Rosenow E C
Mayo Medical School, Rochester, Minnesota.
Clin Chest Med. 1990 Mar;11(1):55-64.
Diffuse pulmonary infiltrates in the immunocompromised host in the majority represent an opportunistic infection. However, in about 25 to 30%, they represent complications of an adverse drug reaction, recurrence of the underlying disease such as leukemia or lymphoma involving the lung, or an idiopathic "fibrosis," and in a small percentage are attributable to an "unrelated" process such as congestive heart failure, pulmonary emboli, community-acquired pneumonia, and so on. In 10 to 20% of the patients, two or more of these processes occur. A pulmonary process in the immunocompromised patient is almost always fatal unless the clinician intervenes with the proper diagnosis and/or effective empiric therapy.
免疫功能低下宿主出现的弥漫性肺浸润,多数情况下代表机会性感染。然而,约25%至30%的情况是药物不良反应的并发症、潜在疾病(如累及肺部的白血病或淋巴瘤)的复发、或特发性“纤维化”,还有一小部分归因于“不相关”的过程,如充血性心力衰竭、肺栓塞、社区获得性肺炎等。10%至20%的患者会出现两种或更多上述情况。免疫功能低下患者的肺部病变如果临床医生不进行正确诊断和/或有效的经验性治疗,几乎总会致命。