Download PDF
Semin Respir Crit Care Med 2024; 45(02): 255-265
DOI: 10.1055/s-0043-1778137
Review Article

Severe Community-Acquired Pneumonia in Immunocompromised Patients

Dara Chean
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Camille Windsor
2   Medical Intensive Care Unit, AP-HP Henri Mondor University Hospital, Créteil, France
,
Antoine Lafarge
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Thibault Dupont
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Sabrine Nakaa
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Livia Whiting
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Adrien Joseph
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Virginie Lemiale
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
,
Elie Azoulay
1   Medical Intensive Care Unit, AP-HP Saint-Louis University Hospital, Paris, France
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Due to higher survival rates with good quality of life, related to new treatments in the fields of oncology, hematology, and transplantation, the number of immunocompromised patients is increasing. But these patients are at high risk of intensive care unit admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia is one of the leading causes of admission. In this setting, the need for invasive mechanical ventilation is up to 60%, associated with a high hospital mortality rate of around 40 to 50%. A wide range of pathogens according to the reason of immunosuppression is associated with severe pneumonia in those patients: documented bacterial pneumonia represents a third of cases, viral and fungal pneumonia both account for up to 15% of cases. For patients with an undetermined etiology despite comprehensive diagnostic workup, the hospital mortality rate is very high. Thus, a standardized diagnosis strategy should be defined to increase the diagnosis rate and prescribe the appropriate treatment. This review focuses on the benefit-to-risk ratio of invasive or noninvasive strategies, in the era of omics, for the management of critically ill immunocompromised patients with severe pneumonia in terms of diagnosis and oxygenation.

Keywords

severe community-acquired pneumonia - ICU - ARF - immunocompromised patients

Supplementary Material



Publication History

Article published online:
24 January 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Harpaz R, Dahl RM, Dooling KL. Prevalence of immunosuppression among US adults, 2013. JAMA 2016; 316 (23) 2547-2548
    CrossrefPubMedGoogle Scholar
  • 2 Baeuerle PA, Reinhardt C. Bispecific T-cell engaging antibodies for cancer therapy. Cancer Res 2009; 69 (12) 4941-4944
    CrossrefPubMedGoogle Scholar
  • 3 Larson RC, Maus MV. Recent advances and discoveries in the mechanisms and functions of CAR T cells. Nat Rev Cancer 2021; 21 (03) 145-161
    CrossrefPubMedGoogle Scholar
  • 4 Mokart D, Pastores SM, Darmon M. Has survival increased in cancer patients admitted to the ICU? Yes. Intensive Care Med 2014; 40 (10) 1570-1572
    CrossrefPubMedGoogle Scholar
  • 5 Darmon M, Bourmaud A, Georges Q. et al. Changes in critically ill cancer patients' short-term outcome over the last decades: results of systematic review with meta-analysis on individual data. Intensive Care Med 2019; 45 (07) 977-987
    CrossrefPubMedGoogle Scholar
  • 6 Zampieri FG, Romano TG, Salluh JIF. Trends in clinical profiles, organ support use and outcomes of patients with cancer requiring unplanned ICU admission: a multicenter cohort study. Intensive Care Med 2021; 47 (02) 170-179
    CrossrefPubMedGoogle Scholar
