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Pneumonia in immunocompromised host

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Pneumonia in immunodeficient patient

Symptoms:

• Nonproductive (dry) cough or cough with mucus-like, greenish, or pus-like sputum
• Chills with shaking
• Fever
• Easy fatigue
• Chest pain that is:
  • Sharp or stabbing
  • Increased by deep breathing
  • Increased by coughing
• Headache
• Loss of appetite
• Nausea and vomiting
• General discomfort, uneasiness, or ill feeling ( malaise )
• Shortness of breath

  Additional symptoms that may occur:

  • Joint stiffness (rare)
  • Muscle stiffness (rare)
  • Swollen glands
  • Excessive sweating or night sweats

Signs and tests:

Crackles or other abnormal breath sounds may be heard when listening to the chest with stethoscope ( auscultation ). Lack of breath sounds can be an important sign.

Tests include:

• Chest x-ray
• Sputum gram stain , other special stains, and culture
• CBC
• Arterial blood gases
• Bronchoscopy
• Chest CT scan, in certain cases
• Lung biopsy, in certain cases

References:

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Cohen J, Powderly WG. Infectious Diseases . 2nd ed. New York, NY: Elsevier, 2004.

Mandell, GL, Bennett JE, Dolin R, eds. Principles of Infectious Diseases . 5th ed. New York, NY: Churchill Livingstone, 2000.

Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis . 2007 Mar 1;44 Suppl 2:S27-72.

American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med . 2005 Feb 15;171(4):388-416.

• Review Date: 11/7/2005
• Reviewed By: Cyrus Badshah, M.D., Ph.D., Assistant Professor of Clinical Medicine, College of Physicians and Surgeons, Columbia University; Assistant Attending Physician, Department of Medicine, Division of Infectious Diseases & Medical Director, Chest (TB) Clinic and Directly Observed Therapy Program, Harlem Hospital Center. Review provided by VeriMed Healthcare Network.

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