Respiratory infection in an immunocompromised person - Revision history

Aidan at 17:40, 10 March 2022

2022-03-10T17:40:14Z

← Older revision		Revision as of 17:40, 10 March 2022
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	\|Steroids and solid organ transplantation		\|Steroids and solid organ transplantation
	\| rowspan="4" \|opportunistic infections, systemic viruses, [[Pneumocystis]], [[Cryptococcus]], [[Mycobacteria]], [[Toxoplasma]]		\| rowspan="4" \|opportunistic infections, systemic viruses, [[Pneumocystis]], [[Cryptococcus]], [[Mycobacteria]], [[Toxoplasma]]
	\| rowspan="4" \|sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan		\| rowspan="4" \|sputum and blood culture, antigenuria, multiplex viral PCR, [[CMV]]/[[HSV]]/[[VZV]] PCR, bronchoalveolar lavage, [[Toxoplasma]]/[[Cryptococcus]] PCR, induced sputum, beta-D glucan
	\|-		\|-
	\|[[Hairy cell leukemia]], [[acute T-cell leukemia]], [[T-cell lymphoma]]		\|[[Hairy cell leukemia]], [[acute T-cell leukemia]], [[T-cell lymphoma]]
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	\|Steroids and solid organ transplantation		\|Steroids and solid organ transplantation
	\| rowspan="5" \|systemic viruses, [[Aspergillus]], [[Mycobacteria]], [[Nocardia]], [[Mucorales]], [[Toxoplasma]]		\| rowspan="5" \|systemic viruses, [[Aspergillus]], [[Mycobacteria]], [[Nocardia]], [[Mucorales]], [[Toxoplasma]]
	\| rowspan="5" \|sputum and blood cultures, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, induced sputum, bronchoalveolar lavage, fungal culture of sputum, [[β-D glucan]] and [[galactomannan]], Aspergillus PCR, Toxoplasma/Cryptococcus PCR		\| rowspan="5" \|sputum and blood cultures, antigenuria, multiplex viral PCR, [[CMV]]/[[HSV]]/[[VZV]] PCR, induced sputum, bronchoalveolar lavage, fungal culture of sputum, [[β-D glucan]] and [[galactomannan]], Aspergillus PCR, Toxoplasma/Cryptococcus PCR
	\|-		\|-
	\|[[Neutropenia]]		\|[[Neutropenia]]
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	\|nodular lesions		\|nodular lesions
	\|bacterial pneumonia, [[Aspergillus]], [[Nocardia]], [[Mucorales]]		\|bacterial pneumonia, [[Aspergillus]], [[Nocardia]], [[Mucorales]]
	\|sputum and blood cultures, antigenuria, sputum with fungal culture, Aspergillus/Mucorales PCR, [[galactomannan]] and [[β-D glucan]], bronchoalveolar lavage		\|sputum and blood cultures, antigenuria, sputum with fungal culture, [[Aspergillus]]/[[Mucorales]] PCR, [[galactomannan]] and [[β-D glucan]], bronchoalveolar lavage
	\|-		\|-
	\|septal thickening		\|septal thickening
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	\|cavitations		\|cavitations
	\|[[Mycobacteria]], [[Histoplasma]], bacterial pneumonia including [[Staphylococcus aureus]]		\|[[Mycobacteria]], [[Histoplasma]], bacterial pneumonia including [[Staphylococcus aureus]]
	\|sputum and blood cultures, mycobacterial culture, Histoplasma PCR		\|sputum and blood cultures, mycobacterial culture, [[Histoplasma]] PCR
	\|-		\|-
	\|excavated nodules		\|excavated nodules
	\|bacterial pneumonia, [[Mucorales]], [[Nocardia]], [[Actinomyces]], [[Aspergillus]]		\|bacterial pneumonia, [[Mucorales]], [[Nocardia]], [[Actinomyces]], [[Aspergillus]]
	\|sputum and blood cultures, Aspergillus/Nocardia/Mucorales PCR, [[galactomannan]] and [[β-D glucan]]		\|sputum and blood cultures, [[Aspergillus]]/[[Nocardia]]/[[Mucorales]] PCR, [[galactomannan]] and [[β-D glucan]]
	\|-		\|-
	\|consolidation		\|consolidation
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	\|ground glass opacities		\|ground glass opacities
	\|[[Pneumocystis]], viral pneumonia, atypical bacterial pneumonia		\|[[Pneumocystis]], viral pneumonia, atypical bacterial pneumonia
	\|sputum and blood culture, Legionella antigenuria, sputum for Pneumocystis, β-D glucan, multiplex viral PCR, CMV/VZV/HSV blood PCR, bronchoalveolar lavage		\|sputum and blood culture, [[Legionella]] antigenuria, sputum for [[Pneumocystis]], β-D glucan, multiplex viral PCR, [[CMV]]/[[VZV]]/[[HSV]] blood PCR, bronchoalveolar lavage
	\|}		\|}