  • 7 Lengliné E, Raffoux E, Lemiale V. et al. Intensive care unit management of patients with newly diagnosed acute myeloid leukemia with no organ failure. Leuk Lymphoma 2012; 53 (07) 1352-1359
    CrossrefPubMedGoogle Scholar
  • 8 Mokart D, Lambert J, Schnell D. et al. Delayed intensive care unit admission is associated with increased mortality in patients with cancer with acute respiratory failure. Leuk Lymphoma 2013; 54 (08) 1724-1729
    CrossrefPubMedGoogle Scholar
  • 9 Azoulay E, Mokart D, Pène F. et al. Outcomes of critically ill patients with hematologic malignancies: prospective multicenter data from France and Belgium—a groupe de recherche respiratoire en réanimation onco-hématologique study. J Clin Oncol 2013; 31 (22) 2810-2818
    CrossrefPubMedGoogle Scholar
  • 10 Esteban A, Frutos-Vivar F, Muriel A. et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med 2013; 188 (02) 220-230
    CrossrefPubMedGoogle Scholar
  • 11 Dumas G, Lemiale V, Rathi N. et al. Survival in immunocompromised patients ultimately requiring invasive mechanical ventilation: a pooled individual patient data analysis. Am J Respir Crit Care Med 2021; 204 (02) 187-196
    CrossrefPubMedGoogle Scholar
  • 12 Azoulay E, Russell L, Van de Louw A. et al; Nine-i Investigators. Diagnosis of severe respiratory infections in immunocompromised patients. Intensive Care Med 2020; 46 (02) 298-314
    CrossrefPubMedGoogle Scholar
  • 13 Di Pasquale MF, Sotgiu G, Gramegna A. et al; GLIMP Investigators. Prevalence and etiology of community-acquired pneumonia in immunocompromised patients. Clin Infect Dis 2019; 68 (09) 1482-1493
    CrossrefPubMedGoogle Scholar
  • 14 Sousa D, Justo I, Domínguez A. et al. Community-acquired pneumonia in immunocompromised older patients: incidence, causative organisms and outcome. Clin Microbiol Infect 2013; 19 (02) 187-192
    CrossrefPubMedGoogle Scholar
  • 15 Azoulay E, Pickkers P, Soares M. et al; Efraim investigators and the Nine-I study group. Acute hypoxemic respiratory failure in immunocompromised patients: the Efraim multinational prospective cohort study. Intensive Care Med 2017; 43 (12) 1808-1819
    CrossrefPubMedGoogle Scholar
  • 16 Contejean A, Lemiale V, Resche-Rigon M. et al. Increased mortality in hematological malignancy patients with acute respiratory failure from undetermined etiology: a Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologique (Grrr-OH) study. Ann Intensive Care 2016; 6 (01) 102
    CrossrefPubMedGoogle Scholar
  • 17 Moreau A-S, Lengline E, Seguin A. et al. Respiratory events at the earliest phase of acute myeloid leukemia. Leuk Lymphoma 2014; 55 (11) 2556-2563
    CrossrefPubMedGoogle Scholar
  • 18 Bauer PR, Chevret S, Yadav H. et al; Efraim investigators and the Nine-I study group. Diagnosis and outcome of acute respiratory failure in immunocompromised patients after bronchoscopy. Eur Respir J 2019; 54 (01) 1802442
    CrossrefPubMedGoogle Scholar
  • 19 Azoulay E, Mokart D, Lambert J. et al. Diagnostic strategy for hematology and oncology patients with acute respiratory failure: randomized controlled trial. Am J Respir Crit Care Med 2010; 182 (08) 1038-1046
    CrossrefPubMedGoogle Scholar
  • 20 Azoulay E, Schlemmer B. Diagnostic strategy in cancer patients with acute respiratory failure. Intensive Care Med 2006; 32 (06) 808-822
    CrossrefPubMedGoogle Scholar
  • 21 Kamel T, Helms J, Janssen-Langenstein R. et al; Clinical Research in Intensive Care Sepsis Group (CRICS-TRIGGERSEP). Benefit-to-risk balance of bronchoalveolar lavage in the critically ill. A prospective, multicenter cohort study. Intensive Care Med 2020; 46 (03) 463-474
    CrossrefPubMedGoogle Scholar
