Wong Justin L, Evans Scott E
Division of Internal Medicine, Department of Pulmonary, Critical Care and Sleep Medicine, The University of Texas Health Sciences Center, 6431 Fannin Street, MSB 1.434, Houston, TX 77030, USA.
Division of Internal Medicine, Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1100, Houston, TX 77030, USA.
Clin Chest Med. 2017 Jun;38(2):263-277. doi: 10.1016/j.ccm.2016.12.005. Epub 2017 Mar 1.
Bacterial pneumonias exact unacceptable morbidity on patients with cancer. Although the risk is often most pronounced among patients with treatment-induced cytopenias, the numerous contributors to life-threatening pneumonias in cancer populations range from derangements of lung architecture and swallow function to complex immune defects associated with cytotoxic therapies and graft-versus-host disease. These structural and immunologic abnormalities often make the diagnosis of pneumonia challenging in patients with cancer and impact the composition and duration of therapy. This article addresses host factors that contribute to pneumonia susceptibility, summarizes diagnostic recommendations, and reviews current guidelines for management of bacterial pneumonia in patients with cancer.
细菌性肺炎给癌症患者带来了难以接受的发病率。尽管这种风险在因治疗导致血细胞减少的患者中往往最为显著，但癌症患者发生危及生命的肺炎的众多因素，涵盖了从肺部结构和吞咽功能紊乱到与细胞毒性疗法及移植物抗宿主病相关的复杂免疫缺陷。这些结构和免疫异常常常使癌症患者的肺炎诊断具有挑战性，并影响治疗的组成和持续时间。本文探讨了导致肺炎易感性的宿主因素，总结了诊断建议，并综述了癌症患者细菌性肺炎管理的现行指南。
