Aspergillosis: The Most Common Community‐Acquired Pneumonia with Gram‐Negative Bacilli as Copathogens in Stem Cell Transplant Recipients with Graft‐versus‐Host Disease
Abstract
We retrospectively reviewed all cases of pneumonia that required hospitalization among allogeneic hematopoietic stem cell transplant (HSCT) recipients with graft-versus-host disease (GVHD) during the period of January 1996 through July 1999. Twelve patients were identified among 88 allogeneic HSCT recipients. All had chronic GVHD and were receiving corticosteroid therapy. Ten of the 12 patients had pulmonary aspergillosis (PA). For 6 of these 10 patients, a gram-negative bacterial pathogen was concurrently isolated from respiratory specimens. At least one-half of the patients with PA had an initial presentation suggestive of bacterial pneumonia; PA was only suspected on the basis of chest CT findings. Aspergillosis is the most common cause of community-acquired pneumonia among allogeneic HSCT recipients with GVHD. CT must be used to exclude an underlying fungal cause in patients who present with a gram-negative pneumonia.
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IPA now predominantly manifests as a community-acquired pneumonia in nonneutropenic HSCT recipients late after engraftment.
“IPA now predominantly manifests as a community-acquired pneumonia in nonneutropenic HSCT recipients late after engraftment (76), and it is associated with the use of corticosteroids and other immunosuppressive therapies for chronic graft-versus-host disease, metabolic abnormalities, acquired iron overload syndromes, aging, cytomegalovirus (CMV) coinfection, and other comorbidities (67, 68, 71).”
From Aspergillus fumigatus and Aspergillosis in 2019 (2019) · cites this paper as [76]
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Aspergillus fumigatus and Aspergillosis in 2019
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- Authors
- Alangaden, G. J., Wahiduzzaman, M., Chandrasekar, P. H., & the Bone Marrow Transplant Group
- Affiliations
- Wayne State University (US)
- Corresponding author
- Alangaden, George J.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-09-15
- Volume
- 35
- Issue
- 6
- Pages
- 659-664
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2081985159
- Cited by
- 45
- References
- 16
- Citations by year
- 2024: 1 · 2023: 2 · 2021: 1 · 2019: 3 · 2018: 1 · 2016: 3 · 2015: 2 · 2014: 2 · 2012: 4
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Brown University
- Wayne State University
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Keywords
- pulmonary aspergillosis, community-acquired pneumonia, Gram-negative bacilli, co-infection, hematopoietic stem cell transplantation, graft-versus-host disease, chronic graft-versus-host disease, corticosteroid therapy, chest CT
- MeSH terms
- Adult, Aspergillosis, Bacillus, Female, Graft vs Host Disease, Gram-Negative Bacteria, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, Community-Acquired Infections, Hematopoietic Stem Cell Transplantation, Pneumonia, Bacterial
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