PDF(Pubmed)
Abstract：
Recipients of hematopoietic stem cell transplants and solid organ transplants frequently develop pulmonary infiltrates from both infectious and non-infectious etiologies. Differentiation and further characterization of microbiologic etiologies-viral, bacterial, and fungal-can be exceedingly challenging. Pediatric patients face unique challenges as confirmatory evaluations with bronchoscopy or lung biopsy may be limited. A generalizable approach to diagnosing and managing these conditions has not been well established. This paper aims to summarize our initial clinical approach while discussing the relative evidence informing our practices. A pediatric patient with characteristic infiltrates who has undergone HSCT is presented to facilitate the discussion. Generalizable approaches to similar patients are highlighted as appropriate while highlighting considerations based on clinical course and key risk factors.
摘要：
造血干细胞移植和实体器官移植的接受者经常由于感染性和非感染性病因而产生肺浸润。微生物病因的分化和进一步表征-病毒，细菌,和真菌-可能非常具有挑战性。儿科患者面临独特的挑战，因为支气管镜检查或肺活检的确证评估可能有限。诊断和管理这些疾病的普遍方法尚未得到很好的确立。本文旨在总结我们最初的临床方法，同时讨论告知我们实践的相关证据。介绍了已接受HSCT的具有特征性浸润的儿科患者，以促进讨论。适当地突出了对类似患者的可通用方法，同时突出了基于临床病程和关键风险因素的考虑因素。
