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Diagnosis of pneumonitis in immunocompromised patients by open lung biopsy
Author(s) -
Haverkos Harry W.,
Dowling John N.,
William A.,
Myerowitz Richard L.,
Lerberg David B.,
Hakala Thomas R.
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19830915)52:6<1093::aid-cncr2820520627>3.0.co;2-4
Subject(s) - medicine , biopsy , malignancy , pneumonia , pneumonitis , lymphoma , lung , gastroenterology , surgery
The records of 59 immunocompromised patients with fever and pulmonary infiltrates who underwent open lung biopsy, were reviewed. A specific diagnosis was made by lung biopsy in 49 (83%) patients, and in 32 instances (54%) the diagnosis was a treatable infection. Only two (3.4%) false‐negative biopsies occurred. Transplant recipients were more likely to have a specific, treatable pneumonia (74%) than patients with a reticuloendothelial malignancy (42%, P < 0.05). This was due to a greater frequency of bacterial pneumonias, primarily due to Legionella , in transplant recipients ( P < 0.01). However, obtaining a specific diagnosis by lung biopsy did not appear to improve outcome. Seventeen of 32 (53%) patients with treatable infections survived, compared to 8 of 16 (50%) with specific, but untreatable, diagnosis and 6 of 11 (55%) with nondiagnostic biopsies. Advanced age and a low platelet count were predictive of death in both transplant recipients and patients with leukemia and lymphoma ( P < 0.05); a high serum creatinine was an additional predictor in renal transplant recipients.