  • 22 Legoff J, Zucman N, Lemiale V. et al. Clinical significance of upper airway virus detection in critically ill hematology patients. Am J Respir Crit Care Med 2019; 199 (04) 518-528
    CrossrefPubMedGoogle Scholar
  • 23 Azoulay E, Mokart D, Kouatchet A, Demoule A, Lemiale V. Acute respiratory failure in immunocompromised adults. Lancet Respir Med 2019; 7 (02) 173-186
    CrossrefPubMedGoogle Scholar
  • 24 Azadeh N, Sakata KK, Saeed A. et al. Comparison of respiratory pathogen detection in upper versus lower respiratory tract samples using the BioFire FilmArray respiratory panel in the immunocompromised host. Can Respir J 2018; 2018: 2685723
    CrossrefPubMedGoogle Scholar
  • 25 Affolter K, Schumann DM, Tamm M. et al. Multiplex PCR on the bronchoalveolar lavage fluid of immunocompromised patients. Chest 2018; 154 (03) 722-725
    CrossrefPubMedGoogle Scholar
  • 26 Azar MM, Schlaberg R, Malinis MF. et al. Added diagnostic utility of clinical metagenomics for the diagnosis of pneumonia in immunocompromised adults. Chest 2021; 159 (04) 1356-1371
    CrossrefPubMedGoogle Scholar
  • 27 Mahle RE, Suchindran S, Henao R. et al. Validation of a host gene expression test for bacterial/viral discrimination in immunocompromised hosts. Clin Infect Dis 2021; 73 (04) 605-613
    CrossrefPubMedGoogle Scholar
  • 28 Hilbert G, Gruson D, Vargas F. et al. Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 2001; 344 (07) 481-487
    CrossrefPubMedGoogle Scholar
  • 29 Antonelli M, Conti G, Bufi M. et al. Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. JAMA 2000; 283 (02) 235-241
    CrossrefPubMedGoogle Scholar
  • 30 Frat J-P, Ragot S, Girault C. et al; REVA network. Effect of non-invasive oxygenation strategies in immunocompromised patients with severe acute respiratory failure: a post-hoc analysis of a randomised trial. Lancet Respir Med 2016; 4 (08) 646-652
    CrossrefPubMedGoogle Scholar
  • 31 Lemiale V, Mokart D, Resche-Rigon M. et al; Groupe de Recherche en Réanimation Respiratoire du patient d'Onco-Hématologie (GRRR-OH). Effect of noninvasive ventilation vs oxygen therapy on mortality among immunocompromised patients with acute respiratory failure: a randomized clinical trial. JAMA 2015; 314 (16) 1711-1719
    CrossrefPubMedGoogle Scholar
  • 32 Lemiale V, Resche-Rigon M, Mokart D. et al. High-flow nasal cannula oxygenation in immunocompromised patients with acute hypoxemic respiratory failure: a Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique Study. Crit Care Med 2017; 45 (03) e274-e280
    CrossrefPubMedGoogle Scholar
  • 33 Azoulay E, Lemiale V, Mokart D. et al. Effect of high-flow nasal oxygen vs standard oxygen on 28-day mortality in immunocompromised patients with acute respiratory failure: the HIGH randomized clinical trial. JAMA 2018; 320 (20) 2099-2107
    CrossrefPubMedGoogle Scholar
  • 34 Coudroy R, Frat JP, Ehrmann S. et al; FLORALI-IM study group and the REVA Research Network. High-flow nasal oxygen alone or alternating with non-invasive ventilation in critically ill immunocompromised patients with acute respiratory failure: a randomised controlled trial. Lancet Respir Med 2022; 10 (07) 641-649
    CrossrefPubMedGoogle Scholar
  • 35 Cheng L-C, Chang SP, Wang JJ, Hsiao SY, Lai CC, Chao CM. The impact of high-flow nasal cannula on the outcome of immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis. Medicina (Kaunas) 2019; 55 (10) 693
    CrossrefPubMedGoogle Scholar
  • 36 Wang Y, Ni Y, Sun J, Liang Z. Use of high-flow nasal cannula for immunocompromise and acute respiratory failure: a systematic review and meta-analysis. J Emerg Med 2020; 58 (03) 413-423
    CrossrefPubMedGoogle Scholar
