Abstract
Background: Pulmonary infection is the major risk during neutropenia induced by chemotherapy
as well as stem cell transplantation. In spite of potent new-generation antifungal
and broad-spectrum antibiotics, one-third of patients usually die from infectious
complications. Early diagnosis and prompt administration of appropriate therapy improve
the survival. Materials and Methods: We prospectively carried out the study to identify the infectious etiology of pulmonary
infiltrates in febrile neutropenia patients by imaging and bronchoscopy. Bacterial
culture, fungal culture, galactomannan and molecular diagnosis for pneumocystis, and
other infectious agent were carried out in the bronchoalveolar lavage (BAL) fluid
and blood. Results: A total of 27 patients were evaluated. Half of the patients belonged to acute leukemia
(46%). We had a diagnostic yield of 65% with the most common isolates being Gram-negative
bacteria and Aspergillus species. Conclusion: Gram-negative organisms were the predominant infectious agents of pulmonary infection.
Our finding emphasizes the importance of BAL in evaluating pulmonary infiltrates in
neutropenic patients with hematological malignancies.
Keywords
Hematological malignancies - infection - pulmonary infiltrate
