Blau Igor-Wolfgang, Heinz Werner J, Schwartz Stefan, Lipp Hans-Peter, Schafhausen Philippe, Maschmeyer Georg
Medizinische Klinik für Hämatologie, Onkologie und Tumorimmunologie, Leitender Oberarzt Knochenmarktransplantation, Campus Virchow Klinikum der Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Klinik für Hämatologie, Onkologie und Tumorimmunologie, Campus Virchow Klinikum der Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, D-13353, Berlin, Deutschland.
MMW Fortschr Med. 2018 Jul;160(Suppl 4):12-17. doi: 10.1007/s15006-018-0727-2. Epub 2018 Jul 4.
Pulmonary complications are frequent in haematologic patients.
This review article summarizes the outcome of a discussion that took place during an expert meeting on the subject of pulmonary infiltrates.
The most common causes of pulmonary infiltrates in haematologic patients are bacterial infections. Viral infections are subject to relevant seasonal variations, but they may also cause an important proportion of pulmonary infiltrates. Microbiological examination of respiratory tract material (if possible, bronchoalveolar lavage, BAL) is the most important diagnostic procedure. Particularly in the case of prolonged (> 7 days) neutropenia, the likelihood of infiltrates being caused by fungal infections increases. For a differential diagnosis, however, also non-infectious causes, e.g. drug-induced infiltrates, have to be taken into consideration. The diagnostic workup, however, should not delay a timely start of an adequate antimicrobial therapy.
肺部并发症在血液学患者中很常见。
这篇综述文章总结了在一次关于肺部浸润主题的专家会议期间进行的讨论结果。
血液学患者肺部浸润最常见的原因是细菌感染。病毒感染存在相关的季节性变化，但它们也可能导致相当比例的肺部浸润。呼吸道材料的微生物学检查（如果可能，支气管肺泡灌洗，BAL）是最重要的诊断程序。特别是在长期（>7天）中性粒细胞减少的情况下，浸润由真菌感染引起的可能性增加。然而，对于鉴别诊断，也必须考虑非感染性原因，例如药物引起的浸润。然而，诊断检查不应延迟及时开始适当的抗菌治疗。
