 2016;375(10):962–70.PubMedCrossRefGoogle Scholar
  40. 40.
    Brook I. Microbiology of sinusitis. Proc Am Thorac Soc. 2011;8(1):90–100.PubMedCrossRefGoogle Scholar
  41. 41.
    Rosenfeld RM, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1–S39.PubMedGoogle Scholar
  42. 42.
    Ito CJ, Jackson RS, Castro-Borobio M, Nanjappa S, Klinkova O, Phommachanh V, Keeler JA, Greene JN, Padhya TA, Tabor MH. Microbiology of acute rhinosinusitis in immunosuppressed patients. Infect Dis Clin Pract. 2017;25:260–3.CrossRefGoogle Scholar
  43. 43.
    Davoudi S, et al. Invasive mould sinusitis in patients with haematological malignancies: a 10 year single-centre study. J Antimicrob Chemother. 2015;70(10):2899–905.PubMedCrossRefGoogle Scholar
  44. 44.
    DelGaudio JM, et al. Computed tomographic findings in patients with invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg. 2003;129(2):236–40.PubMedCrossRefGoogle Scholar
  45. 45.
    DelGaudio JM, Clemson LA. An early detection protocol for invasive fungal sinusitis in neutropenic patients successfully reduces extent of disease at presentation and long term morbidity. Laryngoscope. 2009;119(1):180–3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Moffitt Cancer CenterTampaUSA

Personalised recommendations