  • 37 Ferreyro BL, Angriman F, Munshi L. et al. Association of noninvasive oxygenation strategies with all-cause mortality in adults with acute hypoxemic respiratory failure: a systematic review and meta-analysis. JAMA 2020; 324 (01) 57-67
    CrossrefPubMedGoogle Scholar
  • 38 Clouzeau B, Bui HN, Guilhon E. et al. Fiberoptic bronchoscopy under noninvasive ventilation and propofol target-controlled infusion in hypoxemic patients. Intensive Care Med 2011; 37 (12) 1969-1975
    CrossrefPubMedGoogle Scholar
  • 39 Antonelli M, Conti G, Riccioni L, Meduri GU. Noninvasive positive-pressure ventilation via face mask during bronchoscopy with BAL in high-risk hypoxemic patients. Chest 1996; 110 (03) 724-728
    CrossrefPubMedGoogle Scholar
  • 40 Simon M, Braune S, Frings D, Wiontzek AK, Klose H, Kluge S. High-flow nasal cannula oxygen versus non-invasive ventilation in patients with acute hypoxaemic respiratory failure undergoing flexible bronchoscopy—a prospective randomised trial. Crit Care 2014; 18 (06) 712
    CrossrefPubMedGoogle Scholar
  • 41 Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 1999; 115 (02) 462-474
    CrossrefPubMedGoogle Scholar
  • 42 Daniel P, Rodrigo C, Mckeever TM, Woodhead M, Welham S, Lim WS. British Thoracic Society. Time to first antibiotic and mortality in adults hospitalised with community-acquired pneumonia: a matched-propensity analysis. Thorax 2016; 71 (06) 568-570
    CrossrefPubMedGoogle Scholar
  • 43 Kreitmann L, Vasseur M, Jermoumi S. et al. Relationship between immunosuppression and intensive care unit-acquired colonization and infection related to multidrug-resistant bacteria: a prospective multicenter cohort study. Intensive Care Med 2023; 49 (02) 154-165
    CrossrefPubMedGoogle Scholar
  • 44 Shindo Y, Ito R, Kobayashi D. et al. Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia. Am J Respir Crit Care Med 2013; 188 (08) 985-995
    CrossrefPubMedGoogle Scholar
  • 45 Ramirez JA, Musher DM, Evans SE. et al. Treatment of community-acquired pneumonia in immunocompromised adults: a consensus statement regarding initial strategies. Chest 2020; 158 (05) 1896-1911
    CrossrefPubMedGoogle Scholar
  • 46 Metlay JP, Waterer GW, Long AC. et al. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019; 200 (07) e45-e67
    CrossrefPubMedGoogle Scholar
  • 47 Prina E. et al. Risk factors associated with potentially antibiotic-resistant pathogens in community-acquired pneumonia. Ann Am Thorac Soc 12 2015; 153-160
    CrossrefPubMedGoogle Scholar
  • 48 Maruyama T, Fujisawa T, Ishida T. et al. A therapeutic strategy for all pneumonia patients: a 3-year prospective multicenter cohort study using risk factors for multidrug-resistant pathogens to select initial empiric therapy. Clin Infect Dis 2019; 68 (07) 1080-1088
    CrossrefPubMedGoogle Scholar
  • 49 Monard C, Pehlivan J, Auger G. et al; ADAPT study group. Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia. Crit Care 2020; 24 (01) 434
    CrossrefPubMedGoogle Scholar
  • 50 Serigstad S, Markussen D, Grewal HMS. et al; CAPNOR Study Group. Rapid syndromic PCR testing in patients with respiratory tract infections reduces time to results and improves microbial yield. Sci Rep 2022; 12 (01) 326
    CrossrefPubMedGoogle Scholar
  • 51 Gadsby NJ, Russell CD, McHugh MP. et al. Comprehensive molecular testing for respiratory pathogens in community-acquired pneumonia. Clin Infect Dis 2016; 62 (07) 817-823
    CrossrefPubMedGoogle Scholar
  • 52 Azoulay E, Roux A, Vincent F. et al. A multivariable prediction model for Pneumocystis jirovecii pneumonia in hematology patients with acute respiratory failure. Am J Respir Crit Care Med 2018; 198 (12) 1519-1526
