Pneumonia in the neutropenic cancer patient

Research output: Contribution to journalReview articlepeer-review

56 Scopus citations

Abstract

Purpose of review Pneumonia is the leading cause of death among neutropenic cancer patients, particularly those with acute leukaemia. Even with empiric therapy, case fatality rates of neutropenic pneumonias remain unacceptably high. However, recent advances in the management of neutropenic pneumonia offer hope for improved outcomes in the cancer setting. This review summarizes recent literature regarding the clinical presentation, microbiologic trends, diagnostic advances and therapeutic recommendations for cancer-related neutropenic pneumonia. Recent findings Although neutropenic patients acquire pathogens both in community and nosocomial settings, patients' obligate healthcare exposures result in the frequent identification of multidrug-resistant bacterial organisms on conventional culture-based assessment of respiratory secretions. Modern molecular techniques, including expanded use of galactomannan testing, have further facilitated identification of fungal pathogens, allowing for aggressive interventions that appear to improve patient outcomes. Multiple interested societies have issued updated guidelines for antibiotic therapy of suspected neutropenic pneumonia. The benefit of antibiotic medications may be further enhanced by agents that promote host responses to infection. Summary Neutropenic cancer patients have numerous potential causes for pulmonary infiltrates and clinical deterioration, with lower respiratory tract infections among the most deadly. Early clinical suspicion, diagnosis and intervention for neutropenic pneumonia provide cancer patients' best hope for survival.

Original languageEnglish (US)
Pages (from-to)260-271
Number of pages12
JournalCurrent opinion in pulmonary medicine
Volume21
Issue number3
DOIs
StatePublished - May 7 2015

Keywords

  • cancer
  • galactomannan
  • leukaemia
  • neutropenia
  • pneumonia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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