Moeser A, Lange C, von Lilienfeld-Toal M, Welte T, Pletz M
1Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Deutschland.
2Medizinische Klinik, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel, Deutschland.
Pneumologe (Berl). 2018;15(3):209-224. doi: 10.1007/s10405-018-0174-x. Epub 2018 Mar 16.
Pneumonia occurs frequently in immunocompromised patients and often shows a complicated course of disease when compared to immunocompetent persons. The type of pathogen involved is directly associated with the type of immunosuppression and includes a wide variety of pathogens. Congenital and primary immunodeficiencies often appear during childhood. Acquired immunodeficiencies are most commonly caused by immunosuppressive medication. The concept of immunosuppression can be extended to patients with COPD or elderly patients because the variety of pathogens and specific features regarding frequency and course of the disease are similar to immunosuppressed patients. Computed tomography can provide an indication of the pathogen and is superior to the chest x‑ray in this respect. Blood cultures, antigen and PCR tests are non-invasive diagnostic tools for pathogen diagnostics. Invasive tests include fiberoptic bronchoscopy and complete the diagnostic methods of identifying the causative pathogen.
肺炎在免疫功能低下的患者中频繁发生，与免疫功能正常的人相比，其病程往往较为复杂。所涉及的病原体类型与免疫抑制类型直接相关，包括多种病原体。先天性和原发性免疫缺陷通常在儿童期出现。获得性免疫缺陷最常见的原因是免疫抑制药物。免疫抑制的概念可以扩展到慢性阻塞性肺疾病（COPD）患者或老年患者，因为病原体的种类以及疾病频率和病程的特定特征与免疫抑制患者相似。计算机断层扫描可以提供病原体的线索，在这方面优于胸部X线检查。血培养、抗原和聚合酶链反应（PCR）检测是用于病原体诊断的非侵入性诊断工具。侵入性检查包括纤维支气管镜检查，完善了鉴定致病病原体的诊断方法。