    CrossrefPubMedGoogle Scholar
  • 53 Thomas Jr CF, Limper AH. Pneumocystis pneumonia. N Engl J Med 2004; 350 (24) 2487-2498
    CrossrefPubMedGoogle Scholar
  • 54 Herbrecht R, Denning DW, Patterson TF. et al; Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347 (06) 408-415
    CrossrefPubMedGoogle Scholar
  • 55 Skiada A, Pagano L, Groll A. et al; European Confederation of Medical Mycology Working Group on Zygomycosis. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect 2011; 17 (12) 1859-1867
    CrossrefPubMedGoogle Scholar
  • 56 Cornely OA, Alastruey-Izquierdo A, Arenz D. et al; Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis 2019; 19 (12) e405-e421
    CrossrefPubMedGoogle Scholar
  • 57 Lanternier F, Poiree S, Elie C. et al; French Mycosis Study Group. Prospective pilot study of high-dose (10 mg/kg/day) liposomal amphotericin B (L-AMB) for the initial treatment of mucormycosis. J Antimicrob Chemother 2015; 70 (11) 3116-3123
    CrossrefPubMedGoogle Scholar
  • 58 Marty FM, Ostrosky-Zeichner L, Cornely OA. et al; VITAL and FungiScope Mucormycosis Investigators. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis 2016; 16 (07) 828-837
    CrossrefPubMedGoogle Scholar
  • 59 van Kraaij MGJ, van Elden LJ, van Loon AM. et al. Frequent detection of respiratory viruses in adult recipients of stem cell transplants with the use of real-time polymerase chain reaction, compared with viral culture. Clin Infect Dis 2005; 40 (05) 662-669
    CrossrefPubMedGoogle Scholar
  • 60 Collins JP, Campbell AP, Openo K. et al. Outcomes of immunocompromised adults hospitalized with laboratory-confirmed influenza in the United States, 2011-2015. Clin Infect Dis 2020; 70 (10) 2121-2130
    CrossrefPubMedGoogle Scholar
  • 61 Kim Y-J, Boeckh M, Englund JA. Community respiratory virus infections in immunocompromised patients: hematopoietic stem cell and solid organ transplant recipients, and individuals with human immunodeficiency virus infection. Semin Respir Crit Care Med 2007; 28 (02) 222-242
    Article in Thieme ConnectPubMedGoogle Scholar
  • 62 Khanna N, Widmer AF, Decker M. et al. Respiratory syncytial virus infection in patients with hematological diseases: single-center study and review of the literature. Clin Infect Dis 2008; 46 (03) 402-412
    CrossrefPubMedGoogle Scholar
  • 63 Schnell D, Legoff J, Mariotte E. et al. Molecular detection of respiratory viruses in immunocopromised ICU patients: incidence and meaning. Respir Med 2012; 106 (08) 1184-1191
    CrossrefPubMedGoogle Scholar
  • 64 Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet 2015; 385 (9979) 1729-1737
    CrossrefPubMedGoogle Scholar
  • 65 Kanj SS, Sharara AI, Clavien PA, Hamilton JD. Cytomegalovirus infection following liver transplantation: review of the literature. Clin Infect Dis 1996; 22 (03) 537-549
    CrossrefPubMedGoogle Scholar
  • 66 Fisher RA. Cytomegalovirus infection and disease in the new era of immunosuppression following solid organ transplantation. Transpl Infect Dis 2009; 11 (03) 195-202
    CrossrefPubMedGoogle Scholar
  • 67 de Maar EF, Verschuuren EA, Harmsen MC, The TH, van Son WJ. Pulmonary involvement during cytomegalovirus infection in immunosuppressed patients. Transpl Infect Dis 2003; 5 (03) 112-120
    CrossrefPubMedGoogle Scholar
  • 68 Ljungman P, Boeckh M, Hirsch HH. et al; Disease Definitions Working Group of the Cytomegalovirus Drug Development Forum. Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis 2017; 64 (01) 87-91
    CrossrefPubMedGoogle Scholar
  • 69 Tamm M, Traenkle P, Grilli B. et al. Pulmonary cytomegalovirus infection in immunocompromised patients. Chest 2001; 119 (03) 838-843