Aidan: /* By Defect */

2021-11-01T14:17:25Z

By Defect

← Older revision		Revision as of 14:17, 1 November 2021
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	\|-		\|-
	\|Steroids and solid organ transplantation		\|Steroids and solid organ transplantation
	\| rowspan="3" \|opportunistic infections, systemic viruses, [[Pneumocystis]], [[Cryptococcus]], [[Mycobacteria]], [[Toxoplasma]]		\| rowspan="4" \|opportunistic infections, systemic viruses, [[Pneumocystis]], [[Cryptococcus]], [[Mycobacteria]], [[Toxoplasma]]
	\| rowspan="3" \|sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan		\| rowspan="4" \|sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan
	\|-		\|-
	\|[[Hairy cell leukemia]], [[acute T-cell leukemia]], [[T-cell lymphoma]]		\|[[Hairy cell leukemia]], [[acute T-cell leukemia]], [[T-cell lymphoma]]
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	\|-		\|-
	\|[[HIV]]		\|[[HIV]]
	\|
	\|
	\|-		\|-
	! colspan="3" \|Humoural Immunodeficiency		! colspan="3" \|Humoural Immunodeficiency

Aidan: /* By Defect */

2021-02-16T01:45:57Z

By Defect

← Older revision		Revision as of 01:45, 16 February 2021
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	== Differential Diagnosis ==		==Differential Diagnosis==

	=== By Defect ===		===By Defect===
	{\| class="wikitable"		{\| class="wikitable"
	!Risk Factor		!Risk Factor
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	\| rowspan="3" \|sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan		\| rowspan="3" \|sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan
	\|-		\|-
	\|Hairy cell leukemia, acute T-cell leukemia, T-cell lymphoma		\|[[Hairy cell leukemia]], [[acute T-cell leukemia]], [[T-cell lymphoma]]
	\|-		\|-
	\|Fludarabine, ibrutinib, alemtuzumab		\|[[Fludarabine]], [[ibrutinib]], [[alemtuzumab]]
			\|-
			\|[[HIV]]
			\|
			\|
	\|-		\|-
	! colspan="3" \|Humoural Immunodeficiency		! colspan="3" \|Humoural Immunodeficiency
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	\|Complement deficiency		\|Complement deficiency
	\|-		\|-
	\|Common variable immunodeficiency		\|[[Common variable immunodeficiency]]
	\|-		\|-
	\|Rituximab and other anti-CD20 therapy		\|[[Rituximab]] and other anti-CD20 therapy
	\|-		\|-
	\|Multiple myeloma and CLL		\|[[Multiple myeloma]] and [[CLL]]
	\|-		\|-
	! colspan="3" \|Phagocyte Defects		! colspan="3" \|Phagocyte Defects
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	\| rowspan="5" \|sputum and blood cultures, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, induced sputum, bronchoalveolar lavage, fungal culture of sputum, [[β-D glucan]] and [[galactomannan]], Aspergillus PCR, Toxoplasma/Cryptococcus PCR		\| rowspan="5" \|sputum and blood cultures, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, induced sputum, bronchoalveolar lavage, fungal culture of sputum, [[β-D glucan]] and [[galactomannan]], Aspergillus PCR, Toxoplasma/Cryptococcus PCR
	\|-		\|-
	\|Neutropenia		\|[[Neutropenia]]
	\|-		\|-
	\|Myelodysplastic syndrome		\|[[Myelodysplastic syndrome]]
	\|-		\|-
	\|Acute myelogenous leukemia		\|[[Acute myelogenous leukemia]]
	\|-		\|-
	\|Allogeneic hematopoietic stem cell transplantation		\|[[Allogeneic hematopoietic stem cell transplantation]]
	\|}		\|}

	=== By CT Pattern ===		===By CT Pattern===
	{\| class="wikitable"		{\| class="wikitable"
	!Pattern		!Pattern
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	\|}		\|}

	== Further Reading ==		==Further Reading==

	* Diagnosis of severe respiratory infections in immunocompromised patients. ''Intensive Care Med''. 2020;46:298-314. doi: [https://doi.org/10.1007/s00134-019-05906-5 10.1007/s00134-019-05906-5]		*Diagnosis of severe respiratory infections in immunocompromised patients. ''Intensive Care Med''. 2020;46:298-314. doi: [https://doi.org/10.1007/s00134-019-05906-5 10.1007/s00134-019-05906-5]

	[[Category:Immunocompromised hosts]]		[[Category:Immunocompromised hosts]]

Aidan: Created page with "== Differential Diagnosis == === By Defect === {| class="wikitable" !Risk Factor !Differential Diagnosis !Investigations |- ! colspan="3" |Cell-Mediated Immunodeficiency |- |..."

