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Cited by 346

The DOI matches its Crossref record; 93 of the 93 references it cites were found in a registry or an index.

Diagnosis of severe respiratory infections in immunocompromised patients

Open access
Azoulay, Elie, Russell, Lene, Van de Louw, Andry, Metaxa, Victoria, Bauer, Philippe, Povoa, Pedro, Montero, José Garnacho, Loeches, Ignacio Martin, Mehta, Sangeeta, Puxty, Kathryn, Schellongowski, Peter, Rello, Jordi, Mokart, Djamel, Lemiale, Virginie, Mirouse, Adrien, the Nine-i Investigators·2020·Intensive Care Medicine
DOI 10.1007/s00134-019-05906-5
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Abstract

An increasing number of critically ill patients are immunocompromised. Acute hypoxemic respiratory failure (ARF), chiefly due to pulmonary infection, is the leading reason for ICU admission. Identifying the cause of ARF increases the chances of survival, but may be extremely challenging, as the underlying disease, treatments, and infection combine to create complex clinical pictures. In addition, there may be more than one infectious agent, and the pulmonary manifestations may be related to both infectious and non-infectious insults. Clinically or microbiologically documented bacterial pneumonia accounts for one-third of cases of ARF in immunocompromised patients. Early antibiotic therapy is recommended but decreases the chances of identifying the causative organism(s) to about 50%. Viruses are the second most common cause of severe respiratory infections. Positive tests for a virus in respiratory samples do not necessarily indicate a role for the virus in the current acute illness. Invasive fungal infections ( Aspergillus , Mucorales , and Pneumocystis jirovecii ) account for about 15% of severe respiratory infections, whereas parasites rarely cause severe acute infections in immunocompromised patients. This review focuses on the diagnosis of severe respiratory infections in immunocompromised patients. Special attention is given to newly validated diagnostic tests designed to be used on non-invasive samples or bronchoalveolar lavage fluid and capable of increasing the likelihood of an early etiological diagnosis.

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Metadata

Authors
Azoulay, E., Russell, L., Van de Louw, A., Metaxa, V., Bauer, P., Povoa, P., Montero, J. G., Loeches, I. M., Mehta, S., Puxty, K., Schellongowski, P., Rello, J., Mokart, D., Lemiale, V., Mirouse, A., & the Nine-i Investigators
Venue
Intensive Care Medicine
Publisher
Springer Science and Business Media LLC
Published
2020-02
Volume
46
Issue
2
Pages
298-314
ISSN
  • 0342-4642 (ISSN-L)
  • 1432-1238
DOI
10.1007/s00134-019-05906-5
OpenAlex
W3004917317
Cited by
346
References
93
FWCI
19.67
Type
journal article
Language
en
Open access
bronze

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