    CrossrefPubMedGoogle Scholar
  • 70 Kotton CN, Kumar D, Caliendo AM. et al; The Transplantation Society International CMV Consensus Group. The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation 2018; 102 (06) 900-931
    CrossrefPubMedGoogle Scholar
  • 71 Roberts MB, Fishman JA. Immunosuppressive agents and infectious risk in transplantation: managing the “net state of immunosuppression”. Clin Infect Dis 2021; 73 (07) e1302-e1317
    CrossrefPubMedGoogle Scholar
  • 72 Asberg A, Jardine AG, Bignamini AA. et al; VICTOR Study Group. Effects of the intensity of immunosuppressive therapy on outcome of treatment for CMV disease in organ transplant recipients. Am J Transplant 2010; 10 (08) 1881-1888
    CrossrefPubMedGoogle Scholar
  • 73 Narayanan S, Banerjee C, Holt PA. Cryptococcal immune reconstitution syndrome during steroid withdrawal treated with hydroxychloroquine. Int J Infect Dis 2011; 15 (01) e70-e73
    CrossrefPubMedGoogle Scholar
  • 74 Singh N, Dromer F, Perfect JR, Lortholary O. Cryptococcosis in solid organ transplant recipients: current state of the science. Clin Infect Dis 2008; 47 (10) 1321-1327
    CrossrefPubMedGoogle Scholar
  • 75 Meintjes G, Stek C, Blumenthal L. et al; PredART Trial Team. Prednisone for the prevention of paradoxical tuberculosis-associated IRIS. N Engl J Med 2018; 379 (20) 1915-1925
    CrossrefPubMedGoogle Scholar
  • 76 Bige N, Zafrani L, Lambert J. et al. Severe infections requiring intensive care unit admission in kidney transplant recipients: impact on graft outcome. Transpl Infect Dis 2014; 16 (04) 588-596
    CrossrefPubMedGoogle Scholar
  • 77 Sileri P, Pursell KJ, Coady NT. et al. A standardized protocol for the treatment of severe pneumonia in kidney transplant recipients. Clin Transplant 2002; 16 (06) 450-454
    CrossrefPubMedGoogle Scholar
  • 78 Canet E, Zafrani L, Lambert J. et al. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival. PLoS One 2013; 8 (02) e55870
    CrossrefPubMedGoogle Scholar
  • 79 Yang C-Y, Shih C-J, Yang W-C, Lin C-C. Aggressive immunosuppressant reduction and long-term rejection risk in renal transplant recipients with Pneumocystis jiroveci pneumonia. Exp Clin Transplant 2012; 10 (04) 344-349
    CrossrefPubMedGoogle Scholar
  • 80 Shih CJ, Tarng DC, Yang WC, Yang CY. Immunosuppressant dose reduction and long-term rejection risk in renal transplant recipients with severe bacterial pneumonia. Singapore Med J 2014; 55 (07) 372-377
    CrossrefPubMedGoogle Scholar
  • 81 Santeusanio AD, Menon MC, Liu C. et al. Influence of patient characteristics and immunosuppressant management on mortality in kidney transplant recipients hospitalized with coronavirus disease 2019 (COVID-19). Clin Transplant 2021; 35 (04) e14221
    CrossrefPubMedGoogle Scholar
  • 82 Dequin P-F, Meziani F, Quenot JP. et al; CRICS-TriGGERSep Network. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med 2023; 388 (21) 1931-1941
    CrossrefPubMedGoogle Scholar
  • 83 Pareja JG, Garland R, Koziel H. Use of adjunctive corticosteroids in severe adult non-HIV Pneumocystis carinii pneumonia. Chest 1998; 113 (05) 1215-1224
    CrossrefPubMedGoogle Scholar
  • 84 Moon SM, Kim T, Sung H. et al. Outcomes of moderate-to-severe Pneumocystis pneumonia treated with adjunctive steroid in non-HIV-infected patients. Antimicrob Agents Chemother 2011; 55 (10) 4613-4618
    CrossrefPubMedGoogle Scholar
  • 85 Wieruszewski PM, Barreto JN, Frazee E. et al. Early corticosteroids for Pneumocystis pneumonia in adults without HIV are not associated with better outcome. Chest 2018; 154 (03) 636-644
    CrossrefPubMedGoogle Scholar