2021-02-16T01:44:46Z

Created page with "== Differential Diagnosis == === By Defect === {| class="wikitable" !Risk Factor !Differential Diagnosis !Investigations |- ! colspan="3" |Cell-Mediated Immunodeficiency |- |..."

New page

== Differential Diagnosis ==

=== By Defect ===
{| class="wikitable"
!Risk Factor
!Differential Diagnosis
!Investigations
|-
! colspan="3" |Cell-Mediated Immunodeficiency
|-
|Steroids and solid organ transplantation
| rowspan="3" |opportunistic infections, systemic viruses, [[Pneumocystis]], [[Cryptococcus]], [[Mycobacteria]], [[Toxoplasma]]
| rowspan="3" |sputum and blood culture, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, bronchoalveolar lavage, Toxoplasma/Cryptococcus PCR, induced sputum, beta-D glucan
|-
|Hairy cell leukemia, acute T-cell leukemia, T-cell lymphoma
|-
|Fludarabine, ibrutinib, alemtuzumab
|-
! colspan="3" |Humoural Immunodeficiency
|-
|Splenectomy and asplenism
| rowspan="5" |bacterial pneumonia ([[Streptococcus pneumoniae]], [[Neisseria meningitidis]], [[Haemophilus influenzae]])
| rowspan="5" |sputum and blood cultures, antigenuria, multiplex viral PCR
|-
|Complement deficiency
|-
|Common variable immunodeficiency
|-
|Rituximab and other anti-CD20 therapy
|-
|Multiple myeloma and CLL
|-
! colspan="3" |Phagocyte Defects
|-
|Steroids and solid organ transplantation
| rowspan="5" |systemic viruses, [[Aspergillus]], [[Mycobacteria]], [[Nocardia]], [[Mucorales]], [[Toxoplasma]]
| rowspan="5" |sputum and blood cultures, antigenuria, multiplex viral PCR, CMV/HSV/VZV PCR, induced sputum, bronchoalveolar lavage, fungal culture of sputum, [[β-D glucan]] and [[galactomannan]], Aspergillus PCR, Toxoplasma/Cryptococcus PCR
|-
|Neutropenia
|-
|Myelodysplastic syndrome
|-
|Acute myelogenous leukemia
|-
|Allogeneic hematopoietic stem cell transplantation
|}

=== By CT Pattern ===
{| class="wikitable"
!Pattern
!Differential Diagnosis
!Investigations
|-
|nodular lesions
|bacterial pneumonia, [[Aspergillus]], [[Nocardia]], [[Mucorales]]
|sputum and blood cultures, antigenuria, sputum with fungal culture, Aspergillus/Mucorales PCR, [[galactomannan]] and [[β-D glucan]], bronchoalveolar lavage
|-
|septal thickening
|atypical bacterial pneumonia
|sputum and blood cultures, antigenuria, bronchoalveolar lavage
|-
|cavitations
|[[Mycobacteria]], [[Histoplasma]], bacterial pneumonia including [[Staphylococcus aureus]]
|sputum and blood cultures, mycobacterial culture, Histoplasma PCR
|-
|excavated nodules
|bacterial pneumonia, [[Mucorales]], [[Nocardia]], [[Actinomyces]], [[Aspergillus]]
|sputum and blood cultures, Aspergillus/Nocardia/Mucorales PCR, [[galactomannan]] and [[β-D glucan]]
|-
|consolidation
|bacterial pneumonia, [[Aspergillus]]
|sputum and blood cultures, antigenuria, sputum for fungal culture, [[galactomannan]] and [[β-D glucan]]
|-
|pleural effusion
|bacterial pneumonia, [[tuberculosis]]
|sputum and blood cultures, antigenuria, mycobacterial blood culture, pleural aspiration and culture
|-
|ground glass opacities
|[[Pneumocystis]], viral pneumonia, atypical bacterial pneumonia
|sputum and blood culture, Legionella antigenuria, sputum for Pneumocystis, β-D glucan, multiplex viral PCR, CMV/VZV/HSV blood PCR, bronchoalveolar lavage
|}

== Further Reading ==

* Diagnosis of severe respiratory infections in immunocompromised patients. ''Intensive Care Med''. 2020;46:298-314. doi: [https://doi.org/10.1007/s00134-019-05906-5 10.1007/s00134-019-05906-5]

[[Category:Immunocompromised hosts]]
[[Category:Respiratory infections]]