Lung Infections in Immunocompromised

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Lung Infections in Immunocompromised

Causes

• Tranplantation
• AIDS
  • classically get Pneumocystis carinii pneumonia
• Diabetes Mellitus
• Carcinoma
• Steroids

Organisms

• Pneumocystis carinii
  • breathlessness and cough
  • diffuse bilateral perihilar shadows
  • hypoxaemia especially on exertion
• Mycobacterium tuberculosis
• Mycobacterium avium intracellulare
• CMV
• HSV
• Fungi
• Streptococcus pneumoniae and 'conventional' pathogens
• Toxoplasma

Other Problems

• Kaposi's Sarcoma
• Lymphoma

Investigations

• cultures
  • sputum
  • induced sputum
• bronchoscopy
  • lavage
  • biopsy

Treatment

• PCP
  • co-trimoxazole
  • +/- steroids
  • consider as prophylaxis

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