  • 86 Lemiale V, Debrumetz A, Delannoy A, Alberti C, Azoulay E. Adjunctive steroid in HIV-negative patients with severe Pneumocystis pneumonia. Respir Res 2013; 14 (01) 87
    CrossrefPubMedGoogle Scholar
  • 87 Karlin L, Darmon M, Thiéry G. et al. Respiratory status deterioration during G-CSF-induced neutropenia recovery. Bone Marrow Transplant 2005; 36 (03) 245-250
    CrossrefPubMedGoogle Scholar
  • 88 Azoulay E, Darmon M. Acute respiratory distress syndrome during neutropenia recovery. Crit Care 2010; 14 (01) 114
    CrossrefPubMedGoogle Scholar
  • 89 Mignard X, Biard L, Lemiale V. et al. Granulocyte colony-stimulating factor and respiratory status of critically ill neutropenic patients with hematologic malignancies. Leuk Lymphoma 2019; 60 (05) 1156-1163
    CrossrefPubMedGoogle Scholar
  • 90 Rañó A, Agustí C, Jimenez P. et al. Pulmonary infiltrates in non-HIV immunocompromised patients: a diagnostic approach using non-invasive and bronchoscopic procedures. Thorax 2001; 56 (05) 379-387
    CrossrefPubMedGoogle Scholar
  • 91 Danés C, González-Martín J, Pumarola T. et al. Pulmonary infiltrates in immunosuppressed patients: analysis of a diagnostic protocol. J Clin Microbiol 2002; 40 (06) 2134-2140
    CrossrefPubMedGoogle Scholar
  • 92 Azoulay E, Mokart D, Rabbat A. et al. Diagnostic bronchoscopy in hematology and oncology patients with acute respiratory failure: prospective multicenter data. Crit Care Med 2008; 36 (01) 100-107
    CrossrefPubMedGoogle Scholar
  • 93 Jorge L, Torres D, Languasco A. et al. Clinical usefulness of bronchoalveolar lavage in the management of pulmonary infiltrates in adults with hematological malignancies and stem cell transplantation. Mediterr J Hematol Infect Dis 2020; 12 (01) e2020025
    CrossrefPubMedGoogle Scholar
  • 94 Del Corpo O, Butler-Laporte G, Sheppard DC, Cheng MP, McDonald EG, Lee TC. Diagnostic accuracy of serum (1-3)-β-D-glucan for Pneumocystis jirovecii pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect 2020; 26 (09) 1137-1143
    CrossrefPubMedGoogle Scholar
  • 95 Senécal J, Smyth E, Del Corpo O. et al. Non-invasive diagnosis of Pneumocystis jirovecii pneumonia: a systematic review and meta-analysis. Clin Microbiol Infect 2022; 28 (01) 23-30
    CrossrefPubMedGoogle Scholar
  • 96 Fan L-C, Lu H-W, Cheng K-B, Li H-P, Xu J-F. Evaluation of PCR in bronchoalveolar lavage fluid for diagnosis of Pneumocystis jirovecii pneumonia: a bivariate meta-analysis and systematic review. PLoS One 2013; 8 (09) e73099
    CrossrefPubMedGoogle Scholar
  • 97 Maertens JA, Raad II, Marr KA. et al. Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial. Lancet 2016; 387 (10020): 760-769
    CrossrefPubMedGoogle Scholar
  • 98 Hoenigl M, Prattes J, Spiess B. et al. Performance of galactomannan, beta-d-glucan, Aspergillus lateral-flow device, conventional culture, and PCR tests with bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis. J Clin Microbiol 2014; 52 (06) 2039-2045
    CrossrefPubMedGoogle Scholar
  • 99 White PL, Wingard JR, Bretagne S. et al. Aspergillus polymerase chain reaction: systematic review of evidence for clinical use in comparison with antigen testing. Clin Infect Dis 2015; 61 (08) 1293-1303
    CrossrefPubMedGoogle Scholar
  • 100 de Heer K, Gerritsen MG, Visser CE, Leeflang MM. Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients. Cochrane Database Syst Rev 2019; 5 (05) CD012399
    PubMedGoogle Scholar
  • 101 Leeflang MMG, Debets-Ossenkopp YJ, Wang J. et al. Galactomannan detection for invasive aspergillosis in immunocompromised patients. Cochrane Database Syst Rev 2015; 2015 (12) CD007394
    PubMedGoogle Scholar